Su Ya-Na, Li Jing, Feng Dai-Hao, Lu Ruo-Ruo, Dong Guo-Xi, Zhao Ding-Yun
Department of Health Management, The School of Smart Health and Wellness (Health Medical College), Zhejiang Dongfang Polytechnic, Wenzhou City, Zhejiang Province, PR China.
Department of Evidence-Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, PR China.
J Wound Care. 2023 Dec 2;32(12):773-786. doi: 10.12968/jowc.2023.32.12.773.
To investigate the efficacy and safety of autologous platelet-rich plasma (au-PRP) for diabetic foot ulcer (DFU) treatment.
We conducted database searches (MEDLINE, EMBASE, evidence-based medicine reviews: CENTRAL, PubMed, and Web of Science) and reference mining for randomised controlled trials from inception to 23 January 2022. Results were scrutinised, data were extracted and research quality was investigated by two independent authors. Primary outcome was the proportion of complete ulcer healing. Secondary outcomes included both the mean time to complete healing and the incidence of adverse events. Statistical analyses were performed in RevMan 5.4 (Cochrane, UK). Kaplan-Meier curves for time to complete healing were pooled in R software (version 4.1.2) (R Foundation, Austria).
Of the 231 records identified, 17 studies with a total of 1303 participants (649 randomised to the au-PRP group and 654 to a standard of care (SOC) group) met the eligibility criteria and were included in our study. Compared with SOC, au-PRP appeared to promote the complete healing rate (odds ratio (OR): 2.11; 95% Confidence Interval: 1.55-2.86). Au-PRP also appeared to significantly shorten complete healing time (mean duration: -19.04 days; 95%CI: -20.46--17.61]). There was no significant difference on adverse events. Results were robust on sensitivity analyses.
Based on the findings of this review and meta-analysis, Au-PRP is an effective and safe adjuvant therapy for DFUs.
探讨自体富血小板血浆（au-PRP）治疗糖尿病足溃疡（DFU）的疗效和安全性。
我们进行了数据库检索（MEDLINE、EMBASE、循证医学综述：CENTRAL、PubMed和Web of Science），并从数据库建立至2022年1月23日挖掘随机对照试验的参考文献。由两位独立作者对结果进行审查、提取数据并调查研究质量。主要结局是溃疡完全愈合的比例。次要结局包括完全愈合的平均时间和不良事件的发生率。在RevMan 5.4（英国Cochrane）中进行统计分析。在R软件（版本4.1.2）（奥地利R基金会）中汇总完全愈合时间的Kaplan-Meier曲线。
在检索到的231条记录中，17项研究共1303名参与者（649名随机分配至au-PRP组，654名分配至标准治疗（SOC）组）符合纳入标准并纳入本研究。与SOC相比，au-PRP似乎可提高完全愈合率（比值比（OR）：2.11；95%置信区间：1.55-2.86）。au-PRP似乎还能显著缩短完全愈合时间（平均时长：-19.04天；95%CI：-20.46--17.61）。不良事件方面无显著差异。敏感性分析结果稳健。
基于本综述和荟萃分析的结果，au-PRP是一种治疗DFU的有效且安全的辅助疗法。
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