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基于证据体质量评价的中医药治疗糖尿病视网膜病变效果分析
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| 篇名： | 基于证据体质量评价的中医药治疗糖尿病视网膜病变效果分析 |
| TITLE： | Analysis of the efficacy of traditional Chinese medicine for diabetic retinopathy based on evidence body quality assessment |
| 摘要： | 目的 基于证据质量分级和推荐强度（GRADE）系统对中医药治疗糖尿病视网膜病变（DR）的系统评价/Meta分析进行证据体质量评价。方法检索中英文数据库获取中医药治疗DR的系统评价/Meta分析的相关研究，检索时限均为各数据库建库起至2024年1月13日。根据纳排标准进行文献筛选，提取纳入文献相关资料后，采用GRADE系统对纳入研究的证据体质量等级进行评价，并对结局指标的证据进行整合总结。结果最终纳入51篇文献，结局指标共计135个，19个（14.1%）为高质量、87个（64.4%）为中等质量、26个（19.3%）为低质量、3个（2.2%）为极低质量，总体而言，纳入研究的结局指标证据质量为中等偏低。结局指标疗效的证据整合结果显示，与西医常规治疗、羟苯磺酸钙或安慰剂相比，中医药在提高总有效率、减少出血斑面积、降低黄斑中心凹厚度以及提高视力改善率等方面具有优势。此外，中医药联合西医常规治疗或羟苯磺酸钙的效果显著优于单独使用西医常规治疗或羟苯磺酸钙。结论中医药治疗DR的系统评价/Meta分析研究的证据体质量整体为中等偏低质量水平；基于已有研究结果，中医药治疗DR具有较好的临床疗效。 |
| ABSTRACT： | OBJECTIVE To evaluate the quality of evidence in the systematic evaluation/meta-analysis of traditional Chinese medicine （TCM） for diabetes retinopathy （DR） based on the GRADE system. METHODS Chinese and English databases were searched to obtain the relevant studies of systematic evaluation/meta-analysis of traditional Chinese medicine in the treatment of DR. The search time was from the establishment of each database to January 13th， 2024. According to the inclusion and exclusion criteria， literature screening was conducted. After extracting relevant information from the included literature， the GRADE system was used to evaluate the quality level of the evidence body in the included studies， and the evidence of the outcome indicators was integrated and summarized. RESULTS A total of 51 studies were ultimately included， encompassing 135 outcome indexes. Among these， 19 indicators （14.1%） were of high quality， 87 （64.4%） were of medium quality， 26 （19.3%） were of low quality， and 3 （2.2%） were of very low quality. Overall， the evidence quality of the outcome indicators in the included studies was medium to low quality. The integrated results of evidence on the efficacy of outcome indexes showed that compared with conventional Western medicine， calcium dobesilate or placebo， TCM had significant advantages in improving overall efficacy， reducing bleeding spot area， reducing macular foveal thickness， and increasing visual improvement rate. In addition，the combination of TCM and conventional Western medicine or calcium dobesilate was significantly more effective than using conventional Western medicine or calcium dobesilate alone. CONCLUSIONS The overall quality of the evidence in the systematic evaluation/meta-analysis study on the treatment of DR with TCM is medium to low quality. Based on existing research findings， TCM demonstrates good clinical efficacy in the treatment of DR. |
| 期刊： | 2025年第36卷第07期 |
| 作者： | 令娟；谢卓霖；罗向霞；郭琬盈；李嘉进；周君；罗旭飞 |
| AUTHORS： | LING Juan，XIE Zhuolin，LUO Xiangxia，GUO Wanying，LI Jiajin，ZHOU Jun，LUO Xufei |
| 关键字： | 中医药；糖尿病视网膜病变；Meta分析；系统评价；再评价；GRADE；证据体质量 |
| KEYWORDS： | traditional Chinese medicine； diabetes retinopathy； meta-analysis； systematic evaluation； re-evaluation； GRADE； |
| 阅读数： | 170 次 |
| 本月下载数： | 14 次 |
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