Long-term efficacy and safety of Huangqi ()-based Traditional Chinese Medicine in diabetic peripheral neuropathy: a Meta-analysis of randomized controlled trials.

Ping Jing, Hao Hongzheng, W U Zhenqi, Zou Meijuan, L I Zuojing, Cheng Gang
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Abstract

Objective: To assess the long-term effectiveness of Huangqi (Radix Astragali Mongolici, HQ)-based Traditional Chinese Medicine (TCM) in the treatment of diabetic peripheral neuropathy (DPN).

Methods: Nine databases were searched to retrieve available randomized controlled trials that compared HQ-based TCM and Western Medicines in the treatment of DPN. The methodological quality of the included studies was assessed using the Cochrane bias risk tool, and RevMan 5.4 was used for data analysis. The effect estimates of interest were risk ratio (RR), mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI).

Results: The results from 48 available studies assessing 3759 patients demonstrated that cases administered HQ-based TCM [RR = 1.30, 95% CI (1.21, 1.40), P < 0.000 01] or HQ-based TCM combined with Western Medicines [RR = 1.25, 95% CI (1.19, 1.31), P < 0.000 01] exhibited higher total efficacy rates than individuals who received Western Medicine alone. The results showed that the HQ-based TCM group had decreased Toronto Clinical Scoring System scores [MD =-1.50, 95% CI (-1.83, -1.17), P < 0.000 01], and reduced serum interleukin 6 [SMD = -0.57, 95% CI (-0.87, -0.27), P = 0.0002] and tumor necrosis factors-α levels [SMD = -0.60, 95% CI (-0.95, -0.25), P = 0.0009]. In addition, both HQ-based TCM and HQ-based TCM combined with Western Medicine increased nerve conduction velocity and decreased glycaemia compared with Western Medicine alone. In terms of blood lipids, oxidative stress and adverse drug reactions, there were no significant differences between the HQ-based TCM groups and the Western Medicine control group.

Conclusion: The current Meta-analysis revealed that HQ-based TCM yields higher efficacy and safety than Western Medicine alone for the treatment of DPN, although further well-designed RCTs are required to validate these findings.

黄芪中药对糖尿病周围神经病变的长期疗效和安全性:随机对照试验的 Meta 分析。
目的评估以黄芪为基础的中药治疗糖尿病周围神经病变(DPN)的长期疗效:方法:检索了九个数据库,以检索现有的随机对照试验,这些试验比较了以黄芪为基础的中药和西药治疗 DPN 的效果。使用 Cochrane 偏倚风险工具评估了纳入研究的方法学质量,并使用 RevMan 5.4 进行了数据分析。效果估计值为风险比(RR)、平均差(MD)或标准化平均差(SMD)及 95% 置信区间(CI):48项研究共评估了3759名患者,结果表明,与单独接受西药治疗的患者相比,服用以HQ为基础的中药[RR = 1.30,95% CI (1.21,1.40),P < 0.000 01]或以HQ为基础的中药联合西药[RR = 1.25,95% CI (1.19,1.31),P < 0.000 01]的患者总有效率更高。结果显示,以 HQ 为基础的中药组降低了多伦多临床评分系统评分[MD =-1.50, 95% CI (-1.83, -1.17), P < 0.000 01],降低了血清白细胞介素 6 [SMD = -0.57, 95% CI (-0.87, -0.27), P = 0.0002]和肿瘤坏死因子-α水平[SMD = -0.60, 95% CI (-0.95, -0.25),P = 0.0009]。此外,与单纯西医治疗相比,以 HQ 为基础的中医治疗和以 HQ 为基础的中医治疗联合西医治疗均能提高神经传导速度并降低血糖。在血脂、氧化应激和药物不良反应方面,以 HQ 为基础的中药组与西药对照组之间没有显著差异:目前的 Meta 分析表明,以 HQ 为基础的中医药治疗 DPN 比单纯西药治疗具有更高的疗效和安全性,尽管还需要进一步设计良好的 RCT 来验证这些研究结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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