目的参照国际循证医学中心随机对照文献质量评价标准,研究中西医结合治疗糖尿病性脑梗死文献的研究水平。方法采用计算机和手工相结合的方法检索1978年至2009年中国生物医学文献光盘数据库、中文期刊网全文数据库、中国优秀博硕士学位论文全文数据库、中文科技期刊中医学文献索引、中国重要会议论文全文数据库、MEDLINE等文献资料库,收集中西医结合治疗糖尿病性脑梗死临床研究随机对照文献,研究了文献的数量、质量、干预措施等。结果共收集中西医结合治疗糖尿病性脑梗死文献1 963篇,其中符合meta-分析要求的文献59篇,Jaded评分大于3分的高质量文献仅1篇;研究总有效率的文献52篇、神经功能缺损评分18篇、空腹血糖14篇、糖化血红蛋白6篇、血脂11篇、血液流变学18篇;34篇文献使用了中药汤剂,中药使用频次在10次以上者依次为黄芪(28)、地龙(27)、丹参(21)、川芎(20)、生地(19)、当归(18)、水蛭(15)、麦冬(13)、葛根(12)、桃仁(12)、赤芍(11)、石菖蒲(10)。结论中西医结合治疗糖尿病性脑梗死的临床研究较多,但采用随机对照和双盲试验者不多;有限证据显示糖尿病性脑梗死中医多责之于气阴亏虚、瘀血痰浊,中西医结合治疗有较好的疗效和安全性。
Objective To study the treatise quality of therapy combined Chinese and western medicine of diabetic cerebral infarction according to the treatise evaluation criteria from International Center for Evidence-Based Medicine.Method The data bank Chinese Biomedical Literature Database CD-ROM,Chinese Journal Network Full-text Database,China's outstanding full text of Theses and Dissertations Database,etc.were used to be origin literatures.Result 1963 papers were collected from 1978 to 2009,in which,59 papers meet the requirements of meta-analysis and only 1 paper was classified to high quality treatise with above 3 Jaded score.In the 59 papers,52 papers for the total effective rate,18 for neurological deficit score,14 for fasting blood glucose,6 for glycohemoglobin,11 for blood lipid,18 for hemorheology.In 34 papers TCM decoction were used and the using frequencies of Chinese medicine above 10 times were successively Astragalus(28),Lumbricus(27),Salvia(21),Chuanxiong(20),Habitat(19),Angelica(18),Leech(15),Ophiopogon(13),Pueraria(12),Peach kernel(12),Paeonia(11),Graminei(10).Conclusion The treatises are more but most of them generally are low quality absented with the double-blind randomized controlled trial.The limited evidences demonstrated that the pathogenesis of diabetic cerebral infarction mainly belong to Qiyin deficiency,blood stasis and phlegm.And the theraoy combined Chinese and western medicine for diabetic cerebral infarction is better efficacy and security.