Meta-analysis of efficacy of Taohong Siwu Decoction in the treatment of diabetic peripheral neuropathy

Objective:To evaluate the clinical efficacy of combined/single use of Taohong Siwu decoction in the treatment for diabetic peripheral neuropathy(DPN)by meta-analysis.Methods:Database were searched electronically from the time databases established to November 2020 to collect randomized controlled trials of Taohong Siwu decoction combined with non-specific therapy for DPN in Chinese or English.The trial was assessed by 2 researchers independently,RevMan 5.3 software was used for meta-analysis.Results:A total of 13 studies included 970 patients.Meta-analysis showed that the combined/single use of Taohong Siwu decoction can further improve median sensory nerve velocity〔MD=4.86,95%CI(2.70,7.03),P<0.00001〕,and the curative effect〔OR=4.35,95%CI(3.1,6.06),P<0.00001〕,increase the velocity of the motor nerve〔MD=6.84,95%CI(6.14,7.55),P<0.00001〕,and the velocity of the sensory nerve〔MD=7.46,95%CI(5.84,9.08),P<0.00001〕,decrease TCM syndrome score〔MD=-5.61,95%CI(-6.63,-4.60),P<0.00001〕,and fasting blood-glucose〔MD=-0.24,95%CI(-0.37,-0.11),P<0.00001〕.The GRADE showed B level of evidence.Conclusion:Combined/single use of Taohong Siwu decoction in the treatment for DPN is effective.The safety is not clear,and more high-quality clinical studies are expected to be included to provide evidence support.

The efficacy and safety of Chinese herbal medicine combined with ACEI/ARB fortreatment of incipient diabetic nephropathy： Ameta-analysis

Objective： This meta- analysis evaluated the efficacy and safety of Chinese herbal medicine （CHM） combined withangiotensin-converting enzyme inhibitors （ACEIs） and/or angiotensin-receptor blockers （ARBs）for treatment ofincipient diabetic nephropathy（IDN）. Methods： Nine data bases were searched for randomized controlled trials ofChinese herbal medicine（CHM） and ACEI/ARB for treatment of IDN. Included articles were published betweenJanuary2006 and December 2016. All studies were divided into prescriptions containing both Astragali Radix andRehmanniae Radix （i subgroup）, Astragali Radix（Huangqi） or Rehmanniae Radix（Dihuang） （ii subgroup）, neitherAstragali Radix nor Rehmanniae Radix （iii subgroup）. Review Manager 5.3 was used for subgroup analysis.Results： In total, 28 RCTs with 2017 patients were included. The results showed 1）the urinary albumin excretionrate （UAER） can be reduced significantly using CHM with ACEI or ARB for treatment of IDN compared to ACEIor ARB alone, and reduction of the UAER of the i subgroup was superior to that of the other two subgroups;2）serum creatinine （Scr） levels can be reduced significantly using CHM combined with ACEI or ARB, andreduction of Scr in the ii subgroup was superior to that in the iii subgroup; 3）reduction of BUN in group A was notbetter than that in group B. Conclusion： In summary, CHMs combined with ACEI/ARB can decrease UAER andScr significantly compared to the use of ACEI/ARB during IDN treatment. The effect was more significant in theCHM group containing Astragali Radix or Rehmanniae Radix. The application of Astragali Radix and RehmanniaeRadix should be emphasized in third stage diabetic nephropathy.