OBJECTIVE:To evaluate the efficacy and safety of Buyang Huanwu decoction(BYHWD)in treating diabetic peripheral neuropathy(DPN).METHODS:Eight electronic databases,including China National Knowledge Infrastructure Datab...OBJECTIVE:To evaluate the efficacy and safety of Buyang Huanwu decoction(BYHWD)in treating diabetic peripheral neuropathy(DPN).METHODS:Eight electronic databases,including China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,Chinese Biomedical Literature Database,Cochrane Library,Embase,Web of Science,and PubM ed,were searched for randomized controlled trials(RCTs)of BYHWD to treat DPN.We identified all RCTs related to BYHWD and those on the treatment of DPN with the combination of mecobalamin.RevMan software was used for the statistical analysis.RESULTS:Twenty-one RCTs with a total of 1945 patients were included.The methodological quality of the literature included was low.Meta-analysis showed that the efficacy of the treatment group was significantly better than that of the control group in the treatment of DPN with BYHWD[risk ratio(RR)=0.33,95%CI(0.27,0.40),Z=11.25,P<0.00001].The median nerve of median motor nerve conduction velocity(MNCV)[mean difference(MD)=4.16,95%CI(1.35,6.98)]and median sensory NCV(SNCV)[(MD=3.28,95%CI(2.35,4.22)]were improved in the treatment group.The MNCV in the common peroneal nerve[(MD=1.63,95%CI(0.39,2.87)]and SNCV[(MD=4.56,95%CI(3.16,5.97)]were significantly higher than those in the control group(P<0.01).Plasma viscosity[(MD=-0.15,95%CI(-0.20,-0.09),Z=5.17,P<0.01)],whole blood high shear[(MD=-0.83,95%CI(-1.56,-0.11),Z=2.26,P=0.02)]and whole blood low shear[(MD=-1.61,95%CI(-2.28,-0.94),Z=4.68,P<0.01)]decreased significantly after treatment.There was no significant difference in fasting blood glucose[(MD=-0.42,95%CI(-0.89,0.05),Z=1.76,P=0.08)]between the treatment and control groups;postprandial blood glucose[(MD=-0.62,95%CI(-1.19,0.05),Z=2.12,P=0.03)]decreased significantly.No significant difference was found in the blood lipid levels between the treatment and control groups,including triglycerides[(MD=-0.21,95%CI(-0.52,0.10),Z=1.34,P=0.18)]and cholesterol[(MD=-0.13,95%CI(-0.27,0.00),Z=1.92,P=0.06)].Of the 21 RCTs,only five reported adverse reactions,and four studies reported the length of follow-up.No serious adverse events were reported.None of the studies reported the quality of life and economic conditions.CONCLUSIONS:Our study suggests that BYHWD has a significant therapeutic effect on DPN.High-quality,largescale RCTs are needed to provide more reliable evidence.展开更多
基金Natural Science Foundation-funded Project:Optimization of Distribution of Anti-Diabetes Traditional Chinese Medicine based on Glucose Metabolism Signal Pathway and Uniform Design(No.7182143)。
文摘OBJECTIVE:To evaluate the efficacy and safety of Buyang Huanwu decoction(BYHWD)in treating diabetic peripheral neuropathy(DPN).METHODS:Eight electronic databases,including China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,Chinese Biomedical Literature Database,Cochrane Library,Embase,Web of Science,and PubM ed,were searched for randomized controlled trials(RCTs)of BYHWD to treat DPN.We identified all RCTs related to BYHWD and those on the treatment of DPN with the combination of mecobalamin.RevMan software was used for the statistical analysis.RESULTS:Twenty-one RCTs with a total of 1945 patients were included.The methodological quality of the literature included was low.Meta-analysis showed that the efficacy of the treatment group was significantly better than that of the control group in the treatment of DPN with BYHWD[risk ratio(RR)=0.33,95%CI(0.27,0.40),Z=11.25,P<0.00001].The median nerve of median motor nerve conduction velocity(MNCV)[mean difference(MD)=4.16,95%CI(1.35,6.98)]and median sensory NCV(SNCV)[(MD=3.28,95%CI(2.35,4.22)]were improved in the treatment group.The MNCV in the common peroneal nerve[(MD=1.63,95%CI(0.39,2.87)]and SNCV[(MD=4.56,95%CI(3.16,5.97)]were significantly higher than those in the control group(P<0.01).Plasma viscosity[(MD=-0.15,95%CI(-0.20,-0.09),Z=5.17,P<0.01)],whole blood high shear[(MD=-0.83,95%CI(-1.56,-0.11),Z=2.26,P=0.02)]and whole blood low shear[(MD=-1.61,95%CI(-2.28,-0.94),Z=4.68,P<0.01)]decreased significantly after treatment.There was no significant difference in fasting blood glucose[(MD=-0.42,95%CI(-0.89,0.05),Z=1.76,P=0.08)]between the treatment and control groups;postprandial blood glucose[(MD=-0.62,95%CI(-1.19,0.05),Z=2.12,P=0.03)]decreased significantly.No significant difference was found in the blood lipid levels between the treatment and control groups,including triglycerides[(MD=-0.21,95%CI(-0.52,0.10),Z=1.34,P=0.18)]and cholesterol[(MD=-0.13,95%CI(-0.27,0.00),Z=1.92,P=0.06)].Of the 21 RCTs,only five reported adverse reactions,and four studies reported the length of follow-up.No serious adverse events were reported.None of the studies reported the quality of life and economic conditions.CONCLUSIONS:Our study suggests that BYHWD has a significant therapeutic effect on DPN.High-quality,largescale RCTs are needed to provide more reliable evidence.
