中药复方治疗非增殖期糖尿病视网膜病变的Meta分析

发布时间：2018-07-20 14:02

【摘要】：目的:运用Meta分析方法比较中药复方治疗与单纯西医治疗对糖尿病性视网膜病变患者各项指标的影响。方法:根据糖尿病性视网膜病变(DR)发病机制有高血糖、血管内皮细胞功能紊乱、生长因子、血液流变学改变、炎症等方面,全面收集治疗DR的临床研究文献,并按照文献选择标准进行筛选,比较中药复方治疗与单纯西医疗法对糖化血红蛋白(HbA1c),血浆内皮素(ET),一氧化氮(NO),血管内皮生长因子(VEGF),血清高敏C反应蛋白(hs CRP),肿瘤坏死因子-α(TNF-α),全血黏度(高切、低切),血浆黏度,眼底改变疗效,视力疗效,中医证候疗效的影响,并进行Meta分析。结果:本次研究共收集3 526篇文献,62篇符合纳入标准。其中27篇文献观察了HbA1c,反映近8周的血糖控制;8篇观察了ET,4篇观察了NO,反映血管内皮细胞功能紊乱;8篇观察了VEGF,是在视网膜微血管增生中,发挥主要作用的生长因子;8篇观察了全血黏度(高切、低切),9篇观察了血浆黏度,6篇观察了纤维蛋白原,用以反映血液流变学的改变;3篇观察了CRP,4篇观察了TNF-α,探讨对炎症的影响;39篇观察了临床疗效,23篇观察了眼底改变疗效,20篇观察了视力疗效,29篇观察了中医证候疗效。结论:与单纯西药治疗组相比,中药复方治疗对DR患者NO的改变作用与其效果相当,对HbA1c,ET,TNF-α,hs CRP,VEGF,全血黏度(高切),全血黏度(低切),血浆黏度,纤维蛋白原,临床疗效,眼底改变疗效,视力疗效,中医证候疗效的作用均优于单纯西药治疗组,提示中药复方治疗方法比单纯西医治疗方法作用更加明显。受纳入研究的数量和质量限制,中药复方治疗对DR患者的作用需要更多高质量的随机双盲对照试验加以证实。
[Abstract]:Aim: to compare the effects of traditional Chinese medicine (TCM) and western medicine (WM) on diabetic retinopathy (DM) by meta analysis. Methods: according to the pathogenesis of diabetic retinopathy (Dr), including hyperglycemia, dysfunction of vascular endothelial cells, growth factor, hemorheology, inflammation and so on, the clinical literatures on the treatment of Dr were collected. And according to the selection criteria of literature, To compare the effects of traditional Chinese medicine (TCM) and western medicine alone on glycosylated hemoglobin (HbA1c), plasma endothelin (et), nitric oxide (no), vascular endothelial growth factor (VEGF), serum Gao Min C-reactive protein (hs-CRP), tumor necrosis factor- 伪 (TNF- 伪), whole blood viscosity (high shear, low shear), plasma viscosity. The effects of fundus change, visual acuity and TCM syndromes were analyzed by meta-analysis. Results: a total of 3 526 articles were collected in this study. HBA _ 1c was observed in 27 articles, et _ 1 was observed in 8 articles, et _ 2 was observed in 4 cases, vascular endothelial cell dysfunction was observed in 8 cases, and VEGF was observed in retinal microvascular hyperplasia. Eight articles of growth factor, which play a major role, observed the whole blood viscosity (high shear, low shear), 9 observed plasma viscosity and 6 observed fibrinogen. Three articles were used to reflect the changes of hemorheology. Four articles of CRPU were observed and TNF- 伪 was observed. The effect on inflammation was observed in 39 articles. The clinical curative effect was observed in 23 articles. The curative effect of ocular fundus change was observed in 20 articles. The curative effect of visual acuity was observed in 29 articles. The curative effect of TCM syndrome was observed in 29 articles. Conclusion: compared with the treatment group of western medicine alone, the effect of traditional Chinese medicine compound treatment on the change of no in Dr patients is the same as that in the control group, and the effect on HbA1cTNF- 伪 TNF- 伪 TNF- 伪 TNF- 伪 VEGF, whole blood viscosity (high shear), whole blood viscosity (low shear), plasma viscosity, fibrinogen, clinical efficacy, and so on. The effects of fundus change, visual acuity and TCM syndrome were better than those of western medicine alone, suggesting that the effect of traditional Chinese medicine was more obvious than that of western medicine alone. Limited by the quantity and quality of the study, the effect of traditional Chinese medicine compound therapy on Dr patients needs more high quality randomized double-blind controlled trials.
【作者单位】：上海中医药大学公共健康学院;上海中医药大学附属龙华医院;
【基金】：公共卫生三年行动计划项目(15GWZK1002)
【分类号】：R276.7

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