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中国临床研究英文版:2023,36(2):303-310
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针刺治疗2型糖尿病的Meta分析与GRADE证据评价
(1. 北京中医药大学针灸推拿学院,北京 100029;2. 云南中医药大学,云南 昆明 650500)
Meta-analysis and GRADE evidence evaluation of acupuncture in the treatment of type 2 diabetes mellitus
摘要
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Received:May 31, 2022   Published Online:February 20, 2023
中文摘要: 目的 系统评价针刺治疗2型糖尿病的临床疗效。方法 对国内外12个数据库相关文献进行检索,检索时限为建库至2022年3月。采用RevMan 5.3软件进行Meta分析。结果 共纳入14篇随机对照试验,包括1 344例患者,Meta分析结果显示,针刺加西药在改善空腹血糖[MD=-1.26,95%CI(-1.50,-1.03),Z=10.57,P<0.01]、餐后2 h血糖[MD=-1.65,95%CI(-1.88,-1.42),Z=14.25,P<0.01]、糖化血红蛋白[MD=-0.97,95%CI(-1.25,-0.69),Z=6.76,P<0.01]、胰岛素抵抗指数[MD=-1.35,95%CI(-1.54,-1.15),Z=13.23,P<0.01]方面优于西药治疗。GRADE证据质量评价结果显示,餐后2 h血糖为高等质量证据,空腹血糖、糖化血红蛋白、胰岛素抵抗指数为中等质量证据。结论 针刺加西药治疗2型糖尿病的疗效优于西药治疗,针刺对2型糖尿病有较好的疗效。
Abstract:ObjectiveTo systematically evaluate the clinical efficacy of acupuncture in the treatment of type 2 diabetes mellitus. MethodsThe related literatures of 12 databases at home and abroad were searched for the period from the establishment of the database to March 2022. RevMan 5.3 software was used for Meta-analysis. ResultsA total of 14 randomized controlled trials were included, including 1 344 patients. The results of Meta-analysis showed that acupuncture plus western medicine was superior to western medicine in improving fasting blood glucose[MD=-1.26, 95%CI(-1.50,-1.03), Z=10.57, P<0.01], 2-hour postprandial blood glucose[MD=-1.65, 95%CI(-1.88,-1.42),Z=14.25, P<0.01], glycosylated hemoglobin[MD=-0.97,95%CI(-1.25,-0.69), Z=6.76, P<0.01] and insulin resistance index[MD=-1.35, 95%CI(-1.54,-1.15), Z=13.23, P<0.01]. GRADE evidence quality evaluation results showed that 2-hour postprandial blood glucose was high quality evidence, while fasting blood glucose, glycosylated hemoglobin and insulin resistance index were medium quality evidence. ConclusionThe current evidence shows that the efficacy of acupuncture plus western medicine in the treatment of type 2 diabetes mellitus is better than that of western medicine. Acupuncture has a better effect on type 2 diabetes mellitus.
文章编号:     中图分类号:    文献标志码:B
基金项目:国家自然科学基金(81973935)
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