电刺激对糖尿病相关溃疡患者的影响：系统评价和荟萃分析。
Effect of electrical stimulation on patients with diabetes-related ulcers: a systematic review and meta-analysis.
机构信息
Department of Rehabilitation Medicine, The First Hospital of Jilin University, No.1, Xinmin Street, Chang Chun, 130021, Jilin Province, China.
Department of Clinical Laboratory Medicine, Affiliated Hospital, Changchun University of Chinese Medicine, Changchun, 130021, China.
出版信息
BMC Endocr Disord. 2022 Apr 27;22(1):112. doi: 10.1186/s12902-022-01029-z.
BACKGROUND
This study aimed to systematically review the literature to better understand the efficacy of electrical stimulation (ES) for the treatment of patients with diabetes-related ulcers.
METHODS
We searched the Embase, Medline, and Cochrane Library databases through July 31, 2021. Original trials for ES treatment of patients with diabetes-related ulcers with placebo or standard care as the control group were included. The primary outcomes were ulcer area reduction and healing rates. Meta-analyses were performed to compare the standardized mean difference (SMD) in the percentage of ulcer reduction and risk ratio of non-healing rates between ES treatment and placebo or standard care. We used the Revised Cochrane risk-of-bias tool for randomized trials to assess the risk of bias for each included article. Funnel plots and Egger's test were used to assess publication bias.
RESULTS
Compared to placebo or standard care, ES had a significant benefit for the treatment of patients with diabetes-related ulcers in terms of percentage of ulcer reduction (SMD = 2.56, 95% CI: 1.43-3.69; P < 0.001 (Q-test), I = 93.9%) and ulcer healing rates [risk ratio of non-healing rates for the ES group was 0.72 (95% CI: 0.54-0.96; P = 0.38 (Q-test), I = 2.3%)]. Two, four, and three of the included studies were categorized into low risk of bias, some concerns, and high risk of bias, respectively. No publication bias was found.
CONCLUSIONS
Based on the findings of this meta-analysis, ES could be used to treat patients with diabetes-related ulcers. ES treatment was effective for ulcer area reduction and ulcer healing, although it had a high heterogeneity level among the included studies. Pulsed current ES has the potential benefit of increasing ulcer healing compared to direct current ES. Further large-scale clinical trials are needed to define the adverse events and potentiators of ES in the treatment of patients with diabetes-related ulcers.
背景
本研究旨在系统地回顾文献，以更好地了解电刺激（ES）治疗糖尿病相关溃疡患者的疗效。
方法
我们检索了 Embase、Medline 和 Cochrane 图书馆数据库，截至 2021 年 7 月 31 日。纳入了以安慰剂或标准治疗作为对照组的 ES 治疗糖尿病相关溃疡患者的原始试验。主要结局为溃疡面积减少和愈合率。采用标准化均数差（SMD）比较 ES 治疗与安慰剂或标准治疗的溃疡减少百分比，采用风险比比较非愈合率。我们使用修订后的 Cochrane 随机试验偏倚风险工具评估纳入文章的偏倚风险。采用漏斗图和 Egger 检验评估发表偏倚。
结果
与安慰剂或标准治疗相比，ES 在治疗糖尿病相关溃疡患者方面具有显著优势，可显著降低溃疡面积（SMD=2.56，95%CI：1.43-3.69；P<0.001（Q 检验），I²=93.9%）和提高溃疡愈合率[ES 组非愈合率的风险比为 0.72（95%CI：0.54-0.96；P=0.38（Q 检验），I²=2.3%）]。纳入的研究中有 2 项、4 项和 3 项分别归类为低偏倚风险、存在一定关注和高偏倚风险。未发现发表偏倚。
结论
基于本荟萃分析的结果，ES 可用于治疗糖尿病相关溃疡患者。ES 治疗在减少溃疡面积和促进溃疡愈合方面有效，但纳入的研究存在较高的异质性。与直流电 ES 相比，脉冲电流 ES 具有增加溃疡愈合的潜在益处。需要进一步开展大规模临床试验，以明确 ES 在治疗糖尿病相关溃疡患者中的不良反应和增效剂。
Zotero 插件