Systematic Evaluation And Meta-analysis Of The Clinical Efficacy Of Mudan Granule In The Treatment Of Diabetic Peripheral Neuropathy

Purpose:To evaluate clinical efficacy comprehensively of Mudan granules in treating diabetic peripheral neuropathy using Meta-analysis method by collecting published articles.Material and method:Using electronic competer systematic retrieval China national knowledge infrastructure(CNKI)、Wanfang(WF)、Weipu(VIP)、China biology medicine(CBM)、Pubmed database,collecting Clinical trial literatures on the treatment of diabetic peripheral neuropathy with Mudan granules.The time of retrieval is from the beginning of each database to December 31,2017.Applying Mudan granules and Diabetic peripheral neuropathy as retrieved key words,filtering out the articles that conform to the inclusion criteria.The included articles are evaluated according to the Jadad scale evaluation method,selecting the relevant data to use Revman 5.3 software for meta-analysis.Results: 1.A total of 25 studies are included in the study.The total number of subjects are 2217,of which 1122 are in the experimental groups and 1095 are in the control group.Carrying out statistical analysis of the overall clinical treatment of DPN efficiency of Mudan granule.The result shows that the curative effect of Mudan granule in the treatment group is better than in the control group.There is significant differences between the groups(OR=4.17,95%CI[3.31,5.27],Z=12.05,P<0.00001).2.Subgroup analysis is performed on whether the experimental group is treated with a combination of Western medicine.The results show that in the aspect of treating DPN,there is significant difference in the curative effect of Mudan granule combined with western medicine than the use of Western medicine alone and the effect value is OR=4.06,95% CI[3.13,5.27],Z=10.55,P<0.00001.There is significant difference in the curative effect of Mudan granule than the use of Western medicine and the effect value is OR=3.93,95%CI [2.55,6.06],Z=6.21,P<0.00001.3.Subgroup analysis is performed according to the length of treatment.The result shows that there is significant difference in the curative effect of Mudan granule than the use of Western medicine alone when the treatment course is less than 4 weeks(OR=4.04,95%CI[3.00,5.43],Z=9.24,P<0.00001);while the treatment course is over 4 weeks(OR=4.40,95% CI[3.03,6.41],Z=7.75,P<0.00001).4.In the aspect of motor nerve conduction velocity,there is significant difference in the curative effect of Mudan granule than the control group,the effect measure of median motor nerve conduction velocity is MD=5.69,95%CI[3.67,7.70],Z=5.53,P<0.00001,and the effect measure of common peroneal motor nerve conduction velocity is MD=5.88,95%CI[4.58,7.18],Z=8.86,P<0.00001.In the aspect of sensory nerve conduction velocity,there is significant difference in the curative effect of Mudan granule than the control group,the effect measure of median sensory nerve conduction velocity is MD=6.66,95% CI[4.26,9.07],Z=5.43,P<0.00001 and the effect measure of common peroneal sensory nerve conduction velocity is MD=4.8,95%CI[3.56,6.12],Z=7.40,P<0.00001.Conclusion: 1.In the aspect of treating DPN:The clinical efficacy of Mudan granules treatment group is better than that of the control group.2.The clinical efficacy of Mudan granules combined with Western medicine or Mudan granules alone is better than Western medicine only.And it is not affected by the course of treatment.3.In the aspect of nerve conduction velocity,Mudan granule can improve motor nerve conduction velocity and sensory nerve conduction velocity of the common peroneal nerve and median nerve in patients with DPN.4.This meta-analysis is a single-center,small-sample study that lacks a muti-center,large sample size study.Therefore,it is necessary to adopt a multi-center,randomized,double-blind,large sample size study and the plan is strictly implemented according to clinical trial design.Providing evidence-based medical evidence for clinical trials.