Evaluation Of The Efficacy Of TCM External Therapy Combined With Methylcobalamin In The Treatment Of Diabetic Peripheral Neuropath

Objective: Through the Net Meta technology,we compared moxibustion,acupuncture,Chinese Herbal Fumigation intervention methods combined with oral Mecobalamin in the treatment of Diabetes Peripheral Neuropathy,and chose the best plan.Methods: Based on the comprehensive search of "Diabetic Peripheral Neuropathy","Mecobalamin","Chinese Medicine External Treatment","Acupuncture","Moxibustion"," needling" and "Chinese Medicine Fumigation",and free words to databases such as How Net,Wan Fang,VIP and Pub Med,we searched the RCT literature on the treatment of Diabetic Peripheral Neuropathy with Mecobalamin from January 2011 to December 2021.According to the inclusion criteria and exclusion criteria,the included literature was screened,the basic data were extracted and the literature quality was evaluated.Finally,Rev Man5.3、Stata 16.0and R 4.0.3 software were used to Net Meta analysis,and observe the Clinical Efficacy(Effectiveness),TCSS,MNCV(common peroneal nerve),SNCV(median nerve).Results:1.A total of 46 randomized controlled literature were included,involving 4038 patients with Diabetes Peripheral Neuropathy,3 kinds of external therapies in Traditional Chinese Medicine(Moxibustion,Acupuncture,Herbal Fumigation).2.The results of the network Meta-analysis showed that the external treatment of traditional Chinese medicine combined with oral mecobalamin intervention improved the outcome of diabetic peripheral neuropathy better than oral mecobalamin alone,among which in terms of clinical effectiveness: acupuncture combined with mecobalamin> Traditional Chinese medicine fumigation combined with mecobalamin > moxibustion combined with mecobalamin > mecobalamin alone;in terms of improving TCSS score,traditional Chinese medicine fumigation combined with mecobalamin > acupuncture combined with mecobalamin > moxibustion combined with mecobalamin > simple Methylcobalamin treatment;in terms of improving MNCV-motor nerve conduction velocity(common peroneal nerve),moxibustion combined with mecobalamin > traditional Chinese medicine fumigation combined with mecobalamin > acupuncture combined with mecobalamin > mecobalamin alone;In terms of SNCV-sensory nerve conduction velocity(median nerve),moxibustion combined with mecobalamin > acupuncture combined with mecobalamin > traditional Chinese medicine fumigation combined with mecobalamin > mecobalamin alone.Conclusions:1.Comprehensive conclusions based on low-quality literature: TCM external therapy combined with mecobalamin in the treatment of diabetic neuropathy is better than mecobalamin alone.Among them,acupuncture combined with mecobalamin is the best in terms of clinical effectiveness,and traditional Chinese medicine fumigation combined with washing is the best in terms of clinical effectiveness.The mecobalamin treatment regimen was the best in improving TCSS scores,and the moxibustion combined with mecobalamin treatment regimen was the best in improving nerve conduction velocity.2.Net Meta analysis can evaluate the Clinical Efficacy of more than two groups of intervention methods at the same time,which is better than ordinary metaanalysis.3.Chinese Medicine External Treatment to improve Diabetes Peripheral Neuropathy related indicators and external treatment of Chinese Medicine can directly reach the role of drugs,blood circulation,dredging collateral.