title: Chinese herbal medicine in treatment of diabetic peripheral neuropathy: a systematic review and meta-analysis.
abstract: OBJECTIVE
  There are multimodal and multidisciplinary approaches to treat diabetic peripheral neuropathy (DPN). However, the intractable adverse effects limited their widespread use. Chinese herbal medicine (CHM) is increasingly used for the treatment of DPN. The aim of this study was to review existing evidence on the effectiveness of CHM for the treatment of DPN.
  
  
  METHODS
  Searches were performed with Medline, Embase, Cochrane Central Register of Controlled Trials, CNKI, CBM and Wangfan databases. Controlled trials comparing CHM with other medicine for the treatment of DPN were analyzed.
  
  
  RESULTS
  Eighteen trials met the inclusion criteria. All trials used vitamin B12 and/or B1 as control. Clinical therapeutic effect, divided by three grades including marked effective, effective and ineffective according to the improved degree of subjective symptom, tendon reflex, and nerve conduction velocity, was the only end point reported in all trials, and thus evaluated. The results showed CHM treatment was associated with a superiority in marked effective (odds ratio [OR], 2.40; 95% confidence interval [CI]: 0.94 to 2.97; p<0.001), and effective (OR, 1.39; 95% CI: 1.16 to 1.67; p<0.001). Patients who received CHM treatment was associated with a less likely to report ineffective (OR, 0.26; 95% CI: 0.21 to 0.33, p<0.001). No adverse events were reported in any of the included trials.
  
  
  CONCLUSIONS
  According to the pooled results of our study and the poor quality of the included trials, it might be uncertainty that there was a superiority of CHM for treating DPN. More rigorous controlled trials are required to substantiate or refute these early findings.
authors.affiliation: Department of Clinical Pharmacy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Yanchang Middle Road, Shanghai 200072, China. xuhongbin119@yahoo.cn
authors.forename: Hong-Bin
authors.initials: HB
authors.lastname: Xu
authors.forename: Rui-Hua
authors.initials: RH
authors.lastname: Jiang
authors.forename: Xian-Zhen
authors.initials: XZ
authors.lastname: Chen
authors.forename: Ling
authors.initials: L
authors.lastname: Li
mesh_terms: D003929:Diabetic Neuropathies / Q000188:drug therapy*; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D006801:Humans; D010946:Plants, Medicinal
chemical_list: D004365:Drugs, Chinese Herbal