Background
Methods
Data sources and information retrieval
Inclusion criteria
Type of study
Study objects
Interventions
Exclusion criteria
Outcome measures
Publication bias analysis
Sensitivity analysis
Selection of studies
Quality assessment of included articles
Statistical analysis
Results
Study selection and characteristics of included studies
First author | DM/DPN duration (years) | Age (years) | Sex (M/F) | Sample size | Intervention | Course of treatment | Adverse events | Main outcome measures | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
T | C | T | C | T | C | T | C | T | C | ||||
Chen 2014 [34] | 1/12–10 | 1/6–8 | 53.4 ± 14.8 | 52.9 ± 14.5 | 21/21 | 20/18 | 42 | 38 | J + H + Vitamin B12 | J+ Vitamin B12 | 4 weeks | n.r. | NCV, TER |
Qi 2010 [35] | (103.24 ± 17.62)/12 | (98 ± 20.9)/12 | 56.31 ± 7.4 | 59.7 ± 8.1 | 27/15 | 25/15 | 42 | 40 | J + H + Vitamin B12 | J+ Vitamin B12 | 4 weeks | n.r. | NCV, TER |
Li 2001 [36] | (37 ± 6)/12 | (36 ± 6)/12 | 60 ± 12 | 62 ± 8 | 17/14 | 12/19 | 31 | 31 | J + H + Vitamin B12 | J+ Vitamin B12 | 4 weeks | No | NCV, TER |
Chen 2007 [37] | 10.8 | 10.2 | 55.2 ± 5.4 | 56.3 ± 6.1 | 20/21 | 19/22 | 41 | 41 | J + H + Vitamin B12 & B1 | J+ Vitamin B12 & B1 | 30 days | 0/1 | NCV, TER |
Lin 2010 [38] | 7.0 ± 2.3 | 7.2 ± 2.2 | 56.7 ± 1.8 | 54.9 ± 6.5 | 52/52 | 58/41 | 104 | 99 | J + H + Vitamin B12 | J+ Vitamin B12 | 80 days | n.r. | NCV, TER |
Qiao 2006 [39] | n.r. | n.r. | n.r. | n.r. | n.r. | n.r. | 48 | 42 | J + H | J+ Vitamin B12 | 20 days | No | NCV, TER |
Liu 2006 [40] | 7.3 | 8.31 | 58.2 | 58.4 | 17/30 | 16/30 | 47 | 46 | J + H | J+ Vitamin B12 | 8 weeks | n.r. | NCV, TER |
Hua 2009 [41] | 8.2 | 7.5 | 58.45 | 60.65 | 12/20 | 18/13 | 32 | 31 | J + H | J+ Vitamin B12 | 30 days | n.r. | TER |
Cao 2012 [42] | n.r. | n.r. | 55.8 ± 4.2 | 54.7 ± 3.3 | 35/31 | 28/26 | 66 | 54 | J + H | J+ Vitamin B12 | 8 weeks | 5/2 | NCV, TER |
Zhang 2007 [43] | 7.93 ± 2.36 | 6.88 ± 2.40 | 56.81 ± 9.36 | 55.64 ± 9.73 | 13/17 | 16/14 | 30 | 30 | J + H | J+ Vitamin B12 | 8 Weeks | n.r. | TER |
Hong 2006 [44] | 7.72 ± 4.01 | 7.62 ± 3.80 | 58.22 ± 6.31 | 56.83 ± 7.02 | 20/10 | 18/12 | 30 | 30 | J + H | J+ Vitamin B12, B1 and NGF | 80 days | No | TER |
Chen 2005 [45] | 2.32 ± 1.50 | 2.34 ± 1.21 | 51.20 ± 7.81 | 52.3 ± 8.52 | 28/17 | 18/12 | 45 | 30 | J + H | J+ Vitamin B12 and B6 | 4 weeks | n.r. | NCV, TER |
Lin 2011 [46] | 11.63 ± 5.09 | 11.5 ± 5.98 | 61.85 ± 8.09 | 62.7 ± 8.11 | 35/25 | 18/12 | 60 | 30 | J + H | J+ Vitamin B12 | 3 months | n.r. | NCV, TER |
Yi 2008 [47] | 11.06 ± 3.67 | 11.13 ± 3.59 | 59.87 ± 6.37 | 60.03 ± 6.46 | 16/14 | 15/15 | 30 | 30 | J + H | J+ Vitamin B12 | 4 weeks | n.r. | NCV, TER |
Li 2012 [48] | 8.4 | 7.6 | 56.5 | 54.8 | 35/25 | 38/22 | 60 | 60 | J + H | J+ Vitamin B12 | 4 weeks | No | NCV, TER |
Chen 2009 [49] | 11.16 ± 3.57 | 10.93 ± 4.01 | 59.67 ± 6.27 | 60.03 ± 6.42 | 16/14 | 15/15 | 30 | 30 | J + H | J+ Vitamin B12 | 12 weeks | n.r. | TER |
Huang 2015 [50] | 6–20 | 5–19 | 41–79 | 40–70 | 30/30 | 40/20 | 60 | 60 | J + H | J+ Vitamin B12 | 4 weeks | n.r. | NCV, TER |
Song 2015 [51] | (52.3 ± 41.3)/12 | (54.3 ± 36.7)/12 | 59.8 ± 6.3 | 59.2 ± 9.4 | 14/16 | 13/17 | 30 | 30 | J + H | J+ Vitamin B12 | 12 weeks | n.r. | NCV, TER |
Chen 2015 [52] | 6.91 ± 5.57 | 6.30 ± 4.97 | 54.32,61.07 | 54.38,62.27 | 14/16 | 17/13 | 30 | 30 | J + H | J+ Vitamin B12 | 60 days | n.r. | NCV, TER |
Zhao 2015 [53] | 7.60 ± 5.8 | 7.11 ± 4.90 | 57.41 ± 8.98 | 55.83 ± 9.64 | 22/18 | 21/19 | 40 | 40 | J + H | J+ Vitamin B12 | 8 weeks | 3/4 | NCV, TER |
Liu 2015 [54] | 6.44 ± 2.87 | 6.34 ± 2.78 | 53.15 ± 10.23 | 52.25 ± 10.18 | 34/31 | 35/29 | 65 | 64 | J + H + α-lipoic acid | J+ a-lipoic acid | 4 weeks | 1/3 | NCV, TER |
Ma2015 [55] | 8.5 ± 2.9 | 8.8 ± 2.7 | 62.1 ± 6.7 | 61.8 ± 6.9 | 26/17 | 28/15 | 43 | 43 | J + H + α-lipoic acid | J+ a-lipoic acid | 4 weeks | n.r. | NCV, TER |
Chen 2015 [56] | 12.62 ± 3.17 | 11.26 ± 3.51 | 60.16 ± 5.71 | 61.4 ± 6.15 | 17/13 | 15/15 | 30 | 30 | J + H + Vitamin B12 | J+ Vitamin B12 | 4 months | No | NCV, TER |
Zhang 2015 [57] | 8.9 ± 2.1 | 9.1 ± 2.1 | 53.7 ± 2.3 | 54.2 ± 2.5 | 41/19 | 39/21 | 60 | 60 | J + H + Vitamin B12 | J+ Vitamin B12 | 4 weeks | 1/0 | NCV, TER |
Lang 2015 [58] | 10.72 ± 7.96 | 11.34 ± 8.25 | 58.75 ± 19.01 | 57.02 ± 18.53 | 46/36 | 52/30 | 82 | 82 | J + H + Vitamin B12 + α-lipoic acid | Vitamin B12 + a-lipoic acid | 2 weeks | n.r. | NCV, TER |
Quality of the included studies
Study ID | 12-item criteria | Jadad scale | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | G | H | I | J | K | L | T | a | b | c | d | e | T | |
Chen 2014 [34] | + | − | − | − | − | − | − | ? | + | + | ? | + | 4 | 1 | 1 | 0 | 0 | 0 | 2 |
Qi 2010 [35] | − | − | − | − | − | − | − | ? | + | + | ? | + | 3 | 1 | 0 | 0 | 0 | 0 | 1 |
Li 2001 [36] | − | − | − | − | − | − | − | ? | + | + | + | + | 4 | 1 | 0 | 0 | 0 | 0 | 1 |
Chen 2007 [37] | − | − | − | − | − | − | − | ? | + | + | + | + | 4 | 1 | 0 | 0 | 0 | 0 | 1 |
Lin 2010 [38] | − | − | − | − | − | − | − | ? | + | + | ? | + | 3 | 1 | 0 | 0 | 0 | 0 | 1 |
Qiao 2006 [39] | − | − | − | − | − | − | − | ? | + | + | + | + | 4 | 1 | 0 | 0 | 0 | 0 | 1 |
Liu 2006 [40] | − | − | − | − | − | − | − | ? | + | + | ? | + | 3 | 1 | 0 | 0 | 0 | 0 | 1 |
Hua 2009 [41] | − | − | − | − | − | − | − | ? | + | + | ? | + | 3 | 1 | 0 | 0 | 0 | 0 | 1 |
Cao 2012 [42] | + | − | − | − | − | − | − | ? | + | + | + | + | 5 | 1 | 1 | 0 | 0 | 0 | 2 |
Zhang 2007 [43] | + | − | − | − | − | − | − | ? | + | + | ? | + | 4 | 1 | 1 | 0 | 0 | 0 | 2 |
Hong 2006 [44] | − | − | − | − | − | − | − | ? | + | + | + | + | 4 | 1 | 0 | 0 | 0 | 0 | 1 |
Chen 2005 [45] | − | − | − | − | − | − | − | ? | + | + | ? | + | 3 | 1 | 0 | 0 | 0 | 0 | 1 |
Lin 2011 [46] | − | − | − | − | − | − | − | ? | + | + | ? | + | 3 | 1 | 0 | 0 | 0 | 0 | 1 |
Yi 2008 [47] | − | − | − | − | − | − | − | ? | + | + | ? | + | 3 | 1 | 0 | 0 | 0 | 0 | 1 |
Li 2012 [48] | − | − | − | − | − | − | − | ? | + | + | + | + | 4 | 1 | 0 | 0 | 0 | 0 | 1 |
Chen 2009 [49] | − | − | − | − | − | − | − | ? | + | + | ? | + | 3 | 1 | 0 | 0 | 0 | 0 | 1 |
Huang 2015 [50] | − | − | − | − | − | − | − | ? | + | + | ? | + | 3 | 1 | 0 | 0 | 0 | 0 | 1 |
Song 2015 [51] | − | − | − | − | − | − | − | ? | + | + | ? | + | 3 | 1 | 0 | 0 | 0 | 0 | 1 |
Chen 2015 [52] | − | − | − | − | − | − | − | ? | + | + | ? | + | 3 | 1 | 0 | 0 | 0 | 0 | 1 |
Zhao 2015 [53] | − | − | − | − | − | − | − | ? | + | + | + | + | 4 | 1 | 0 | 0 | 0 | 0 | 1 |
Liu 2015 [54] | + | − | − | − | − | − | − | ? | + | + | + | + | 5 | 1 | 1 | 0 | 0 | 0 | 2 |
Ma 2015 [55] | + | − | − | − | − | − | − | ? | + | + | ? | + | 4 | 1 | 1 | 0 | 0 | 0 | 2 |
Chen 2015 [56] | − | − | − | − | − | − | − | ? | + | + | + | + | 4 | 1 | 0 | 0 | 0 | 0 | 1 |
Zhang 2015 [57] | − | − | − | − | − | − | − | ? | + | + | + | + | 4 | 1 | 0 | 0 | 0 | 0 | 1 |
Lang 2015 [58] | − | − | + | − | − | − | − | ? | + | + | ? | + | 4 | 1 | 0 | 0 | 0 | 0 | 1 |
Yang- warming Chinese herbs
Study ID | Name of the formula | Yang-warming herbs used in the formula | Usage |
---|---|---|---|
Chen 2014 [34] | Wenyangbushen Tang (Decoction) | Rougui (Cinnamomum cassia bark), Fuzi (Aconitum carmichaeli root), Shanzhuyu (Cornusofficinalis) | 100 ml BID |
Qi 2010 [35] | Yiqiwenyangtongluo Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Xixin (Asarum heterotropoidesrhizhome) | 200 ml BID |
Li 2001 [36] | YiqiyangyinwenyangHuoxue Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Fuzi (Aconitum carmichaeli root),Ganjiang (Zingiber officinale), Shanzhuyu (Cornusofficinalis) | 200 ml BID |
Chen 2007 [37] | Yiqiwenyanghuoxue Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Fuzi (Aconitum carmichaeli root) | _ |
Lin 2010 [38] | Yiqiwenyanghuoxuetongluo Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Xixin (Asarum heterotropoidesrhizhome) | _ |
Qiao 2006 [39] | Wenyanghuoxuetongluo Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Xixin (Asarum heterotropoidesrhizhome), Rougui (Cinnamomum cassia bark), Buguzhi (Psoraleacorylifolia fruit) | _ |
Liu 2006 [40] | Wenyangqushitongluo Tang (Decoction) | Fuzi (Aconitum carmichaeli root), Rougui (Cinnamomum cassia bark),Paojiang (dried Zingiber officinale), Mahuang (Ephedra sinica stem), Lujiaojiao (Cervus Nippon horn) | _ |
Hua 2009 [41] | Wenyangtongluo Tang (Decoction) | Mahuang (Ephedra sinica stem),Guizhi(Cinnamomum cassia twig) | 100 ml BID |
Cao 2012 [42] | TongluoJiaonang (Capsule) | Guizhi (Cinnamomum cassia twig), Xixin (Asarum heterotropoidesrhizhome) | 6 capsules TID |
Zhang 2007 [43] | Yiqihuoxuewenyang Tang (Decoction) | Fuzi (Aconitum carmichaeli root), Mahuang (Ephedra sinica stem), Xixin (Asarum heterotropoidesrhizhome), Guizhi (Cinnamomum cassia twig) | _ |
Hong 2006 [44] | Yiqiwenyanghuoxuetongluo Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Xixin (Asarum heterotropoidesrhizhome) | _ |
Chen 2005 [45] | Yiqiwenyangtongluo Tang (Decoction) | Lujiaojiao (Cervus Nippon horn), Xianling pi (Herbaepimedii), Mahuang (Ephedra sinica stem), Shanzhuyu (Cornusofficinalis) | 200 ml BID |
Lin 2011 [46] | Zhiyu Tang (Decoction) | Shanzhuyu (Cornusofficinalis) | _ |
Yi 2008 [47] | Guilong Wan (Pills) | Guizhi (Cinnamomum cassia twig), Xixin (Asarum heterotropoidesrhizhome) | _ |
Li 2012 [48] | Guilong Wan (Pills) | Guizhi (Cinnamomum cassia twig), Xixin (Asarum heterotropoidesrhizhome) | |
Chen 2009 [49] | Guilong Wan (Pills) | Guizhi (Cinnamomum cassia twig), Xixin (Asarum heterotropoidesrhizhome) | 5 g TID |
Huang 2015 [50] | Dangguisini Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Xixin (Asarum heterotropoidesrhizhome), Ganjiang (Zingiber officinale) | - |
Song 2015 [51] | Modified Guizhishaoyaozhimu Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Ganjiang (Zingiber officinale), Fuzi (Aconitum carmichaeli root), Mahuang (Ephedra sinica stem), | 200 ml BID |
Chen 2015 [52] | Ruxiangyingtong Powder | Guizhi (Cinnamomum cassia twig), Shengjiang (Fresh Zingiber officinale) | 200 ml TID |
Zhao 2015 [53] | Yiqihuoxuetongluo Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Xixin (Asarum heterotropoidesrhizhome), Fuzi (Aconitum carmichaeli root) | 300 ml BID |
Liu 2015 [54] | Modified Buyanghuanwu Tang (Decoction) | Huluba (Trigonellafoenum- graecum seeds), Haima (Hippocampus japonicas) | _ |
Ma 2015 [55] | Modified Dangguisini Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Shengjiang (Fresh Zingiber officinale), Xixin (Asarum heterotropoidesrhizhome) | _ |
Chen 2015 [56] | Huangqiguizhiwuwu Tang (Decoction) | Rougui (Cinnamomum cassia bark), Xixin (Asarum heterotropoidesrhizhome) | _ |
Zhang 2015 [57] | Wenyangzhitong Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Xixin (Asarum heterotropoidesrhizhome) | _ |
Lang 2015 [58] | Modified Huangqiguizhiwuwu Tang (Decoction) | Guizhi (Cinnamomum cassia twig), Shengjiang (Fresh Zingiber officinale) | 100 ml BID |