title: Topical herbal medicine for treatment of diabetic peripheral neuropathy: a systematic review of randomized controlled trials.
abstract: BACKGROUND
  Topical Chinese herbal medicine (CHM) is generally used in China, separately or in combination with conventional medicine, to treat diabetic peripheral neuropathy (DPN). Clinical studies have shown beneficial effects of CHM compared with conventional medicine.
  
  
  METHODS
  A systematic literature search of Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, Chinese BioMedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI) and Chinese Scientific Journal Database (VIP) information was conducted till March 2010. Randomized controlled trials (RCTs) were included if they compared topical CHM to conventional medicine, placebo or no treatment for patients with DPN. Revman 5.0.17 was used as software for data analysis. The effect expectancy is depicted as relative risk and mean difference with a 95% confidence interval.
  
  
  RESULTS
  23 RCTs including 22 topical CHMs were included. The methodological quality of the included trials is generally poor in terms of sequence generation, concealment of allocations, blinding, incomplete data outcome and selective outcome reports. 17 trials showed beneficial effects of CHM on global symptom improvement, 6 beneficial effects of CHM on nerve velocity conduction, 4 beneficial effects of CHM on numbness improvement and 4 beneficial effects of CHM on pain relief. Adverse events with relation to CHM were reported in 3 trials including skin redness, a burning feeling, a prickling sensation and rash.
  
  
  CONCLUSIONS
  Due to weak evidence, the claimed benefits of topical CHM for DPN are inconclusive; more stringent studies are needed to support clinical practice.
authors.affiliation: Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, 11 Bei San Huan Dong Lu, Chaoyang District, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Ya-Feng
authors.initials: YF
authors.lastname: Luo
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Liu
mesh_terms: D000287:Administration, Topical; D000368:Aged; D015982:Bias; D003929:Diabetic Neuropathies / Q000188:drug therapy*; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects; D008517:Phytotherapy / Q000009:adverse effects / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
chemical_list: D004365:Drugs, Chinese Herbal