Meta-analysis Of Efficacy And Safety Of Integrated Traditional Chinese And Western Medicine In The Treatment Of Diabetic Foot

Objective: This study mainly collated relevant literatures through Meta analysis to systematically evaluate the effectiveness and safety of integrated traditional Chinese and western medicine in the treatment of diabetic foot,so as to provide further clinical evidence-based basis for the treatment of diabetic foot by traditional Chinese medicine.Methods:We searched CNKI database,VIP database,Wan Fang Data database,CBM database,Pub Med database,Cochrane Library and Embase database to find the clinical randomized controlled trials on the treatment of diabetic foot with integrated traditional Chinese and western medicine in the past 10 years.Relevant literatures were screened according to the inclusion criteria and exclusion criteria,and the included literatures were identified.The quality of the included literatures was evaluated using the modified Jadad scale and Rev Man5.3 software.Meta-analysis was also performed on the effective rate,cure rate,ankle-brachial index,total peroneal nerve conduction velocity,ulcer area and adverse reactions.Results: Seventeen clinical randomized controlled trials involving a total of 1778 patients were eventually included.The results of Meta-analysis indicated that :(1)In terms of effective rate,16 studies had this index,and direct comparison showed no heterogeneity.The results were as follows :(OR=4.59,95%CI[3.36-6.28],Z=9.64,P < 0.0001).The clinical effective rate of the integrated Chinese and western medicine group was higher than that of the western medicine group.In terms of subgroup analysis,there was no heterogeneity among the three subgroups.The results of the4-week treatment group were(OR=4.82,95%CI[2.20-10.57],Z=3.92,P <0.0001),and the results of the 4-week treatment group were(OR=3.86,95%CI[2.39-6.24],Z=5.51,P < 0.00001),OR more than 8 weeks of treatment(OR=6.84,95%CI[3.72-12.55],Z=6.20,P < 0.00001).Compared with western medicine treatment,the efficacy of integrated Chinese and western medicine treatment group was more significant no matter at 4 weeks,8 weeks or above.(2)In terms of cure rate,14 studies showed this index,and the Meta-analysis results after eliminating the studies with strong heterogeneity were(OR=2.37,95%CI [1.79,3.15],Z=5.98,P < 0.00001).The clinical cure rate of the integrated Chinese and western medicine group was higher than that of the western medicine group.(3)As for the ankle-brachial index,there were 2 studies with high heterogeneity,and the results were(MD=0.22,95%CI[-0.10,0.53],Z=1.36,P=0.0005 < 0.1).Only descriptive analysis indicated that the combination of traditional Chinese and western medicine group was better than the western medicine group in improving the ankle-brachial index of patients.(4)In terms of the peroneal nerve conduction velocity,there were 3 studies with this index without heterogeneity.The results were(MD=3.46,95%CI[2.51,4.41],Z=7.11,P < 0.00001).The improvement of the peroneal nerve conduction velocity in the integrated Chinese and western medicine group was better than that in the western medicine group.(5)In terms of ulcer area,this index was found in 4 studies,and the Meta-analysis results were(SMD=-2.33,95%CI[-3.82,-0.84],Z=3.06,P < 0.00001)after eliminating the studies with strong heterogeneity.The combination of traditional Chinese and western medicine group was better than the western medicine group in reducing ulcer area.(6)In terms of adverse reactions,the safety of integrated traditional Chinese and western medicine treatment and western medicine treatment of diabetic foot is better,with fewer adverse reactions and high safety.Conclusions:(1)The effective rate,cure rate,ankle-brachial index,peroneal nerve conduction velocity and ulcer area in the treatment of diabetic foot in the integrated Chinese and western medicine group were better than those in the western medicine group,but the medium and long-term efficacy and healing situation were unclear.(2)The safety level of the integrated Chinese and western medicine group in the treatment of diabetic foot is similar to that of the western medicine group,with fewer adverse reactions,which is worthy of recommendation.