A Systematic Evaluation Of The Treatment Of Diabetic Peripheral Neuropathy By Acupoint Application Of Traditional Chinese Medicine

Purpose: To evaluate the clinical efficacy and safety of acupoint application of traditional Chinese medicine in the treatment of diabetic peripheral neuropathy.Material and method:Retrieving papers from CKNI,Wanfang Database,VIP,CBM,The Cochrane Library and Chinese Medical Current Contents.Searching all RCT studies from 2000 to December2018.The study contained 37 articles,including 3226 patients with DPN,1626 in the experimental group,and 1600 in the control group.Using Rev Man5.3 software and traditional chinese medicine inheritance support system for systematic evaluation and drug analysis.Using GRADE method to score the evidence quality.Results: 1.Total efficiency of acupoint application of traditional Chinese medicine in the treatment of DPN:acupoint application of traditional Chinese medicine for DPN is more effective than control group.[OR=4.84,95% Cl(3.87,6.05),Z=13.83,(P<0.00001)] 2.Efficiency of acupoint application of traditional Chinese medicine: acupoint application of traditional Chinese medicine is more effective than control group.[OR=4.72,95% Cl(3.12,7.14),Z=7.35,(P<0.00001)];efficiency of acupoint application of traditional Chinese medicine combined western medicine:acupoint application of traditional Chinese medicine combined western medicine is more effective than control group.[OR=4.98,95% Cl(3.45,7.20),Z=8.54,(P<0.00001)];efficiency of acupoint application of traditional Chinese medicine combined Chinese medicine fumigation:acupoint application of traditional Chinese medicine combined Chinese medicine fumigation is more effective than control group.[OR=7.02,95% Cl(4.35,11.33),Z=7.99,(P<0.00001)].3.Acupoint application of traditional Chinese medicine,acupoint application of traditional Chinese medicine combined western medicine and acupoint application of traditional Chinese medicine combined Chinese medicine fumigation compared with western medicine group:OR(acupoint application+Chinese medicine fumigation)>OR(acupoint application+western medicine)>OR(acupoint application),the clinical efficiency of acupoint application of traditional Chinese medicine combined Chinese medicine fumigation is best.4.Nerve conduction velocity:acupoint application of traditional Chinese medicine can effectively improve the motor conduction velocity of the median nerve,more effective than control group.[MD=3.69,95% Cl(2.40,4.98),Z=5.6,(P<0.00001)];acupoint application of traditional Chinese medicine can effectively improve sural nerve conduction velocity of the median nerve,more effective than control group.[MD=1.20,95% Cl(0.59,1.80),Z=3.86,(P=0.0001)];acupoint application of traditional Chinese medicine can effectively improve sural nerve conduction velocity of the common peroneal nerve,more effective than control group.[MD=2.61,95% Cl(1.30,3.92),Z=3.90,(P<0.0001)];acupoint application of traditional Chinese medicine can effectively improve the motor conduction velocity of the phrenic nerve,more effective than control group.[MD=2.17,95% Cl(1.10,3.24),Z=3.99,(P<0.0001)].5.TCSS:acupoint application of traditional Chinese medicine can effectively improve TCSS,more effective than control group.[MD=3.69,95% Cl(2.40,4.98),Z=5.6,(P<0.00001)].6.Blood glucose:acupoint application of traditional Chinese medicine can effectively improve fasting blood-glucose,more effective than control group.[MD=-0.39,95% Cl(-0.70,-0.07),Z=2.38,(P=0.02)];the effect of improving 2h-PG is equal to that of western medicine.[MD=-0.28,95% Cl(-0.65,-0.09),Z=1.48,(P=0.14)].7.The GRADE of the quality of evidence:LOW.Conclusion: 1.Chinese medicine acupoint application for DPN is better than western medicine.2.No matter whether it is simply application or application combined with western medicine or application combined with fumigation,the efficiency is better than western medicine group.Application combined with fumigation is better.3.Chinese medicine acupoint application is superior to western medicine in improving the median nerve motor and sural nerve conduction velocity,the common peroneal nerve sural nerve conduction velocity,the phrenic nerve motor nerve conduction velocity,the TCSS and the fasting blood glucose in patients with DPN.4.Chinese medicine acupoint application is safety for DPN.5.The GRADE of the quality of evidence:LOW.