A Systematic Review Of The Efficacy And Safety Of Danggui Sini Decoction In The Treatment Of Diabetic Peripheral Neuropathy

OBJECTIVE:The efficacy and safety of danggui sini decoction in the treatment of diabetic peripheral neuropathy were systematically evaluated by meta analysis method,so as to guide clinical drug selection.METHODS:Using computer to retrieve CNKI,Wanfang full-text database,VIP,Chinese biomedical literature database,Medline,EMBase,Ovid,Cochrane and other database,screening randomized controlled trial on the treatment of diabetic peripheral neuropathy with danggui sini decoction,retrieval time span from the building up of database to December 31,2017.Inclusion criteria:On the basis of routine treatment,patients in experimental group were treated with danggui sini decoction or danggui sini decoction combined with western medicine,patients in control group were treated with western medicine or nothing.Taking total efficiency as the main outcome index.The documents qualified for quality evaluation were included,using RevMan5.3 to conduct a meta analysis.RESULTS:This study include 33 documents,2713 patients with diabetic peripheral neuropathy.Meta analysis results showed that:① Danggui sini decoction compared with western medicine or nothing:the valid rate of danggui sini decoction treatment group was significantly higher than the control group,[RR=1.36,95%CI(1.28,1.46),P<0.00001];Median nerve motor nerve conduction velocity improved significantly better than the control group,[MJD=1.64,95%CI(0.30,2.99)’ P=0.02];There was no significant difference in the improvement of the conduction velocity of the median sensory nerve compared with the control group,[MD=0.91,95%CI(-0.13,1.96),P=0.09];Peroneal nerve motor nerve conduction velocity improved significantly better than the control group;Peroneal nerve sensory nerve conduction velocity improved significantly better than the control group;Tibial nerve motor nerve conduction velocity improved significantly better than the control group;Tibial nerve sensory nerve conduction velocity improved significantly better than the control group.② Danggui sini decoction combined with western medicine compared with western medicine:the valid rate of danggui sini decoction combined with western medicine treatment group was significantly higher than the control group,[RR=1.26,95%CI(1.21,1.32),P<0.00001];Median nerve motor nerve conduction velocity improved significantly better than the control group;Median nerve sensory nerve conduction velocity improved significantly better than the control group;Peroneal nerve motor nerve conduction velocity improved significantly better than the control group;Peroneal nerve sensory nerve conduction velocity improved significantly better than the control group;Tibial nerve motor nerve conduction velocity improved significantly better than the control group,[MD=2.03,95%CI(0.86,3.20),P=0.0007];Tibial nerve sensory nerve conduction velocity improved significantly better than the control group,[MD=2,65,95%CI(1.53,3.76),P<0.00001];The scores of Toronto clinical scoring system were significantly higher than the control group.③The 33 study included,only 4 studies reported there had been no adverse reactions,2 studies reported there had been adverse reactions,but there was no difference between the two groups,other studies were not mentioned.CONCLUSION:①The improvement of valid rate and conduction velocity of median nerve motor nerve,peroneal nerve motor nerve,peroneal nerve sensory nerve,tibial nerve motor nerve,tibial nerve sensory nerve,of patients who had been treated with danggui sini decoction,were significantly better than those who had been treated with western medicine,there was no significant difference in the improvement of the conduction velocity of the median sensory nerve between danggui sini decoction and western medicine.② The improvement of valid rate and conduction velocity of median nerve motor nerve,median nerve sensory nerve,peroneal nerve motor nerve,peroneal nerve sensory nerve,tibial nerve motor nerve,tibial nerve sensory nerve,and the scores of TCSS,of patients who had been treated with danggui sini decoction combined with western medicine,were significantly better than those who had bean treated with western medicine.③ The quality of studies included is generally not high,most studies do not mention adverse reactions.Therefore,the long-term efficacy and safety of danggui sini decoction in the treatment of diabetic peripheral neuropathy can not be evaluated.