复方丹参滴丸治疗非增殖性糖尿病视网膜病变：13项随机对照试验的Meta分析

Compound Danshen Dripping Pill for Treating Nonproliferative Diabetic Retinopathy: A Meta-Analysis of 13 Randomized Controlled Trials.

作者信息

Huang Wenjing, Bao Qi, Jin De, Lian Fengmei

机构信息

Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beixiange 5, Xicheng District, Beijing 100053, China.

China Academy of Chinese Medical Sciences, Beixiange 5, Xicheng District, Beijing 100700, China.

出版信息

Evid Based Complement Alternat Med. 2017;2017:4848076. doi: 10.1155/2017/4848076. Epub 2017 Aug 24.

OBJECTIVE

We assess the clinical effect of compound Danshen dripping pill (CDDP) for treating diabetic retinopathy (DR).

METHODS

Electronic databases were searched from January 2001 to October 2016 to locate randomized controlled trials (RCTs). Efficacy was measured as main outcome and microaneurysms, hemorrhage, exudate, vision, and fundus fluorescein angiography (FFA) were measured as second outcomes. Methodological quality for each study was evaluated, RevMan 5 software was used to assess treatment effects, and GRADE was used to rate quality of evidence.

RESULTS

We located 13 RCTs and methodological quality was evaluated as high risk. Statistics indicated CDDP for treating DR was better than controls and DR risk was reduced 64% with CDDP (RR: 0.36, = 0.68); retinal microaneurysms (MD = -4.32NO, < 0.00001); retinal hemorrhages (MD = -0.70PD, = 0.03); exudate improvements (MD = -0.09PD, = 0.79); visual changes (MD = -0.12 letter, = 0.006); FFA (RR: 0.40, = 0.003). About GRADE, quality of evidence was "low." . CDDP may be safe and efficacious for treating or delaying DR and may improve vision or delay vision loss.

目的

评估复方丹参滴丸（CDDP）治疗糖尿病视网膜病变（DR）的临床疗效。

方法

检索2001年1月至2016年10月的电子数据库，以查找随机对照试验（RCT）。将疗效作为主要结局指标，将微动脉瘤、出血、渗出、视力和眼底荧光血管造影（FFA）作为次要结局指标进行测量。评估每项研究的方法学质量，使用RevMan 5软件评估治疗效果，并使用GRADE对证据质量进行评级。

结果

我们找到了13项RCT，方法学质量评估为高风险。统计表明，CDDP治疗DR优于对照组，使用CDDP可使DR风险降低64%（RR：0.36，95%CI：0.26-0.68）；视网膜微动脉瘤（MD=-4.32，95%CI：-5.45至-3.19，P<0.00001）；视网膜出血（MD=-0.70，95%CI：-1.36至-0.04，P=0.03）；渗出改善（MD=-0.09，95%CI：-0.22至0.04，P=0.79）；视力变化（MD=-0.12，95%CI：-0.21至-0.03，P=0.006）；FFA（RR：0.40，95%CI：0.25-0.64，P=0.003）。关于GRADE，证据质量为“低”。CDDP治疗或延缓DR可能安全有效，并可能改善视力或延缓视力丧失。