Ma Yuqi, Chen Ji, Huang Xinggui, Liu Yuan
School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Pharmacol. 2022 Nov 4;13:957483. doi: 10.3389/fphar.2022.957483. eCollection 2022.
In recent years, people pay more and more attention to diabetic peripheral neuropathy (DPN). As a neurotrophic agent, mecobalamin is able to repaire nerves, which has already become a consensus among experts. However, it has been found that mecobalamin has poor effect to increase nerve conduction velocity, which is an important indicator. Clinical data have shown that Chinese medicine injection, combined with mecobalamin injection, can significantly improve nerve conduction velocity of the limbs. Nevertheless, several kinds of Chinese medicine injections have been used to treat DPN. The effect of these Chinese medicine injections for DPN are various. Therefore, it is necessary to evaluate the effectiveness of Chinese medicine injections combined with mecobalamin in the treatment of DPN. All relevant articles published before 12 March 2022 were searched in eight electronic databases. Randomized controlled trials (RCTs) on Chinese medicine injections plus Mecobalamin for DPN were identified according to inclusion criteria, and were assessed using the revised Cochrane risk of bias tool (ROB2.0). R software and stata15 was used to create the ranking probabilities and network meta-analysis. A total of 80 RCTs involving 6,980 patients were included. The results showed that mecobalamin plus Dengzhanxixin injection (ME + DZXX) ranked first in overall response rate [RR = 1.64, 95% CI (1.26, 2.21)] and median motor nerve conduction velocity [MD = 9.46, 95% CI (5.67, 13.28)]. Then, mecobalamin plus Kudiezi Injection (ME + KDZ) had the best effect in median sensory nerve conduction velocity [MD = 10.41, 95% CI (-13.31, -7.52)], and mecobalamin plus Honghua injection (ME + HH) ranked highest in common peroneal motor nerve conduction velocity [MD = 6.8, 95% CI (4.13, 9.49)] and common peroneal sensory nerve conduction velocity [MD = -6.25, 95% CI (-8.85, -3.65)]. This study determined the efficacy of different Chinese medicine injections combined with mecobalamin. DZXX may be the best adjunctive Chinese medicine injection for DPN patients. However, due to potential risk of bias and limited RCTs, our results need to be treated with reservations.
近年来，人们越来越关注糖尿病周围神经病变（DPN）。甲钴胺作为一种神经营养药物，能够修复神经，这已成为专家们的共识。然而，已经发现甲钴胺在提高神经传导速度（这是一个重要指标）方面效果不佳。临床数据表明，中药注射剂联合甲钴胺注射剂可显著提高肢体神经传导速度。尽管如此，已有多种中药注射剂用于治疗DPN。这些中药注射剂治疗DPN的效果各不相同。因此，有必要评估中药注射剂联合甲钴胺治疗DPN的有效性。在八个电子数据库中检索了2022年3月12日前发表的所有相关文章。根据纳入标准确定了关于中药注射剂加甲钴胺治疗DPN的随机对照试验（RCT），并使用修订后的Cochrane偏倚风险工具（ROB2.0）进行评估。使用R软件和stata15创建排序概率和网络荟萃分析。共纳入80项涉及6980例患者的RCT。结果显示，甲钴胺加灯盏细辛注射液（ME + DZXX）在总有效率[RR = 1.64，95%CI（1.26，2.21）]和运动神经传导速度中位数[MD = 9.46，95%CI（5.67，13.28）]方面排名第一。其次，甲钴胺加苦碟子注射液（ME + KDZ）在感觉神经传导速度中位数[MD = 10.41，95%CI（-13.31，-7.52）]方面效果最佳，甲钴胺加红花注射液（ME + HH）在腓总运动神经传导速度[MD = 6.8，95%CI（4.13，9.49）]和腓总感觉神经传导速度[MD = -6.25，95%CI（-8.85，-3.65）]方面排名最高。本研究确定了不同中药注射剂联合甲钴胺的疗效。灯盏细辛注射液可能是DPN患者最佳的辅助中药注射剂。然而，由于存在潜在的偏倚风险且RCT数量有限，我们的结果需要谨慎对待。
