{"title":"电刺激治疗糖尿病溃疡的比较疗效和安全性：随机对照试验的网络荟萃分析。","authors":"Jiaxin Zhong, Yi Lan, Zixin Cai","doi":"10.1007/s12325-025-03380-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic ulcers (DUs) are a common complication of diabetes, significantly impairing quality of life and placing a burden on healthcare systems. Electrical stimulation (ES) therapy is a non-invasive technique that promotes wound healing using various current types, including direct current (DC), pulsed current (PC), and alternating current (AC). However, the comparative efficacy and safety of these ES modalities for DUs remain unclear.</p><p><strong>Methods: </strong>This study presents a network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing the efficacy and safety of various ES therapies for DU treatment. A comprehensive literature search was conducted to identify studies evaluating ulcer healing rates, the number of healed ulcers, and adverse events. The treatments analyzed included symmetry biphasic square-wave pulse, asymmetric biphasic square-wave pulse, very low levels of stimulation current, twin-peak monophasic pulse, cathodal direct current (CDC), high-voltage pulsed current (HVPC), and low-intensity biphasic pulse current. The SUCRA (surface under the cumulative ranking curve) and mean rank values were used to assess the relative effectiveness of each modality.</p><p><strong>Results: </strong>The analysis included data from 11 RCTs. Treatment effects were compared using SUCRA and mean ranking values. HVPC, CDC, and asymmetric biphasic square-wave pulse were ranked highest for ulcer healing rates and the number of healed ulcers, with asymmetric biphasic square-wave pulse demonstrating the most consistent efficacy across these outcomes.</p><p><strong>Conclusion: </strong>This network meta-analysis suggests that HVPC, CDC, and asymmetric biphasic square-wave pulse are the most effective ES therapies for promoting DU healing.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0000,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative Efficacy and Safety of Electrical Stimulation Therapies for Diabetic Ulcers: A Network Meta-analysis of Randomized Controlled Trials.\",\"authors\":\"Jiaxin Zhong, Yi Lan, Zixin Cai\",\"doi\":\"10.1007/s12325-025-03380-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Diabetic ulcers (DUs) are a common complication of diabetes, significantly impairing quality of life and placing a burden on healthcare systems. Electrical stimulation (ES) therapy is a non-invasive technique that promotes wound healing using various current types, including direct current (DC), pulsed current (PC), and alternating current (AC). However, the comparative efficacy and safety of these ES modalities for DUs remain unclear.</p><p><strong>Methods: </strong>This study presents a network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing the efficacy and safety of various ES therapies for DU treatment. A comprehensive literature search was conducted to identify studies evaluating ulcer healing rates, the number of healed ulcers, and adverse events. The treatments analyzed included symmetry biphasic square-wave pulse, asymmetric biphasic square-wave pulse, very low levels of stimulation current, twin-peak monophasic pulse, cathodal direct current (CDC), high-voltage pulsed current (HVPC), and low-intensity biphasic pulse current. The SUCRA (surface under the cumulative ranking curve) and mean rank values were used to assess the relative effectiveness of each modality.</p><p><strong>Results: </strong>The analysis included data from 11 RCTs. Treatment effects were compared using SUCRA and mean ranking values. HVPC, CDC, and asymmetric biphasic square-wave pulse were ranked highest for ulcer healing rates and the number of healed ulcers, with asymmetric biphasic square-wave pulse demonstrating the most consistent efficacy across these outcomes.</p><p><strong>Conclusion: </strong>This network meta-analysis suggests that HVPC, CDC, and asymmetric biphasic square-wave pulse are the most effective ES therapies for promoting DU healing.</p>\",\"PeriodicalId\":7482,\"journal\":{\"name\":\"Advances in Therapy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Advances in Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12325-025-03380-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12325-025-03380-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Comparative Efficacy and Safety of Electrical Stimulation Therapies for Diabetic Ulcers: A Network Meta-analysis of Randomized Controlled Trials.
Introduction: Diabetic ulcers (DUs) are a common complication of diabetes, significantly impairing quality of life and placing a burden on healthcare systems. Electrical stimulation (ES) therapy is a non-invasive technique that promotes wound healing using various current types, including direct current (DC), pulsed current (PC), and alternating current (AC). However, the comparative efficacy and safety of these ES modalities for DUs remain unclear.
Methods: This study presents a network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing the efficacy and safety of various ES therapies for DU treatment. A comprehensive literature search was conducted to identify studies evaluating ulcer healing rates, the number of healed ulcers, and adverse events. The treatments analyzed included symmetry biphasic square-wave pulse, asymmetric biphasic square-wave pulse, very low levels of stimulation current, twin-peak monophasic pulse, cathodal direct current (CDC), high-voltage pulsed current (HVPC), and low-intensity biphasic pulse current. The SUCRA (surface under the cumulative ranking curve) and mean rank values were used to assess the relative effectiveness of each modality.
Results: The analysis included data from 11 RCTs. Treatment effects were compared using SUCRA and mean ranking values. HVPC, CDC, and asymmetric biphasic square-wave pulse were ranked highest for ulcer healing rates and the number of healed ulcers, with asymmetric biphasic square-wave pulse demonstrating the most consistent efficacy across these outcomes.
Conclusion: This network meta-analysis suggests that HVPC, CDC, and asymmetric biphasic square-wave pulse are the most effective ES therapies for promoting DU healing.
期刊介绍：
Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged.
The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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