Meta-analysis on Effect of Traditional Chinese Medicine Compound on Proliferative Diabetic Retinopathy

WANG Feng; SONG Hua-ling; MA Yan-yun; TANG Jing-jing; ZHANG Yi-yi; ZHOU Dian; ZENG Jin; SHI Rong

doi:10.13422/j.cnki.syfjx.2017150202

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Meta-analysis on Effect of Traditional Chinese Medicine Compound on Proliferative Diabetic Retinopathy

更新时间：2024-01-04

- Meta-analysis on Effect of Traditional Chinese Medicine Compound on Proliferative Diabetic Retinopathy
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 23, Issue 15, Pages: 202-210(2017)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.2017150202
  CLC： R276.7
- Published：2017
- 稿件说明：
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WANG Feng, SONG Hua-ling, MA Yan-yun, et al. Meta-analysis on Effect of Traditional Chinese Medicine Compound on Proliferative Diabetic Retinopathy[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(15): 202-210.
DOI：

WANG Feng, SONG Hua-ling, MA Yan-yun, et al. Meta-analysis on Effect of Traditional Chinese Medicine Compound on Proliferative Diabetic Retinopathy[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(15): 202-210. DOI： 10.13422/j.cnki.syfjx.2017150202.

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（hsCRP），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，hsCRP，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

Objective: To compare the effects of traditional Chinese medicine (TCM) compound and western medicine in treating diabetic retinopathy by Meta-analysis. Method: According to pathogenesis of diabetic retinopathy (DR) in high blood sugar

blood vessel endothelial cell dysfunction

growth factors

changes in blood rheology and inflammation

clinical research literatures for treatment of diabetic retinopathy were collected and screened according to the literature selection criteria

in order to compare the effects of TCM and western medicine on glycosylated hemoglobin (HbA1c)

endothelin (ET) and nitric oxide (NO)

vascular endothelial growth factor (VEGF) and serum high-sensitivity C-reactive protein (hsCRP) and tumor necrosis factor-α (TNF-α)

whole blood viscosity (high shear)

whole blood viscosity (low shear)

plasma viscosity

fundus change

vision and TCM syndrome

and the meta-analysis was made. Result: This study collected 3 526 literatures

including 62 literatures up to standards. Among them

27 literatures recorded observation of HbA1c

reflecting nearly eight weeks of glucose control; 8 literatures recorded observation of ET

and 4 literatures recorded observation of NO

reflecting the vascular endothelial cell function disorder; 8 literatures recorded observation of VEGF

proving that it is the growth factor playing a major role in the retinal micro-vascular proliferation; 8 literatures recorded observation of the whole blood viscosity (high shear)

8 literatures recorded observation of the whole blood viscosity (low shear)

9 literatures recorded observation of the plasma viscosity

6 literatures recorded observation of fibrinogen

so as to reflect the change in blood rheology; 3 literatures recorded observation of hsCRP

4 literatures recorded observation of TNF-α

discussing the effects on inflammation; 39 literatures recorded observation of the clinical efficacy

23 literatures recorded observation of the efficacy in changing fundus

20 literatures recorded observation of the efficacy in vision

and 29 literatures recorded observation of the effect of TCM syndrome. Conclusion: Compared with the pure western medicine treatment group

TCM compound was equal in the effect on NO in patients with diabetic retinopathy

but superior in glycosylated hemoglobin

TNF-α

serum hsCRP

VEGF

whole blood viscosity (high shear)

whole blood viscosity (low shear)

plasma viscosity

fibrinogen

clinical efficacy

fundus change and vision. This suggests that TCM shows a more significant efficacy than pure western medicine. However

because of the limited quantity and quality of literatures

the effect of TCM compound in patients with DR shall be further confirmed by the randomized

double-blind

placebo-controlled with more high-quality double-blind randomized controlled trials.

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