Meta Analysis Of Huangqi Guizhi Wuwu Decoction In The Treatment Of Diabetic Peripheral Neuropathy

Objective:to evaluate the quality and curative effect of Astragalus guizhiwuwu decoction in the treatment of diabetic peripheral neuropathy by means of meta analysis.To provide evidence-based medicine for the clinical treatment of diabetic peripheral neuropathy with Huangqi Guizhi Wuwu decoction.Methods:computer search was conducted for pubmeda embase cochrane library.China knowledge Web database and Wanfang database.Chinese scientific and technological journals database and biomedical literature database of Weipu.Random controlled trial of Radix Astragali Guizhi Wuwu decoction for treatment of patients with DPN:randomized controlled trials,RCCs,researchers follow the literature from December 2017.Enter and exclude the standard reading abstract,The full text that meets the inclusion criteria is read in parallel,then strictly screened and cross-checked.By using the bias risk assessment tool of cochrane cooperation network,the quality of the included documents is evaluated,and the basic information of the study is extracted.The effective data are analyzed by meta using Revman5.3 software.Results:a total of 115 articles were preliminarily reviewed and accorded with,and 17articles were included in the literature,including 1752 cases of DPN patients,two of which were master's papers,and the rest were all periodical articles,including 1752patients with dpn.The quality of literature was generally not high.Both the treatment group and the control group were treated with routine basic treatment.The treatment group was treated with Huangqi Guizhi Wuwu decoction originally or added or subtracted on the basis of oral or intramuscular injection of mecobalamin.The control group was treated by oral or intramuscular injection of mecobalamin on the basis of basic treatment.The results were as follows:1.The total clinical effective rate of physical signs and nerve conduction velocity:the total clinical effective rate in the treatment group was better than that in the control group?4.05,95%CI[3.00,5.47],and the effect quantity test was 9.11P<0.00001?.2.The effect on the nerve conduction velocity:1)the treatment group increased the median spirit.The effect of mncv was significantly higher than that of the control group?5.54,95%ci[3.67,7.40],and the effect quantity test was zhi5.82P<0.00001g,which had statistical significance.?.2)the effect of increasing sncv of median nerve in the treatment group was significantly higher than that in the control group?5.12,95%CI[3.88,6.37],the effect was 8.06P<0.00001,with statistical significance.3?The effect of increasing mncv of the common peroneal nerve in the treatment group was significantly higher than that in the control group?4.06,95%CI[2.35,5.77],and the effect quantity test zao 4.65?p<0.00001,P<0.00001?.4?the effect of increasing the sncv of the common peroneal nerve in the treatment group was significantly higher than that in the control group?4.82,95%CI[3.096.55],the effect was 5.46,P<0.00001?.Statistical significance.3.the effect on blood sugar:five studies involved blood sugar indicators,After treatment,the fasting blood glucose and two hours postprandial blood glucose levels in both groups were decreased.The effect of decreasing fasting blood glucose in the treatment group was higher than that in the control group?MD=-3.69,95%ci[-4.46,-2.91]?.The effect of reducing 2 h postprandial blood glucose level in the treatment group was higher than that in the control group(MD=-3.35,95%CI[-3.84,-1.74],the effect was 4.31,P<0.0001,with statistical significance.4.The effect on plasma viscosity in the treatment group was higher than that in the control group(MD=-0.27,95%CI[-0.34,-0.19],the effect was higher than that in the control group?-0.27,-0.34,-0.19?.Statistical significance.5.Safety indicators:5^{[7][9][10][13][22]}articles included in the study were statistically analyzed for adverse reactions.No obvious adverse reactions were reported in the treatment group,but no obvious side effects were found in the control group except one case^[10]with mild nausea.6.According to their baseline blood glucose,they can be divided into three subgroups:fasting blood glucose?7mmol/l and postprandial blood glucose?10mmol/L;other criteria;no mention of the three subgroups of the criteria.The results showed fasting plasma glucose?7 mmol/l and blood glucose?10 mmol/l at 2 hours post-meal?OR,3.72;95%CI,2.07to 6.70;Z=4.39,p<0.00001,I²=0%?,Other standards?OR,4.68;95%CI,2.81to7.82;Z=5.91,p<0.00001I²=0%?,Unmentioned group?OR,3.75;95%CI,2.32to6.06;Z=5.38,p<0.00001,I²=0%?,There was no significant statis-tical effect between the three groups?OR,4.05;95%CI,3.00 to 5.47;Z=9.11,P<0.00001,I²=0%?.Conclusion:Huangqi Guizhi Wuwu decoction in the treatment of DPN in clinical efficacy,improve nerve conduction velocity,improve blood sugar and reduce plasma viscosity is better than the use of mecobalamin alone.There was no significant adverse reaction in the study including safety evaluation,which is worthy of clinical application.However,there are still some limitations in meta-analysis,the general quality of literature is not high,the diagnostic criteria of TCM are not uniform,the blind method is almost not used in the study,and many studies do not mention the number of missing and withdrawing samples.The adverse reactions and long-term follow-up reports of Huangqi Guizhi Wuwu decoction in the treatment of DPN were also relatively lacking,so it was not possible to draw a precise and precise conclusion.A more standardized and detailed randomized controlled trial of large samples is still needed to verify the efficacy and safety of Huangqi Guizhi Wuwu decoction in the treatment of DPN.