CAJ | 학술논문

目的评价经皮电神经刺激(TENS)治疗症状性糖尿病周围神经病的有效性与安全性.方法计算机检索PUBMED、EMBASE、Cochrane Central Register of Controlled Trials、中国生物医学文献数据库.由2位评价员独立检索、筛选文献,对符合纳入标准的文献进行方法学质量评价并对各被研究患者的基本特征、干预措施、疗效观察指标等资料进行提取.用Revman4.2.8软件进行统计分析.结果共纳入3个随机对照试验(RCT),包括78例患者.3个RCT采用无效刺激作为对照,按TENS治疗时间将其分为4,6,12周3个亚组进行缓解疼痛有效性的分析,报道治疗第4周与第6周时患者情况的各有1个RCT,结果显示TENS组优于无效刺激组,其差异有统计学意义[SMD-5.37,95%CI(-6.97,-3.77);SMD-1.01,95%CI(-2.01,-0.01)],报道治疗第12周时患者情况的有2个RCT,其中1个RCT显示TENS组优于无效刺激组.另1个则无明显差异,Meta-分析显示2组之间差异无统计学意义[SMD-1.65,95%CI(-4.02,0.73)].在改善患者麻木等其他主观症状方面,TENS组明显优于无效刺激组[WMD-0.18,95%CI(-0.32,-0.051)].结论 TENS是一种治疗症状性糖尿病周围神经病有前景的、安全的治疗方法 .因纳入样本量较少,观察时间较短,长期疗效尚不清楚,仍值得临床上进一步研究.
목적 평개경피전신경자격(TENS)치료증상성당뇨병주위신경병적유효성여안전성.방법 계산궤검색PUBMED、EMBASE、Cochrane Central Register of Controlled Trials、중국생물의학문헌수거고.유2위평개원독립검색、사선문헌,대부합납입표준적문헌진행방법 학질량평개병대각피연구환자적기본특정、간예조시、료효관찰지표등자료진행제취.용Revman4.2.8연건진행통계분석.결과 공납입3개수궤대조시험(RCT),포괄78례환자.3개RCT채용무효자격작위대조,안TENS치료시간장기분위4,6,12주3개아조진행완해동통유효성적분석,보도치료제4주여제6주시환자정황적각유1개RCT,결과 현시TENS조우우무효자격조,기차이유통계학의의[SMD-5.37,95%CI(-6.97,-3.77);SMD-1.01,95%CI(-2.01,-0.01)],보도치료제12주시환자정황적유2개RCT,기중1개RCT현시TENS조우우무효자격조.령1개칙무명현차이,Meta-분석현시2조지간차이무통계학의의[SMD-1.65,95%CI(-4.02,0.73)].재개선환자마목등기타주관증상방면,TENS조명현우우무효자격조[WMD-0.18,95%CI(-0.32,-0.051)].결론 TENS시일충치료증상성당뇨병주위신경병유전경적、안전적치료방법 .인납입양본량교소,관찰시간교단,장기료효상불청초,잉치득림상상진일보연구.
Objective To systematically review the effectiveness and safety of transcutaneous electricalnerve stimulation (TENS) on symptomatic diabetic neuropathy (DNP). Methods Electronic databases such asPUBMED, EMBASE, Cochrane Central Register of Controlled Trials, and Chinese Biomedical Database weresearched by using such mesh and text keywords as "TENS" and "diabetic neuropathy". Randomized controlled trials(RCTs) on the effect of TENS on symptomatic diabetic neuropathy were included. Studies were selected and availa-ble data was extracted independently by two reviewers. Meta-analysis was performed using RevMan 4.2.8 software.Results Three RCTs involving 78 patients were included in this study. Compared with sham-stimulation, TENStherapy significantly reduced the score in pain (SMD -2.35, 95% CI [-4.24, -0.46 ] ) and the score in numb-ness (WMD -0.18, 95% CI [-0.32, -0.05 ] ). Subgroup analysis shows that TENS therapy was associated with a significant reduction in the score of pain in both 4-week treatment duration ( SMD - 5.37, 95% CI [ - 6.97,- 3.77 ] ) and 6-week treatment duration ( SMD - 1.01, 95% CI [ - 2.01, - 0.01 ] ), but not 12-week treatmentduration (SMD - 1.65, 95% CI [ -4.02, 0.73 ] ). Conclusion TENS therapy is a promising and safe strategyfor treatment of symptomatic diabetic neuropathy. More studies are still warranted to accumulate the evidence of theeffect of TENS therapy on DNP.