本文關(guān)鍵詞： 文獻(xiàn)評價(jià)/循證醫(yī)學(xué) 糖尿病/腦梗死 中西醫(yī)結(jié)合 隨機(jī)對照雙盲試驗(yàn) Meta-分析 神經(jīng)功能缺失 空腹血糖 糖化血紅蛋白　出處：《中華中醫(yī)藥雜志》2010年11期 　論文類型：期刊論文

【摘要】：目的:參照國際循證醫(yī)學(xué)中心隨機(jī)對照文獻(xiàn)質(zhì)量評價(jià)標(biāo)準(zhǔn)研究中西醫(yī)結(jié)合治療糖尿病性腦梗死文獻(xiàn)質(zhì)量,并與單純西醫(yī)治療糖尿病性腦梗死進(jìn)行比較。方法:收集中西醫(yī)結(jié)合治療糖尿病性腦梗死臨床研究隨機(jī)對照文獻(xiàn),評價(jià)了文獻(xiàn)的數(shù)量、質(zhì)量、干預(yù)措施等,并運(yùn)用Meta分析方法比較中西醫(yī)結(jié)合與單純西醫(yī)治療糖尿病性腦梗死的總有效率、神經(jīng)功能缺損評分(NDS)、空腹血糖(FBG)和糖化血紅蛋白(GHb)。結(jié)果:共收集文獻(xiàn)1963篇,其中符合meta-分析要求的文獻(xiàn)59篇,Jaded評分3分的高質(zhì)量文獻(xiàn)僅1篇;研究總有效率的文獻(xiàn)52篇、神經(jīng)功能缺損評分18篇、空腹血糖14篇、糖化血紅蛋白6篇、血脂11篇、血液流變學(xué)18篇;34篇文獻(xiàn)使用了中藥湯劑,中藥使用頻次在10次以上者依次為黃芪(28)、地龍(27)、丹參(21)、川芎(20)、生地黃(19)、當(dāng)歸(18)、水蛭(15)、麥冬(13)、葛根(12)、桃仁(12)、赤芍(11)、石菖蒲(10);中西醫(yī)結(jié)合治療臨床總有效率為92.17%,單純西醫(yī)治療組為74.44%,兩組差異顯著(Z=14.88,P0.01);兩組NDS加權(quán)均數(shù)差(WMD)為-4.60分,95%可信區(qū)間為(-5.47,-3.73)分,差異有統(tǒng)計(jì)學(xué)意義(Z=10.41,P0.01);兩組FBG加權(quán)均數(shù)差為-0.93mmol/L,95%可信區(qū)間為(-1.57,-0.28)mmol/L,差異有顯著性(Z=2.82,P0.01);兩組GHb加權(quán)均數(shù)差為-0.60%,95%可信區(qū)間為(-1.69,0.49)%,差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:中西醫(yī)結(jié)合治療糖尿病性腦梗死的臨床研究較多,但大多沒有采取隨機(jī)對照和雙盲試驗(yàn),文獻(xiàn)質(zhì)量普遍偏低;有限證據(jù)顯示中西醫(yī)結(jié)合治療糖尿病性腦梗死在臨床總有效率、改善神經(jīng)功能缺損評分和空腹血糖等方面明顯優(yōu)于單純西醫(yī)治療組,而在改善糖化血紅蛋白方面兩組作用基本一致。受納入研究的數(shù)量和質(zhì)量限制,中西醫(yī)結(jié)合治療對糖尿病性腦梗死血糖的影響需要更多高質(zhì)量的隨機(jī)雙盲對照試驗(yàn)加以證實(shí)。
[Abstract]:Objective: through randomized control according to the international literature quality evaluation standard of Medicine Center of integrated traditional Chinese and Western medicine treatment of diabetic cerebral infarction and the quality of literature, and the pure western medicine treatment of diabetic cerebral infarction were compared. Methods: combined treatment of diabetic cerebral infarction randomized controlled clinical study of literature of traditional Chinese medicine and Western medicine, the quality evaluation of the number of documents, and intervention measures. And compare the total efficiency of combining traditional Chinese and Western medicine and Western medicine treatment of diabetic cerebral infarction with Meta analysis method, neural function defect score (NDS), fasting blood glucose (FBG) and glycosylated hemoglobin (GHb). Results: a total of 1963 literatures, which meet the requirements of meta- analysis of the 59 articles, Jaded score high quality literature 3 only 1 of the total efficiency; the 52 literatures, the neurological deficit scores of 18, 14 fasting blood glucose, glycosylated hemoglobin 6, blood 11, blood rheology 瀛，

本文編號：1534480