Meta-analysis of Traditional Chinese Medicine Combined with Anti-VEGF Treat-ment for Wet Age-related Macular Degeneration Using the Tonifying Deficiency and Clearing Turbidity Method
Meta-analysis of Traditional Chinese Medicine Combined with Anti-VEGF Treat-ment for Wet Age-related Macular Degeneration Using the Tonifying Deficiency and Clearing Turbidity Method
韩治华 1吴雪梅 1冀璐 1吴沂旎 1安胜2
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作者信息
1. 陕西省中医医院,西安 710003
2. 陕西摩美得气血和制药有限公司研发中心医学部,西安 712000
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摘要
目的 系统评价"补虚化浊法"中药联合抗血管内皮生长因子(VEGF)治疗湿性年龄相关性黄斑变性(wAMD)的临床疗效.方法 检索PubMed、Web of Science、Embase、中国知网、万方、维普、中国生物医学文献数据库中应用"补虚化浊法"中药治疗wAMD的随机对照试验文献,检索时间为建库至2023年5月31日,对文献按照纳入标准与排除标准进行筛选和数据录取,采用Cochrane软件评价文献质量,采用RevMan 5.4软件进行统计分析.结果 共纳入13项研究,包括患者1,002例(1,041只眼),其中采用"补虚化浊法"联合抗VEGF治疗的治疗组501例(523只眼),单纯抗VEGF治疗的对照组501例(518只眼).治疗组在提高国际标准视力[MD=0.100,95%CI(0.050,0.140),Z=4.310,P=0.000]、LogMAR视力[MD=-0.080,95%CI(-0.110,-0.050),Z=5.560,P=0.000]、视力总有效率[OR=2.070,95%CI(1.280,3.340),Z=2.970,P=0.000]、降低黄斑中心凹厚度[MD=-19.130,95%CI(-24.940,-13.310),Z=6.450,P=0.000]、提高荧光渗漏吸收率[OR=4.910,95%CI(2.870,8.400),Z=5.800,P=0.000]、提高临床总有效率[OR=3.810,95%CI(1.990,7.310),Z=4.030,P=0.000]方面优于对照组,差异均有统计学意义.结论 "补虚化浊法"中药联合抗VEGF治疗wAMD疗效优于单纯抗VEGF治疗.
Abstract
OBJECTIVE To systematically evaluate the clinical efficacy of Traditional Chinese Medicine(TCM)combined with anti-vascular endothelial growth factor(VEGF)treatment in wet age-related macular degeneration(wAMD)using the tonifying deficiency and clearing turbidity method.METHODS PubMed,Web of Science,Embase,CNKI,Wanfang Database,VIP Database,and China Biomedical Literature Database were searched for randomized controlled trials using the tonifying deficiency and clearing turbidity TCM method for wAMD treatment.The search was conducted from database inception to May 31st,2023.Literature screening and data extraction were performed based on inclusion and exclusion criteria.Cochrane software was used to assess the quality of the literature,and RevMan 5.4 software was used for statistical analysis.RESULTS A total of 13 studies were included,comprising 1,002 patients(1,041 eyes),with 501 patients(523 eyes)in the treatment group receiving TCM combined with anti-VEGF treatment,and 501 patients(518 eyes)in the control group receiving only anti-VEGF treatment.The treatment group showed statistically significant improvements compared to the control group in terms of improving international standard visual acuity[MD=0.100,95%CI(0.050,0.140),Z=4.310,P=0.000],LogMAR visual acuity[MD=-0.080,95%CI(-0.110,-0.050),Z=5.560,P=0.000],overall visual efficacy rate[OR=2.070,95%CI(1.280,3.340),Z=2.970,P=0.000],reducing central macular thickness[MD=-19.130,95%CI(-24.940,-13.310),Z=6.450,P=0.000],increasing fluorescein leakage absorption rate[OR=4.910,95%CI(2.870,8.400),Z=5.800,P=0.000],and improving total clinical efficacy rate[OR=3.810,95%CI(1.990,7.310),Z=4.030,P=0.000],all differences were statistically significant.CONCLUSIONS TCM combined with anti-VEGF treatment using the tonifying deficiency and clearing turbidity method is more effective for wAMD than anti-VEGF treatment alone.
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