中西医结合治疗糖尿病性脑梗死系统评价研究

发布时间：2018-02-25 17:26

  本文关键词： 文献评价/循证医学 糖尿病/脑梗死 中西医结合 随机对照双盲试验 Meta-分析 神经功能缺失 空腹血糖 糖化血红蛋白　出处：《中华中医药杂志》2010年11期 　论文类型：期刊论文

【摘要】：目的:参照国际循证医学中心随机对照文献质量评价标准研究中西医结合治疗糖尿病性脑梗死文献质量,并与单纯西医治疗糖尿病性脑梗死进行比较。方法:收集中西医结合治疗糖尿病性脑梗死临床研究随机对照文献,评价了文献的数量、质量、干预措施等,并运用Meta分析方法比较中西医结合与单纯西医治疗糖尿病性脑梗死的总有效率、神经功能缺损评分(NDS)、空腹血糖(FBG)和糖化血红蛋白(GHb)。结果:共收集文献1963篇,其中符合meta-分析要求的文献59篇,Jaded评分3分的高质量文献仅1篇;研究总有效率的文献52篇、神经功能缺损评分18篇、空腹血糖14篇、糖化血红蛋白6篇、血脂11篇、血液流变学18篇;34篇文献使用了中药汤剂,中药使用频次在10次以上者依次为黄芪(28)、地龙(27)、丹参(21)、川芎(20)、生地黄(19)、当归(18)、水蛭(15)、麦冬(13)、葛根(12)、桃仁(12)、赤芍(11)、石菖蒲(10);中西医结合治疗临床总有效率为92.17%,单纯西医治疗组为74.44%,两组差异显著(Z=14.88,P0.01);两组NDS加权均数差(WMD)为-4.60分,95%可信区间为(-5.47,-3.73)分,差异有统计学意义(Z=10.41,P0.01);两组FBG加权均数差为-0.93mmol/L,95%可信区间为(-1.57,-0.28)mmol/L,差异有显著性(Z=2.82,P0.01);两组GHb加权均数差为-0.60%,95%可信区间为(-1.69,0.49)%,差异无统计学意义。结论:中西医结合治疗糖尿病性脑梗死的临床研究较多,但大多没有采取随机对照和双盲试验,文献质量普遍偏低;有限证据显示中西医结合治疗糖尿病性脑梗死在临床总有效率、改善神经功能缺损评分和空腹血糖等方面明显优于单纯西医治疗组,而在改善糖化血红蛋白方面两组作用基本一致。受纳入研究的数量和质量限制,中西医结合治疗对糖尿病性脑梗死血糖的影响需要更多高质量的随机双盲对照试验加以证实。
[Abstract]:Objective: through randomized control according to the international literature quality evaluation standard of Medicine Center of integrated traditional Chinese and Western medicine treatment of diabetic cerebral infarction and the quality of literature, and the pure western medicine treatment of diabetic cerebral infarction were compared. Methods: combined treatment of diabetic cerebral infarction randomized controlled clinical study of literature of traditional Chinese medicine and Western medicine, the quality evaluation of the number of documents, and intervention measures. And compare the total efficiency of combining traditional Chinese and Western medicine and Western medicine treatment of diabetic cerebral infarction with Meta analysis method, neural function defect score (NDS), fasting blood glucose (FBG) and glycosylated hemoglobin (GHb). Results: a total of 1963 literatures, which meet the requirements of meta- analysis of the 59 articles, Jaded score high quality literature 3 only 1 of the total efficiency; the 52 literatures, the neurological deficit scores of 18, 14 fasting blood glucose, glycosylated hemoglobin 6, blood 11, blood rheology 瀛，

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