Extracorporeal shock wave therapy (ESWT) favors healing of diabetic foot ulcers: A systematic review and meta-analysis

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes research and clinical practice Pub Date : 2024-09-03 DOI:10.1016/j.diabres.2024.111843

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Abstract

Aims

To investigate the efficacy and safety of extracorporeal shockwave therapy(ESWT) for diabetic foot ulcers(DFUs).

Methods

Search in PubMed, EMBASE, the Cochrane Controlled Register of Trials (CENTAL), and Web of Science for randomized controlled trials (RCTs) published before August 8, 2023. All identified studies were screened following the selection criteria. Finally, we employed the STATA 14.0 software for conducting a meta-analysis to evaluate the efficacy and safety of ESWT.

Results

A total of ten RCTs with moderate methodological quality were included for data analysis. The findings showed that ESWT was significantly associated with significantly complete healed ulcers (risk ratio [RR]: 1.57, 95 % confidence interval [CI]:1.26 to 1.95) and lower rate of unchanged ulcers (RR: 0.25, 95 %CI: 0.14 to 0.42) compared to controls. Subgroup analysis further revealed that ESWT was better than both hyperbaric oxygen therapy (HOT) and the standard of care (SOC). Moreover, ESWT also significantly improved the average transcutaneous partial oxygen pressure (TcPO2) (mean difference[MD]: 1.71, 95 %CI: 1.22 to 2.19, p < 0.001). However, the rate of ≥ 50 % improved ulcers and treatment-emergent adverse events (TEAEs) were not significantly different between the ESWT and controls.

Conclusions

ESWT has shown promising efficacy and a favorable safety profile in the treatment of DFUs.

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体外冲击波疗法（ESWT）有利于糖尿病足溃疡的愈合：系统回顾和荟萃分析。

目的：研究体外冲击波疗法（ESWT）治疗糖尿病足溃疡（DFUs）的有效性和安全性：在PubMed、EMBASE、Cochrane对照试验登记（CENTAL）和Web of Science中搜索2023年8月8日之前发表的随机对照试验（RCT）。我们按照筛选标准对所有确定的研究进行了筛选。最后，我们使用 STATA 14.0 软件进行了荟萃分析，以评估 ESWT 的有效性和安全性：结果：我们共纳入了 10 项方法学质量中等的 RCT 进行数据分析。结果显示，与对照组相比，ESWT 与溃疡明显完全愈合（风险比 [RR]：1.57，95% 置信区间 [CI]：1.26 至 1.95）和溃疡未愈合率较低（RR：0.25，95%CI：0.14 至 0.42）有显著相关性。分组分析进一步显示，ESWT 的效果优于高压氧疗法（HOT）和标准护理（SOC）。此外，ESWT 还能明显改善平均经皮氧分压（TcPO2）（平均差[MD]：1.71, 95 %CI: 1.22 to 2.19, p 结论：ESWT 在治疗 DFU 方面具有良好的疗效和安全性。

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.