Meta-analysis On The Treatment Of Diabetic Foot With Autologous Bone Marrow Stem Cells

Objective To evaluate the clinical efficacy of autologous bone marrow stem cells in the treatment of diabetic foot.Methods A comprehensive search in Pub Med,the Cochrane Library,EMbase,CNKI,VIP,Wangfang and CBM databases was conducted.Two of the investigators independently screened all relevant studies and completed data extraction according to the pre-defined inclusion and exclusion criteria We applied the risk of biases criteria,recommended by “Cochrane Handbook for Systematic Reviews of Interventions”,to perform quality assessment.All statistical analyses were performed with Review Manager Software(Rev Man5.3).Results The current study comprised 8 eligible RCTs,involving 468 diabetic foot patients.Meta-analysis showed that compared with conventional therapy,autologous BMSC transplantation could promote ulcer healing rate [RR=2.10,95%CI(1.67,2.64),P<0.00001],improve anklebrachial index [MD=0.16,95%CI(0.13,0.19),P<0.00001] and increase skin temperature of ill limb [MD=1.23,95%CI(0.50,1.96),P=0.0010].Besides,autologous BMSC transplantation could decrease the rate of amputation [RR=0.19,95%CI(0.06,0.66),P=0.008],reduce the score of intermittent claudication [MD=-0.86,95%CI(-0.99,-0.73),P<0.00001],and decrease the score of rest pain [MD=-1.33,95%CI(-1.77,-0.88),P<0.00001].No treatment-related adverse events or side effects were reported for all included studies.Conclusion Autologous BMSC treatment for DF could promote the ulcer healing rate,ankle-brachial index,and sick limb's skin temperature.Besides,Autologous BMSC transplantation could reduce amputation rate,the score of intermittent claudication and the score of rest pain.However,further large-scale,double-blind randomized studies are needed to prove this option.