Meta - Analysis Of Therapeutic Effect Of Traditional Chinese Medicine On Diabetic Peripheral Neuropathy

Purpose:To evaluate the clinical efficacy of Traditional Chinese Medicine compound on treating DPN and discuss the prescription regularity of Traditional Chinese Medicine compound.Material and method : Searching the Chinese National Knowledge Infrastructure(CNKI);VIP;Wanfang Data.All database retrieval time started from building the librarys to March 15, 2015.Using "Diabetes peripheral neuropathy" as main key word, merged "decoction, prescription,method,drink" one of the four words as searching keywords.Using the modified Jadad score standard to evaluate the quality of the included literatures.The meta-analysis performed by Rev Man5.3 and used Rev Man5.3 to process heterogeneity inspection.Selecting the corresponding statistical model according to the results of the heterogeneity inspection.Ending Effect index presented by odds ratio(OR) or the mean difference(MD), both within 95% confidence interval(CI).The analysis of usage frequency of Chinese herbal medicines performed by excel.Results:23 randomized controlled trials were included in this paper,1926 patients were included in those 23 literatures,932 patients were in treatment group,932 patients were in control group.Sample capacity was from 37 to 203;intervention methods、course of the treatment and the test results were all stated in these literatures.The results showed curative effect comprehensive efficacy OR(odds ratio)=5.27[95%CI(4.12,6.75)],overall effect test Z=13.19,P<0.00001.Median nerve motor branch conduction velocity comprehensive efficacy MD(mean difference)=2.95[95%CI(1.85,4.05)],overall effect test Z=5.25,P<0.00001.Median nerve sensory branch conduction velocity comprehensive efficacy MD(mean difference)=2.83[95%CI(1.85,3.82)],overall effect test Z=5.64,P<0.00001.Peroneal nerve motor branch conduction velocity comprehensive efficacy MD(mean difference)=3.49[95%CI(2.53,4.46)],overall effect test Z=7.07, P<0.00001.Peroneal nerve sensory branch conduction velocity comprehensive efficacy MD(mean difference)=3.05[95%CI(2.26,3.84)],overall effect test Z=7.55,P<0.00001.Tibial nerve motor branch conduction velocity comprehensive efficacy MD(mean difference)=2.77[95%CI(1.84,3.71)],overall effect test Z=5.81,P<0.00001.Tibial nerve sensory branch conduction velocity comprehensive efficacy MD(mean difference)=2.97[95%CI(2.22,3.73)],overall effect test Z=7.71,P<0.00001.More than 50% blood-activation Chinese medicines are used and it is over 70% in company with Chinese medicines for reinforcing qi and Chinese medicines nourishing yin.More than 50% blood-activation Chinese medicines are used and it is over 70% in company with Chinese medicines for reinforcing qi,Chinese medicines for dredging collaterals and Chinese medicines nourishing yin in the treatment of healing Median nerve motor branch.More than 50% blood-activation Chinese medicines are used and it reached 86% in company with Chinese medicines for reinforcing qi,Chinese medicines for dredging collaterals,Chinese medicines warming yang and Chinese medicines nourishing yin in the treatment of healing Median nerve sensory branch.More than 50% blood-activation Chinese medicines are used and it reached 80% in company with Chinese medicines for reinforcing qi and Chinese medicines nourishing yin in the treatment of healing Peroneal nerve motor branch.More than 50% blood-activation Chinese medicines are used and it reached 76% in company with Chinese medicines for reinforcing qi and Chinese medicines nourishing yin in the treatment of healing Peroneal nerve sensory branch.More than 50% blood-activation Chinese medicines are used and it reached 81% in company with Chinese medicines for reinforcing qi and Chinese medicines dredging collaterals in the treatment of healing Tibial nerve motor branch.More than 50% blood-activation Chinese medicines are used and it reached 80% in company with Chinese medicines for reinforcing qi and Chinese medicines warming yang in the treatment of healing Tibial nerve sensory branch. Conclusion:(1)Traditional Chinese Medicine compound accompanied with trophic nerve or other medicines have better curative effects than trophic nerve or other medicines in treatment on diabetic peripheral neuropathy.(2)Traditional Chinese Medicine for blood-activation,reinforcing qi,nourishing yin were the most used medicine on DPN,the blood-activation medicine was the most important one,that prompted those three play an important role on improving symptoms and improve nerve conduction velocity.(3)In the meta-analysis,literatures of traditional Chinese medicine based on inclusion criteria had low Jadad score, implied the lack of using methodology is quite common,the quality needed to improve.