中西医结合治疗外伤性视神经病变疗效评价的Meta分析

目的:系统评价中西医结合治疗外伤性视神经病变(TON)的临床疗效及安全性。方法:通过计算机检索PubMed、Embase、Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库、维普数据库自建库至2020-05的关于中西医结合与单纯西医治疗TON的随机对照研究,使用Cochrane评价手册对纳入文献进行质量评价,使用RevMan5.3统计软件进行资料提取与Meta分析。结果:共筛选出12篇符合纳入、排除标准的文献;Meta分析结果显示,与单纯西药治疗TON比较,中西医结合治疗有效率更高RR=1.33,95%CI(1.23~1.45),P<0.001];在改善视力MD=0.18,95%CI(0.14~0.23),P<0.001]、视野平均缺损MD=-3.08,95%CI(-5.20~0.96),P=0.004]、视觉诱发电位P100波峰潜时MD=-9.47,95%CI(-16.37~2.57),P=0.007]以及视觉诱发电位P100波峰振幅MD=1.44,95%CI(0.22~2.66),P=0.02]上作用更显著。纳入文献有2篇提及不良反应的发生和处理,余10篇均未描述。结论:与单纯西医治疗相比,中西医结合治疗TON的疗效更佳。

Meta-analysis of efficacy evaluation of traditional Chinese medicine combined with Western medicine in the treatment of traumatic optic neuropathy

AIM:To evaluate the efficacy and safety of traditional Chinese medicine combined with Western medicine(TCM-WM)in the treatment of traumatic optic neuropathy(TON).METHODS:The computer searched PubMed,EMBASE,Cochrane Library,Chinese Biomedical Literature Database(CBM),Wan-Fang Database,China National Knowledge Infrastructure(CNKI)database and Weipu database.Search time was limited from their inception to May 2020.A comprehensive search strategy was designed to identify all randomized controlled trials(RCTs)comparing TCM-WM therapy versus WM therapy alone.The methodological quality of the included trials was assessed by the quality grade evaluation used in Cochrane handbook.Data extraction and Meta-analysis were performed by RevMan5.3 statistical software.RESULTS:Twelve RCTs were included.The Meta-analysis showed that compared with the WM therapy alone in treating TON,TCM-WM therapy was better in improving the effective rateRR=1.33,95%CI(1.23-1.45),P<0.001],visual acuityMD=0.18,95%CI(0.14-0.23),P<0.001],visual field mean defectMD=-3.08,95%CI(-5.20-0.96),P=0.004],P100 lantencyMD=-9.47,95%CI(-16.37-2.57),P=0.007]as well as P100 amplitudeMD=1.44,95%CI(0.22-2.66),P=0.02].Two researches reported the occurrence and treatment of adverse reactions,and the remaining included researches did not report the adverse reactions.CONCLUSION:The TCM-WM therapy in treating TON is more effective compared with the WM therapy alone.