Objective To compare the influence of traditional Chinese medicine treatment and single western medicine treatment for the hemorheology indexes of patients with diabetic retinopathy by meta analysis.Methods The databases of PubMed,Medline,CBM disc,Cochrane library,CNKI,VIP,Wanfang,China Master's Theses Full-text Database and proceedings of the academic conference were retrieved.The retrieval time limit was from January 2000 to October 2016.The related clinical randomized controlled trials were researched,and the enrolled literatures were taken quality assessment and data extraction,and Revman5.3 software was used to take Meta analysis.Results In total,26 clinical randomized controlled trials and 2421 patients were enrolled,with 1307 cases in experimental group and 1114 cases in control group.The levels of whole high blood viscosity (200/s) (SMD =-0.63,95％CI:-0.91--0.34,P ＜ 0.01),whole low blood viscosity (5/s) (WMD =-0.76,95％CI:-1.02--0.50,P ＜ 0.01),plasma viscosity (SMD =-0.62,95％CI:-1.02--0.22,P =0.002),fibrinogen (SMD =-0.67,95％CI:-0.80--0.54,P ＜ 0.01),red blood cell aggregation index (SMD =-0.96,95％CI:-1.46--0.47,P =0.0001) in the experimental group were significantly lower than those of control group,the fundus changing curative effect (RR =1.22,95％CI:1.17-1.28,P ＜ 0.01) and TCM syndrome curative effect (RR =1.55,95％ CI:1.18-2.03,P =0.002) were significantly better than those of control group.The whole middle blood viscosity (30/s) between two groups had no statistically significant difference (MD =-1.22,95％CI:-2.66-0.21,P =0.10).Sensitivity analysis showed that the results were stable and reliable.Conclusion Traditional Chinese medicine treatment can reduce the whole high blood viscosity (200/s),whole low blood viscosity (5/s),plasma viscosity,fibrinogen,erythrocyte aggregation index of patients with diabetic retinopathy,and improve the fundus changing curative effect and TCM syndrome curative effect,all of which are superior to those of single western medicine treatment,while it has no effect on the whole middle blood viscosity (30/s).This paper shows that traditional Chinese medicine treatment for diabetic retinopathy has certain creative effect,but the methodological quality remains to be further improved,which needs more high-quality randomized,double-blind,controlled literatures to confirm.%目的 运用Meta分析方法比较中医药治疗与单纯西医治疗对糖尿病性视网膜病变患者血液流变学指标的影响.方法 检索PubMed、Medline、CBM disc、Cochrane图书馆、CNKI、VIP、万方和中国优秀博硕士学位论文全文数据库、学术会议论文集等,检索年限为2000年1月～2016年10月.全面收集相关临床随机对照研究,对纳入的文献进行质量评价与数据提取,采用Revman5.3软件进行Meta分析.结果 共纳入26篇临床随机对照研究,共2421例患者,试验组1307例,对照组1 114例.试验组患者的全血高切黏度(200/s)(SMD=-0.63,95％CI:-0.91～-0.34,P＜ 0.01)、全血低切黏度(5/s)(WMD=-0.76,95％CI:-1.02～-0.50,P＜ 0.01)、血浆黏度(SMD=-0.62,95％CI:-1.02～-0.22,P=0.002)、纤维蛋白原(SMD=-0.67,95％CI:-0.80～-0.54,P＜ 0.01)、红细胞聚集指数(SMD=-0.96,95％CI:-1.46～-0.47,P=0.0001)明显低于对照组,眼底改变疗效(RR=1.22,95％CI:1.17～1.28,P＜ 0.01)、中医证候疗效(RR=1.55,95％CI:1.18～2.03,P=0.002)明显优于对照组.两组全血中切黏度(30/s)比较差异无统计学意义(MD=-1.22,95％CI:-2.66～0.21,P=0.10).敏感性分析显示结果稳定可靠.结论 中医药治疗能够降低糖尿病性视网膜病变患者全血高切黏度(200/s)、全血低切黏度(5/s)、血浆黏度、纤维蛋白原、红细胞聚集指数,提高眼底改变疗效、中医证候疗效,其作用均优于单纯西医治疗,对全血中切黏度(30/s)没有影响.本次分析提示,中医药治疗对糖尿病性视网膜病变有一定疗效,但研究方法学质量有待进一步提高,需要更多高质量的随机双盲对照试验加以证实.
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