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. 2023 Mar 6:14:1072991.
doi: 10.3389/fphar.2023.1072991. eCollection 2023.

The efficacy and safety of Chinese herbal medicine in the treatment of painful diabetic neuropathy: A systematic review and meta-analysis

Min Song  1   2 , Baogeng Huai  1 , Zhenpeng Shi  1 , Wenyi Li  1 , Yutan Xi  3 , Zhenguo Liu  1 , Jihang Zhang  1 , Junyu Zhou  1 , Yun Qiao  4 , Deshan Liu  4
Affiliations

The efficacy and safety of Chinese herbal medicine in the treatment of painful diabetic neuropathy: A systematic review and meta-analysis

Min Song et al. Front Pharmacol. .

Abstract

Objective: The objective of this systematic review and meta-analysis is to assess the effectiveness and security of Chinese herbal medicine (CHM) in the therapy of painful diabetic neuropathy (PDN). Methods: We searched databases for randomized controlled trials (RCTs) of CHM in the treatment of PDN. Outcome indicators included nerve conduction velocity, clinical efficiency, pain score, TCM syndrome score, and adverse events. Stata 16.0 was used to carry out the Meta-analysis. Results: A total of 21 RCTs with 1,737 participants were included. This meta-analysis found that using CHM as adjuvant treatment or as monotherapy for PDN can improve SCV of median nerve [mean difference (MD) = 3.56, 95% Confidence interval (CI) (2.19, 4.92) ], MCV of median nerve [ MD = 3.82, 95% CI (2.51, 5.12) ], SCV of common peroneal nerve [ MD = 4.16, 95% CI (1.62, 6.70) ], MCV of common peroneal nerve [ MD = 4.37, 95% CI (1.82, 6.93) ], SCV of gastrocnemius nerve [ MD = 4.95, 95% CI (3.52, 6.37) ], SCV of tibial nerve [ MD = 3.17, 95% CI (-2.64, 8.99) ], MCV of tibial nerve [MD = 6.30, 95%CI (5.00, 7.60)] and clinical effective rate [ odds ratio (OR) = 4.00, 95% CI (2.89, 5.52) ] and reduce pain score [standardized mean difference (SMD) = -2.23, 95% CI (-3.04, -1.41) ], TCM syndrome score [ MD = -4.70, 95% CI (-6.61, -2.80) ]. In addition, compared to the control group, adverse events of Chinese medicine intervention occurred less. Conclusion: CHM as adjuvant therapy or single treatment has a good curative effect and is safe for patients with PDN, which is worthy of clinical promotion and use, however; higher quality clinical studies are still needed to prove. Systematic Review Registration: https://www.crd.york.ac.uk/, identifier CRD42022327967.

Keywords: Chinese herbal medicine; efficacy; meta-analysis; painful diabetic neuropathy; safety; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Prisma 2020 Flow Diagram.
FIGURE 2
FIGURE 2
Risk-of-bias (A) Risk-of-bias graph; (B) Risk-of-bias summary.
FIGURE 3
FIGURE 3
Forest plot of Pain Score.
FIGURE 4
FIGURE 4
Forest plot of SCV of median nerve.
FIGURE 5
FIGURE 5
Forest plot of MCV of median nerve.
FIGURE 6
FIGURE 6
Forest plot of SCV of Common Peroneal Nerve.
FIGURE 7
FIGURE 7
Forest plot of MCV of Common Peroneal Nerve.
FIGURE 8
FIGURE 8
Forest plot (A) SCV of Sural Nerve; (B) SCV of Tibial Nerve; (C) MCV of Tibial Nerve; (D) TCM Syndrome Score.
FIGURE 9
FIGURE 9
Forest plot of Clinical Effective Rates.
FIGURE 10
FIGURE 10
The funnel plot (A) pain score; (B) clinical effective rate; (C) SCV symmetry of median nerve.
See this image and copyright information in PMC

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