An Xuedong, Jin De, Duan LiYun, Zhao Shenghui, Zhou Rongrong, Lian Fengmei, Tong Xiaolin
Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China.
China Academy of Chinese Medical Sciences, Beijing, 100700 China.
Chin Med. 2020 Sep 17;15:99. doi: 10.1186/s13020-020-00380-4. eCollection 2020.
Diabetic retinopathy (DR) is the leading cause of blindness in many countries. The current treatment for non-proliferative DR (NPDR) using Western medicine (WM) alone is insufficient. At present, the combination of NPDR treatment with traditional Chinese medicine (TCM) and WM is universally applied. We aimed to evaluate the effectiveness and safety of TCM as an add-on for NPDR using a systematic review and meta-analysis.
Data from randomized controlled trials (RCTs) of TCM for NPDR treatment along with WM before July 6, 2019, were collected from the , , , , and . Relevant data were extracted by two reviewers. statistics was adopted to appraise heterogeneity. If < 50% the fixed-effects model was employed, otherwise a random-effect model was employed. (PROSPERO: CRD42019134947).
Eighteen RCTs (1522 patients) were included based on the inclusion and exclusion criteria. The results showed that compared with WM alone, TCM (including Compound Xueshuantong Capsule, Qiming Granule, and others) combined with WM for NPDR could improve the overall effiicacy [n = 1686, RR 1.24 (1.18,1.30), < 0.00001, = 0%], and reduce the influence of risk factors related to NPDR, such as glycated hemoglobin level [n = 360, MD - 0.85 (- 1.28, - 0.41), = 0.0001, = 72%], triglyceride (P < 0.00001), and total cholesterol ( = 0.0008). Moreover, no serious adverse events were reported.
Compared with WM alone, TCM + WM could significantly improve NPDR and also reduce the correlation levels of risk factors, such as hyperglycemia, dyslipidemia. However, the small sample included in the study might lead to a publication bias, and therefore, our results should be treated with caution.
糖尿病视网膜病变（DR）是许多国家失明的主要原因。目前仅使用西药（WM）治疗非增殖性DR（NPDR）并不充分。目前，NPDR治疗采用中药（TCM）与西药联合应用较为普遍。我们旨在通过系统评价和荟萃分析评估中药作为NPDR附加治疗的有效性和安全性。
收集2019年7月6日前中药联合西药治疗NPDR的随机对照试验（RCT）数据，来源于……。由两名研究者提取相关数据。采用……统计方法评估异质性。若……<50%，则采用固定效应模型，否则采用随机效应模型。（国际前瞻性系统评价注册库：CRD42019134947）。
根据纳入和排除标准，纳入18项RCT（1522例患者）。结果显示，与单纯西药相比，中药（包括复方血栓通胶囊、芪明颗粒等）联合西药治疗NPDR可提高总体疗效[n = 1686，RR 1.24（1.18，1.30），……<0.00001，……= 0%]，并降低与NPDR相关的危险因素的影响，如糖化血红蛋白水平[n = 360，MD -0.85（-1.28，-0.41），……= 0.0001，……= 72%]、甘油三酯（P < 0.00001）和总胆固醇（……= 0.0008）。此外，未报告严重不良事件。
与单纯西药相比，中药加西药可显著改善NPDR，并降低血糖、血脂异常等危险因素的相关水平。然而，本研究纳入的样本量较小，可能导致发表偏倚，因此，我们的结果应谨慎对待。
