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中药外用治疗糖尿病足溃疡:系统评价的综合分析。

Treatment of diabetic foot ulcers with external application of Chinese herbal medicine: An overview of overlapping systematic reviews.

机构信息

The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.

The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China.

出版信息

Int Wound J. 2024 Apr;21(4):e14563. doi: 10.1111/iwj.14563. Epub 2023 Dec 22.


DOI:10.1111/iwj.14563
PMID:38135909
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10961878/
Abstract

This overview of systematic reviews (SRs) and meta-analysis (MAs) aimed to systematically collate, appraise and synthesize evidence for the treatment of diabetic foot ulcers (DFUs) with the external application of Chinese herbal medicine (CHM). SRs/MAs of external application of CHM for DFUs were collected by searching Cochrane Library, Web of science, CNKI, PubMed, VIP, Embase and Wanfang. Two independent reviewers carried out the literature selection and data extraction. Subsequently, AMSTAR-2 tool, PRISMA, and GRADE system were applied by two reviewers independently to evaluate the methodological quality, reporting quality, and evidence quality of the included studies, respectively. Eight SRs/MAs met the eligibility criteria and were included. According to AMSTAR-2, a very low methodological quality assessment was given to the included SRs/MAs due to the flaws of items 2, 4 and 7. The PRISMA system identified protocol and registration weaknesses, as well as search method weaknesses. With GRADE, no high-quality evidence was identified to support the role of external application of CHM for DFUs, and the quality of evidence for the vast majority of outcomes was rated as low or moderate. In conclusion, low- to moderate-quality evidence supports the promise of external application of CHM for the treatment of DFUs. Due to the limitations of the evidence supporting external application of CHM for DFUs, rigorously designed and larger samples of high-quality studies are needed going forward before broad recommendations can be made.

摘要

这篇系统评价(SRs)和荟萃分析(MAs)综述旨在系统地收集、评估和综合中草药(CHM)外用于治疗糖尿病足溃疡(DFUs)的证据。通过检索 Cochrane Library、Web of science、CNKI、PubMed、VIP、Embase 和万方数据库,收集了 CHM 外用于 DFUs 的 SRs/MAs。两名独立的评审员进行了文献选择和数据提取。随后,两名评审员分别使用 AMSTAR-2 工具、PRISMA 和 GRADE 系统评估纳入研究的方法学质量、报告质量和证据质量。符合纳入标准的 8 篇 SRs/MAs 被纳入。根据 AMSTAR-2,由于项目 2、4 和 7 的缺陷,纳入的 SRs/MAs 的方法学质量评估为极低。PRISMA 系统确定了方案和注册的弱点以及搜索方法的弱点。使用 GRADE,没有高质量的证据支持 CHM 外用于 DFUs 的作用,绝大多数结局的证据质量被评为低或中。总之,低到中等质量的证据支持 CHM 外用于治疗 DFUs 的前景。由于支持 CHM 外用于 DFUs 的证据存在局限性,需要未来设计更严谨、样本更大的高质量研究,才能提出广泛的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6991/10961878/4e54ec071b89/IWJ-21-e14563-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6991/10961878/4e54ec071b89/IWJ-21-e14563-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6991/10961878/4e54ec071b89/IWJ-21-e14563-g001.jpg

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引用本文的文献

[1]
RETRACTION: Treatment of Diabetic Foot Ulcers With External Application of Chinese Herbal Medicine: An Overview of Overlapping Systematic Reviews.

Int Wound J. 2025-4

[2]
Healing of diabetic foot ulcer with topical and oral administrations of herbal products: A systematic review and meta-analysis of randomized controlled trials.

Int Wound J. 2024-2

本文引用的文献

[1]
An umbrella review of Lianhua Qingwen combined with Western medicine for the treatment of coronavirus disease 2019.

Acupunct Herb Med. 2022-9

[2]
The effect of externally applied traditional Chinese medicine in diabetic foot: A systematic review and meta-analysis of 34 RCTs.

Foot (Edinb). 2023-9

[3]
Advances in traditional Chinese medicine as adjuvant therapy for diabetic foot.

World J Diabetes. 2022-10-15

[4]
The Effects of Tai Chi Exercise Among Adults With Chronic Heart Failure: An Overview of Systematic Review and Meta-Analysis.

Front Cardiovasc Med. 2021-3-18

[5]
Acupuncture for the Treatment of Tension-Type Headache: An Overview of Systematic Reviews.

Evid Based Complement Alternat Med. 2020-3-19

[6]
Current Challenges and Opportunities in the Prevention and Management of Diabetic Foot Ulcers.

Diabetes Care. 2018-4

[7]
Association between prospective registration and overall reporting and methodological quality of systematic reviews: a meta-epidemiological study.

J Clin Epidemiol. 2017-10-31

[8]
AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both.

BMJ. 2017-9-21

[9]
Diabetic Foot Ulcers and Their Recurrence.

N Engl J Med. 2017-6-15

[10]
Diabetic foot ulcer severity predicts mortality among veterans with type 2 diabetes.

J Diabetes Complications. 2017-3

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