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| 针灸疗法治疗糖尿病肾病的系统评价和Meta回归分析 |
| Acupuncture for Diabetic Nephropathy : Systematic Review and Meta-regression Analysis |
| 投稿时间：2018-09-25 修订日期：2018-09-25 |
| DOI： |
| 中文关键词: 针灸 糖尿病肾病 Meta回归分析 |
| 英文关键词: acupuncture diabetic nephropathy Meta－regression Analysis |
| 基金项目: |
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| 中文摘要: |
| 目的：系统评价针灸治疗糖尿病肾病的疗效及安全性。方法：通过检索The Cochrane Library、PubMed、EMBASE、CBM、CNKI、VIP和WanFang Data，纳入针灸治疗糖尿病肾病的RCT研究和Quasi-RCT研究，检索时限为建库至2018年4月20日，语言不限。2 位研究者按纳入与排除标准筛选文献、提取资料，并对文献进行质量评价，采用RevMan5.3软件进行Meta分析，STATA12.0软件进行Meta回归分析。结果：共纳入30个RCT，总人数2260。结果显示：（1）24小时尿蛋白：针灸疗法优于基础治疗组（MD -72.84,95%CI -115.55～-30.13,P<0.0001,I2=82%）。（2）针灸疗法相较于基础治疗能显著提高腰酸、浮肿、尿频、肢体麻木等症状改善的有效率（P<0.05），同时，在选穴方面，以脾胃二经的穴位作用更明显。（3）针灸疗法在改善血肌酐、糖化血红蛋白、总胆固醇、甘油三酯等实验室指标方面优于基础治疗，差异有统计学意义（P<0.05）。（4）不良反应：本课题纳入的文献中仅有1篇文章提到了感染的发生率。结论：针灸疗法可以改善DN患者的腰酸、浮肿、肢体麻木、尿频等症状，同时，针灸疗法可以不同程度的减低血糖及血脂，减少尿蛋白的排泄，延缓肾功能的恶化。就不良反应而言，针灸疗法总体安全。 |
| 英文摘要: |
| Objective: To systematically review the efficacy and safety of acupuncture in treatment of DN. Methods: All randomized controlled trials(RCTs) of acupuncture for the treatment of DN were collected from the Cochrane Library，PubMed，EMBASE，CBM，CNKI，VIP and WanFang Data without language limitation. Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data，and assessed methodological quality of included studies．Meta－analysis was then conducted using RevMan 5.3 software, while STATA12.0 software for Meta-regression analysis. Results: A total of 30 RCTs involving 2260 patients were included.The result of Meta－analysis:（1）24-hour urinary protein: Compared with the basic treatment, acupuncture showed more effects（MD -72.84,95%CI -115.55～-30.13,P<0.0001,I2=82%）,.（2）In terms of the efficiency in relieving the symptoms such as lumbago, edema, frequent urination and numbness of limbs, acupuncture did show advantage（P<0.05）. In the selection of acupoints, the effects of the two meridians of spleen and stomach were more obvious. （3）Meta－analysis showed that acupuncture can reduce the level of serum creatinine(Scr), glycosylated hemoglobin(GHb), total cholesterol(TC) and triglyceride(TG). （4）Side effects：In our study, there is only one article mentioned the incidence of infection. Conclusions: Acupuncture could relive the symptoms such as lumbago, edema, frequent urination and numbness of limbs of DN. To some extent, acupuncture could reduce the level of serum Scr, GHb, TC and TG. In terms of side effects，acupuncture was relatively safe． |
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