臺灣博碩士論文加值系統

目的: 治療糖尿病足潰瘍的方法有很多。 本研究目的是調查第2型糖尿病患者足部潰瘍的不同治療方法 。
研究設計和方法： 為評估糖尿病足潰瘍（DFU）的治療方法，本研究進行臨床試驗的系統評價， 利用薈萃分析評估臨床試驗的結果。本研究採用系統性文獻回顧和統合分析(Meta-Analyses, PRISMA ）的方式分析。本研究於PubMed數據庫和Web-of-Science搜索 1972年１月 至 2017 年 11 月臨床試驗研究， 共取得165篇文章 ， 在165篇文章中，有56篇排除在入選標準的時間範圍之外，剩下109篇 進一步納入篩選。 分別從PubMed和 Web-of-Science 檢索2007年1月至2017年11月的相關之臨床研究，PubMed取得79篇, Web-of-Science取得30篇。本研究僅納入臨床試驗研究，再排除非英文與無相關內容的研究之後，最後只篩選出41篇研究納入本研究。
結果：篩選165例符合條件的對照試驗，其中41例保留用於本系統評價和薈萃分析。總體而言，分組分析結果顯示，在治療方案中添加抗炎劑或標準足部護理均有效果; （勝算比（OR）0.17,95％信賴區間（CI）0.06-0.50; p = 0.001）和標準治療組與對照組（勝算比（OR）0.37,95％信賴區間（CI）0.23-0.58; p <0.0001）。該系統性文獻回顧和統合分析結果提出確保抗炎藥和標準足部護理在DFU治療中起重要作用的證據。

Objective: There are many treatment approaches towards diabetic foot ulcers. The aim of this study was to investigate the different treatment methods among type 2 diabetes mellitus patients with foot ulcers.
Research design and methods: A systematic review of clinical trials was conducted in order to assess treatments for diabetic foot ulcers (DFU). A meta-analysis was utilized in estimating the results from the included clinical trials. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was adopted for the preferred reporting items in this study. Clinical trial searches were conducted on databases PubMed and Web-of-Science using the time span January 1972 to November 2017, one hundred and sixty five (165) articles were sourced, of the one hundred and sixty five (165) articles sourced, fifty six (56) were excluded due to the time span allocated to the inclusion criteria and one hundred and nine (109) remained and underwent further screening for inclusion. Only clinical trials were included in this this analysis. At the end of the screening process, a total of forty one (41) studies were included in this systematic review and meta-analysis.
Results: One hundred and sixty five eligible control trials were screened and forty one retained for this systematic review and meta-analysis. Overall, subgroup analysis results show that the additions of anti-inflammatory agents or standard foot care to treatment regimens are both favorable in the treatment of DFUs; anti-inflammatory agent with treatment group versus the control group difference (mean difference (OR) 0.17, 95% confidence interval (CI) 0.06–0.50; p =0.001) and standard care with treatment group versus the control group (mean difference (OR) 0.37, 95% confidence interval (CI) 0.23–0.58; p <0.0001). This systematic review and meta-analysis proposes assuring evidence of the significant role both anti-inflammatory agents and standard foot care play in DFU treatment.

TABLE OF CONTENTS
Acknowledgement 3

Chinese Abstract 5

English Abstract 7

LIST OF TABLES 11

LIST OF FIGURES 12 10

LIST OF ABBREVIATIONS 13

Chapter 1 Introduction 15

I Background of research 15
II Significance 20
III Purpose of study 21
IV Definition of variables 21

Chapter 2 Literature Review 24

I Link between Diabetes and Foot Ulcers 24
II Risk factors of foot ulcers in DM2 patients 28
III Treatment for Diabetic Foot Ulcers 31


Chapter 3 Methods 34

I Data source and studies selection 34
II Inclusion and exclusion criteria 34
III Statistical analysis 37

Chapter 4 Results 39

I Articles screening 39
II Participants and studies characteristics 41
III Quality assessment 59
IV Publication bias 60
V Meta-analysis 60
VI Studies outputs 72

Chapter 5 Discussion 95

Chapter 6 Conclusion and Suggestions 97

REFERENCES 99

APPENDIX 115

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