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Journal of Traditional Chinese Medicine >

2023 , Vol. 43 >Issue 5: 841 - 850

DOI: https://doi.org/10.19852/j.cnki.jtcm.20230802.002

Meta Analysis

Efficacy and safety of Buyang Huanwu decoction (补阳还五汤) for diabetic peripheral neuropathy: a systematic review and Meta-analysis

  • Meizhen ZHANG ,
  • Xiaohui HAO ,
  • Yiting TANG ,
  • Yupeng CHEN ,
  • Puyu HE ,
  • Liming ZHAO ,
  • Bing PANG ,
  • Qing NI
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  • 1 Department of Endocrinology, Guang’anmen Hospital of China Academy of Chinese Medical Sciences, Beijing 100053, China
    2 Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China
    3 Department of Endocrinology, Guang’anmen Hospital of China Academy of Chinese Medical Sciences, Beijing 100053, China

Received date: 2022-09-26

  Accepted date: 2022-12-11

  Online published: 2023-08-02

Supported by

Natural Science Foundation-funded Project, Optimization of Distribution of Anti-Diabetes Traditional Chinese Medicine based on Glucose Metabolism Signal Pathway and Uniform Design(7182143)

Fold

Abstract

OBJECTIVE: To evaluate the efficacy and safety of Buyang Huanwu decoction (BYHWD) in treating diabetic peripheral neuropathy (DPN).
METHODS: Eight electronic databases, including China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, Chinese Biomedical Literature Database, Cochrane Library, Embase, Web of Science, and PubMed, were searched for randomized controlled trials (RCTs) of BYHWD to treat DPN. We identified all RCTs related to BYHWD and those on the treatment of DPN with the combination of mecobalamin. RevMan software was used for the statistical analysis.
RESULTS: Twenty-one RCTs with a total of 1945 patients were included. The methodological quality of the literature included was low. Meta-analysis showed that the efficacy of the treatment group was significantly better than that of the control group in the treatment of DPN with BYHWD [risk ratio (RR) = 0.33, 95% CI (0.27, 0.40), Z = 11.25, P < 0.000 01]. The median nerve of median motor nerve conduction velocity (MNCV) [mean difference (MD) = 4.16, 95% CI (1.35, 6.98)] and median sensory NCV (SNCV) [(MD = 3.28, 95% CI (2.35, 4.22)] were improved in the treatment group. The MNCV in the common peroneal nerve [(MD = 1.63, 95% CI (0.39, 2.87)] and SNCV [(MD = 4.56, 95% CI (3.16, 5.97)] were significantly higher than those in the control group (P < 0.01). Plasma viscosity [(MD = －0.15, 95% CI (－0.20, －0.09), Z = 5.17, P < 0.01)], whole blood high shear [(MD = － 0.83, 95% CI (－1.56, －0.11), Z = 2.26, P = 0.02)]and whole blood low shear [(MD = － 1.61, 95% CI (－2.28, －0.94), Z = 4.68, P < 0.01)] decreased significantly after treatment. There was no significant difference in fasting blood glucose [(MD = －0.42, 95% CI (－ 0.89, 0.05), Z = 1.76, P = 0.08)] between the treatment and control groups; postprandial blood glucose [(MD = －0.62, 95% CI (－ 1.19, 0.05), Z = 2.12, P = 0.03)] decreased significantly. No significant difference was found in the blood lipid levels between the treatment and control groups, including triglycerides [(MD = －0.21, 95% CI (－0.52, 0.10), Z = 1.34, P = 0.18)] and cholesterol [(MD = －0.13, 95% CI (－ 0.27, 0.00), Z = 1.92, P = 0.06)]. Of the 21 RCTs, only five reported adverse reactions, and four studies reported the length of follow-up. No serious adverse events were reported. None of the studies reported the quality of life and economic conditions.
CONCLUSIONS: Our study suggests that BYHWD has a significant therapeutic effect on DPN. High-quality, large-scale RCTs are needed to provide more reliable evidence.

Key words： diabetic peripheral neuropathy; safety; treatment outcome; nerve conduction studies; hemorheology; randomized controlled trial; Meta-analysis; Buyang Huanwu decoction

Cite this article

Meizhen ZHANG , Xiaohui HAO , Yiting TANG , Yupeng CHEN , Puyu HE , Liming ZHAO , Bing PANG , Qing NI . Efficacy and safety of Buyang Huanwu decoction (补阳还五汤) for diabetic peripheral neuropathy: a systematic review and Meta-analysis[J]. Journal of Traditional Chinese Medicine, 2023 , 43(5) : 841 -850 . DOI: 10.19852/j.cnki.jtcm.20230802.002

References

1. Danaei G, Finucane MM, Lu Y, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet 2011; 378: 31-40.
2. Chinese Diabetes Society. Guidelines for the prevention and control of type 2 diabetes in China (2017 Edition). Zhong Guo Tang Niao Bing Za Zhi 2018; 10: 4-67.
3. Lee CC, Perkins BA, Kayaniyil S, et al. Peripheral neuropathy and nerve dysfunction in individuals at high risk for type 2 diabetes: The PROMISE Cohort. Diabetes Care 2015; 38: 793-800.
4. Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th ed. Diabetes Res Clin Pract 2019; 157: 107843.
5. Wang QR (Qing dynasty), Yi Lin Gai Cuo. Beijing: China Medical Science and Technology Press, 2011: 1-67.
6. Xu S, Hua WJ. Research progress of Buyang Huanwu decoction in the treatment of diabetic peripheral neuropathy. Zhong Yi Xue 2020; 9: 92-7.
7. Pan R, Cai J, Zhan L, et al. Buyang Huanwu decoction facilitates neurorehabilitation through an improvement of synaptic plasticity in cerebral ischemic rats. BMC Complement Altern Med 2017; 17: 173.
8. Zheng XY. Guiding principles for clinical research of new drugs of Traditional Chinese Medicine. Beijing: China Medical Science and Technology Press, 2002: 233-7.
9. Higgins JPT, Green S. Corchrane Reviewers’ Handbook 5.2 [updated March 2013], ReviewManager (RevMan) [Computer program]. Version 5.2; 2013.
10. Ning RZ, Zhang TY, Ma J. Effect of modified Buyang Huanwu decoction on diabetic peripheral neuropathy and insulin-like growth factor. Zhong Yi Yao Xue Bao 2020; 48: 41-4.
11. Liu B. Therapeutic effect of modified Buyang Huanwu ecoction on diabetic peripheral neuropathy of Qi deficiency and blood stasis type. Tang Niao Bing Xin Shi Jie 2018; 21: 179-80.
12. Pan XJ. Therapeutic effect of Buyang Huanwu decoction on T2DM peripheral neuropathy of Qi deficiency and blood stasis type. Yunnan: Yunnan university of Chinese medicine, 2017: 1-51.
13. Li YF. Clinical study of modified Buyang Huanwu decoction in the treatment of diabetic peripheral neuropathy. Guangxi: Guangxi university of Chinese medicine, 2009: 1-55.
14. Peng H. Clinical observation on the treatment of diabetic peripheral neuropathy with modified Buyang Huanwu decoction. Hubei: Hubei University Of Chinese Medicine, 2009: 1-36.
15. Luo XY. Clinical study on Buyang Huanwu decoction in the treatment of type 2 diabetic peripheral neuropathy. Hubei: Hubei University Of Chinese Medicine, 2007: 1-42.
16. Wang SX, Chen L, Ma XJ. 130 cases of diabetic peripheral neuropathy treated with modified Buyang Huanwu decoction. Zhong Guo Zhong Yi Yao Xin Xi Za Zhi 2005; 12: 60-1.
17. Liu CH, Fan GJ, Tang XY. Clinical observation on 42 cases of diabetic peripheral neuropathy treated with Buyang Huanwu decoction. Sichuan Zhong Yi 2003; 21: 31-2.
18. Han Y. Treatment of 30 cases of type 2 diabetic peripheral neuropathy with Buyang Huanwu decoction: a control study of 20 cases treated with Mecobalamin tablets. Zhejiang Zhong Yi Za Zhi 2005; 40: 430-1.
19. Gong LZ, Li YF, Zhang JX, Zhang YP, Qiao XY, Zhang J. Clinical observation on the treatment of diabetic peripheral neuropathy with Buyang Huanwu decoction. Shi Yong Zhong Yi Yao Za Zhi 2017; 33: 1364-5.
20. Wu Y, Ma D. Clinical observation of Buyang Huanwu decoction combined with mecobalamin injection in the treatment of diabetic peripheral neuropathy. Lin Chuang He Li Yong Yao Za Zhi 2015; 8: 34-5.
21. Sun SZ, Wang YZ. Clinical observation on 42 cases of diabetic peripheral neuropathy treated by Buyang Huanwu decoction combined with mecobalamin. Jiangsu Zhong Yi Yao 2008; 40: 48-9.
22. Zhang T. Buyang Huanwu decoction in treating 60 cases of diabetic peripheral neuropathy. Tianjin Zhong Yi Yao 2008; 25: 216.
23. Sun BX, Li LQ. Clinical effect of Buyang Huanwu decoction on diabetic peripheral neuropathy. Ji Yin Zu Xue Yu Ying Yong Sheng Wu Xue 2017; 36: 3398-402.
24. Yang YQ, Xing DZ. Clinical study of modified Buyang Huanwu decoction combined with mecobalamin in the treatment of senile diabetic peripheral neuropathy. Xin Zhong Yi 2019; 51: 67-9.
25. Cui Y, Pan MX. Therapeutic effect of Buyang Huanwu decoction combined with mecobalamin on diabetic peripheral neuropathy. Hebei Zhong Yi 2004; 26: 374-5.
26. Zhuang HZ. 30 cases of diabetic peripheral neuropathy treated with integrated Traditional Chinese and Western Medicine. Zhong Guo Zhong Yi Yao Xian Dai Yuan Cheng Jiao Yu 2011, 9: 60.
27. Liu JG. Therapeutic effect of Buyang Huanwu decoction on diabetic peripheral neuropathy. Zhong Yi Lin Chuang Yan Jiu 2015, 7: 113-4.
28. Ji TC. Clinical observation on the treatment of diabetic peripheral neuropathy with Buyang Huanwu decoction. Zhong Yi Lin Chuang Yan Jiu 2014; 6: 74-5.
29. Jiao FE, Cong K, Ji XY. Therapeutic effect of Buyang Huanwu decoction on diabetic peripheral neuropathy. Liaoning Zhong Yi Za Zhi 2013; 40: 740.
30. Jiang ZS, Ren ZX, Zhang SL, Li HY. Clinical study on the treatment of diabetic peripheral neuropathy by supplementing Qi and activating Yang, activating blood and dredging collaterals. Shandong Zhong Yi Yao Da Xue Xue Bao 2005; 29: 200-2.
31. Zhao L. Clinical observation of modified Buyang Huanwu decoction in the treatment of type Ⅱ diabetes mellitus. Hubei Zhong Yi Za Zhi 2002; 24: 8-9.
32. Xu XM, Chen XJ, Chen ran, Zhang JY, Zhang YL. Effect of Buyang Huanwu decoction on whole blood specific viscosity, TXB2, PLO and SOD in rats. Shanxi Yi Ke Da Xue Xue Bao 2002; 33: 212-4.
33. Xing SL, Li ZH, Sun JH, Liu YP, Pu LH. Antioxidant effect of Buyang Huanwu decoction. Jie Pou Xue Za Zhi 2005; 28: 529-32.
34. Chen LG, Qu Y, GE HY, Hu XQ, Nie YA, He MQ. Effect of Buyang Huanwu decoction on the expression of vascular endothelial cell adhesion molecules in rats with blood stasis syndrome. Zhong Cao Yao 2005; 36: 706-9.
35. Wang QY. Effect of astragalus injection on hemorheology in rabbits with blood stasis syndrome. Zhong Yao Yao Li Xue Yu Lin Chuang 2004; 20: 19-20.
36. Jiang DF, Yin CH, Yu NG, et al. Effect of Astragalosides on hemorheology in aged rats. Ji Chu Zhong Yi Za Zhi 2002; 16: 15-6.
37. Zhuang WQ. Clinical efficacy of Jingui Shenqi pill combined with Buyang Huanwu decoction in the treatment of diabetic peripheral neuropathy. clinical efficacy of diabetic peripheral neuropathy. Tang Niao Bing Xin Shi Jie 2017; 20: 168-9.
38. Jiang JL, Zhang RL, Zhang RP. Clinical study of Buyang Huanwu decoction and Huangqi Guizhi Wuwu decoction combined with western medicine in the treatment of diabetic peripheral neuropathy. Zhong Xi Yi Jie He Xin Nao Xue Guan Bing Za Zhi 2020; 18: 840-2.
39. Li S, Liu SR. Treatment of 47 cases of diabetic peripheral neuropathy with Buyang Huanwu decoction. Guang Ming Zhong Yi 2016; 31: 674-5.
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