针灸治疗2型糖尿病周围神经病变的系统评价

摘要

[目的]评价针灸治疗2型糖尿病周围神经病变的临床疗效及安全性。[方法]计算机检索CENTRAL、Cochrane、Web of Science、CBM、CN－KI、VIP和WanFang数据库，查找所有有关针灸治疗2型糖尿病周围神经病变的随机对照试验（RCT），检索时限均为建库至2014年3月19日。同时手检纳入文献的参考文献。按纳入与排除标准，由两名研究者独立进行RCT的筛选、资料提取和质量评价后，采用Revman5.2软件进行Meta分析，并采用GRADE系统进行证据质量评价。[结果]共纳入7个研究，364例患者。Meta分析结果显示：①有效率。针灸与药物比较，结果显示两组间有统计学意义[RR=1.33，95%CI=（0.95，1.87）]表明针灸治疗能提高治疗2型糖尿病周围神经病变的有效率。②MNCV。其中正中神经，结果显示两组间有统计学意义[MD=2.29，95%CI=（0.61，3.98）]；腓总神经，结果显示两组间有统计学意义[MD =2.16，95%CI=（0.16，4.16）]。③SNCV。其中正中神经，结果显示两组间有统计学意义[MD=1.79,95%CI=（0.57,3.02）]；腓总神经，结果显示两组间有统计学意义[MD=3.59,95%CI=（2.28,4.91）]。基于系统评价结果，采用GRADE系统推荐分级方法评价证据质量，结果显示，证据水平均为低级，推荐强度为弱推荐。[结论]针灸治疗2型糖尿病周围神经病变的疗效优于常规药物治疗，由于本次评价纳入研究质量所限，需要更多高质量、大样本的RCT进一步论证。%Objective] To evaluate the acupuncture treatment of type 2 diabetes peripheral neuropathy clinical curative effect and safety. [Methods] Com-puter retrieval of the CENTRAL, Cochrane, Web Of Science, CBM, CNKI, VIP database, find al about acupuncture and moxibustion treatment of type 2 diabetic gastroparesis of randomized control ed trial(RCT), build library retrieval time until March 19, 2014.At the same time ShouJian into literature references.According to inclusion and exclusion criteria, independently by two researchers after RCT extraction and filtering, data quality evaluation, using Revman5.2 Meta analysis software, use the GRADE system for quality evaluation of evidence. [Results] Seven studies involving 364 patients were includ-ed.Meta analysis showed:(1) effective rate:the acupuncture compared with drugs, the results between the two groups were statistical y significant (RR=3.35, 95% CI=(2.05, 5.48)], suggesting that acupuncture treatment can improve efficiency for the treatment of type 2 diabetes peripheral neuropathy. (2) MNCV:the median nerve, and results showed that the statistical significance was found between the two groups[MD=2.29, 95%CI=(0.61, 3.98)].Includ-ing philalways nervous, the result showed that between the two groups had statistical significance[MD=2.16, 95% CI=(0.16, 4.16)].(3)SNCV:includ-ing median nerve, the results showed that the statistical significance was found between the two groups[MD=1.79, 95% CI=(0.57, 3.02)].Including phi-lalways nervous, the result showed that the two groups had statistical significance[MD=3.59, 95%CI=(2.28, 4.91)].Based on GRADE system ,al the evidence was at low level and weak recommendation. [Conclusion] Acupuncture-moxibustion for the type 2 diabetes peripheral neuropathy is better than the conven-tional medicine treatment.Limited by the guality of the inclusive literalures, it needs more high quality, large sample of RCT further argument.