中西医结合治疗对糖尿病性脑梗死血脂影响的Meta-分析

目的：运用Meta分析方法比较研究了中西医结合与单纯西医治疗糖尿病性脑梗死血脂的变化。方法：全面收集中西医结合治疗糖尿病性脑梗死的临床研究文献,比较中西医结合疗法与纯西医疗法对总胆固醇、甘油三酯、高密度脂蛋白胆固醇以及低密度脂蛋白胆固醇影响的随机对照试验,并进行Meta分析。结果59篇合格文献中11篇观察了总胆固醇和甘油三酯,9篇观察了高密度脂蛋白,6篇观察了低密度脂蛋白。Meta-分析显示中西医结合治疗组与单纯西医治疗组比较,总胆固醇加权均数差为-0.28mmol/L,95%CI为（-0.48,-0.09）mmol/L,高密度脂蛋白加权均数差为0.18mmol/L,95%CI为（0.05,0.30）mmol/L,差异均具有显著性意义（P〈0.01）;低密度脂蛋白加权均数差为0.01mmol/L,95%CI为（-0.14,0.15）mmol/L,甘油三酯加权均数差为-0.15mmol/L,95%可CI为（-0.32,0.01）mmol/L,差异均无显著性（P〉0.05）。经敏感性分析显示以上结果稳定可靠。结论：现有的有限证据表明,中西医结合治疗对糖尿病性脑梗死总胆固醇和高密度脂蛋白胆固醇有较好的调节作用。受纳入研究的数量和质量限制,中西医结合治疗对糖尿病性脑梗死血脂的调节需要更多高质量的随机对照双盲试验加以证实。

Meta-analysis on Blood Lipid of Chinese and Western Medicine Treatment of Diabetic Cerebral Infarction

Objective：To summarize the published treatises of treatment of diabetic cerebral infarction using integration of Chinese western medcine（ICWM） or only western medcine and compare the changes of blood lipid between the two treatments.Methods：To collect completely the clinic study of ICWM for diabetic cerebral infarction,choose the eligibility studies and make Meta-analysis of total cholesterol（TC）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C） and triglyceride（TG）.Results：Of the 59 eligibility papers,11paper researched the changes of TC and TG,9 papers HDL-C and 6 papers LDL-C.Meta-analysis revealed that the weighted mean differences（WMD） of ICWM group to only western medicine treatment group were significantly respectively -0.28mmol/L（95%CI -0.48,-0.09,P0.01）in TC and 0.18mmol/L （95%CI 0.05,0.30,P0.01）in HDL-C.There were not obvious differences in LDL-C with 0.01mmol/L WMD（95%CI -0.14,0.15,P0.05） and TG with -0.15 mmol/L（95%CI -0.32,0.01,P0.05）between ICWM and only western medicine treatment.The reliability of the above results of sensitivity tests had been confirmed.Conclusion：The existed limited evidences suggest that ICWM treatment of diabetic cerebral infarction can significantly improve TC and HDL-C. It needs more high-quality randomized,double-blind,placebo-controlled trials to confirm the effect of ICWM treatment of diabetic cerebral infarction.on blood lipid.