Open Access自体富血小板凝胶治疗糖尿病慢性皮肤溃疡:随机对照试验的meta分析
Author(s) -
Li Yan,
Gao Yunyi,
Gao Yun,
Chen Dawei,
Wang Chun,
Liu Guanjian,
Yang Xin,
Ran Xingwu
Publication year - 2019
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.12850
Subject(s) - medicine , meta analysis , cochrane library , randomized controlled trial , subgroup analysis , odds ratio , diabetic foot , confidence interval , diabetes mellitus , relative risk , medline , surgery , political science , law , endocrinology
Background In recent years, many studies have reported that autologous platelet‐rich gel (APG) is an effective adjuvant treatment for chronic cutaneous ulcers in diabetics. The aim of this study was to explore the efficacy and safety of APG for the topical treatment of diabetic chronic cutaneous ulcers. Methods The China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals (VIP), Chinese Wanfang database, PubMed, EMBASE, EBSCOhost, and Cochrane Library were systematically searched for relevant studies published up to 18 October 2017. Fixed‐ and random‐effects models were used to calculate risk ratios (RR), odds ratios (ORs), and mean difference (MD) with 95% confidence intervals (95% CI). Subgroup analyses were conducted according to the Diabetic Foot Wagner Classification. Results Fifteen randomized control trials (RCTs) with 829 patients were eligible for inclusion in this analysis. Compared with standard care or conventional treatment, APG significantly improved the healing rate (RR 1.39; 95% CI 1.29, 1.50; P < 0.00001), shortened the healing time (MD ‐9.18; 95% CI −11.32, −7.05; P < 0.00001), and reduced the incidence of infection (OR 0.34; 95% CI 0.15, 0.77; P = 0.009). Conclusions Current evidence suggests that APG is effective and safe, and is feasible for use as an adjuvant treatment for diabetic ulcers, especially chronic refractory ulcers. However, more RCTs with a good design and of a high quality are needed before the use of APG can be implemented widely.