CAJ | 학술논문

目的:运用循证医学方法,对活血化瘀中药方剂改善胰岛素抵抗的随机对照试验进行系统评价.方法:全面收集2008年2月以前的以活血化瘀为主要疗法治疗胰岛素抵抗相关性疾病的随机或半随机对照试验文献,采用Jadad质量标准对文献进行评分;利用RevMan 4.2软件对多个研究结果的总体效应进行Meta分析.结果:13篇文献符合纳入标准,只有1篇被评为高质量文献.在提高胰岛素敏感指数方面,目标主要是观察活血化瘀中药疗效组(亚组Ⅰ)中7篇文章的研究结果,提示活血化瘀组疗效优于对照组,两组差异有统计学意义[WMD0.86,95%CI(0.45,1.26)];在目标主要是比较活血化瘀中药与有胰岛素增敏作用的西药疗效差异组(亚组Ⅱ)中,4篇文章的研究结果提示活血化瘀组疗效优于对照组,但两组差异无统计学意义[WMD 0.72,95%CI(-0.03,1.48)].未发现明显的副作用和不良反应.结论:目前资料表明,活血化瘀法治疗胰岛素抵抗安全有效,但所纳入的文献质量普遍偏低,势必影响结果的论证强度,故尚需更多高质量的随机对照试验提供高质量的证据.
목적:운용순증의학방법,대활혈화어중약방제개선이도소저항적수궤대조시험진행계통평개.방법:전면수집2008년2월이전적이활혈화어위주요요법치료이도소저항상관성질병적수궤혹반수궤대조시험문헌,채용Jadad질량표준대문헌진행평분;이용RevMan 4.2연건대다개연구결과적총체효응진행Meta분석.결과:13편문헌부합납입표준,지유1편피평위고질량문헌.재제고이도소민감지수방면,목표주요시관찰활혈화어중약료효조(아조Ⅰ)중7편문장적연구결과,제시활혈화어조료효우우대조조,량조차이유통계학의의[WMD0.86,95%CI(0.45,1.26)];재목표주요시비교활혈화어중약여유이도소증민작용적서약료효차이조(아조Ⅱ)중,4편문장적연구결과제시활혈화어조료효우우대조조,단량조차이무통계학의의[WMD 0.72,95%CI(-0.03,1.48)].미발현명현적부작용화불량반응.결론:목전자료표명,활혈화어법치료이도소저항안전유효,단소납입적문헌질량보편편저,세필영향결과적론증강도,고상수경다고질량적수궤대조시험제공고질량적증거.
Objective: To evaluate the randomized controlled trials on treating diseases related with insulin resistance by Chinese medicine of activating blood circulation adopting the principle of evidence-based medicine (EBM). Methods: Pertinent literatures were retrieved roundly, and scored depending on Jaded Quality Scale. Mata-analysis was applied on the total effect of outcomes reported using RevMan 4.2 software. Results: Among the 13 literatures met the inclusion criteria,only one trial was appraised as high quality. Meta-analysis based on 7 included studies (subgroup Ⅰ) show that Chinese medicine of activating blood circulation was more effective to elevate insulin sensitivity index (ISI) compared with the control group with statistical significance (WMDO. 86,95 % CI 0.45 to 1.26). Meta-analysis based on other 4 included studies (subgroup Ⅱ) show the similar result compared with insulin sensitizer, but with no statistical significance (WMDO. 72,95 % CI- 0.03 to 1.48 ). The side effect or adverse effect reported was not obvious. Conclusions: Chinese medicine of activating blood circulation is effective and safe for diseases related with insulin resistance. Due to the poor quality of original articles, the evidence is not definite. Our results suggest that further and larger-scale trials of using Chinese medicine of activating blood circulation to treat diseases related with insulin resistance be needed.