Lin Ruifang, Yu Yunfeng, Yin Yuman, Liu Xiu, Wu Yongjun, Xiang Qin, Luo Yaoyue, Yu Rong
School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China.
School of Pharmacy, Hunan University of Chinese Medicine, Changsha, Hunan, China.
Front Pharmacol. 2025 Jul 10;16:1594386. doi: 10.3389/fphar.2025.1594386. eCollection 2025.
The benefit of Chinese herbal foot-baths in treating diabetic foot remains unclear. This study aims to assess the efficacy of Chinese herbal foot-baths for diabetic foot with Wagner grade of 0 or 1 and identify key candidate herbs.
A comprehensive search of eight databases was conducted for studies published up to 24 May 2025. Relevant data on study characteristics, outcomes, and risk of bias were extracted. The meta-analysis and trial sequential analysis (TSA) were performed using RevMan 5.3 and TSA 0.9.5.10 beta, respectively. The risk ratio (RR) and mean difference (MD) were respectively used as effect sizes for dichotomous and continuous outcomes. Publication bias was assessed with funnel plots and Egger's tests.
13 studies involving 921 participants were included in this review. The meta-analysis showed that compared to warm water foot-bath, Chinese herbal foot-baths significantly improved the clinical effective rate (RR 1.42, 95%CI 1.31-1.53, < 0.00001), ankle-brachial index (MD 0.19, 95%CI 0.11-0.26, < 0.00001), common peroneal nerve motor nerve conduction velocity (MD 4.09, 95%CI 2.41-5.77, < 0.00001), common peroneal nerve sensory nerve conduction velocity (MD 3.83, 95%CI 2.48-5.17, < 0.00001). The glycosylated hemoglobin A1c (MD -0.15, 95%CI -0.30-0.01, = 0.04), and fasting blood glucose levels (MD -0.28, 95%CI -0.54-0.02, = 0.04) were significantly reduced. However, no significant differences were observed in 2-h postprandial blood glucose, total cholesterol, triglycerides, and adverse events ( > 0.05). Additionally, except for the clinical effective rate, there are no potential publication biases in other results. Furthermore, the data mining identified the key candidate herbs used in the foot bath as [ Presl], [ 'Chuanxiong'], [ Pall.], [ (Oliv.) Diels] [ (L.), Batsch], [ L.], and [ F. Schmidt].
Chinese herbal foot-baths can improve clinical symptoms as well as vascular and nerve functions in diabetic foot patients with Wagner grades 0 or 1, without increasing the incidence of adverse events. The seven herbs identified through data mining offer a reference for formulating Chinese herbal foot-baths. However, these clinical findings and the pharmacological effects of the herbal combinations require further validation.
www.crd.york.ac.uk/PROSPERO/view/CRD42024615181, CRD42024615181.
中药足浴治疗糖尿病足的益处尚不清楚。本研究旨在评估中药足浴对瓦格纳分级为0或1级的糖尿病足的疗效，并确定关键候选草药。
全面检索了8个数据库，查找截至2025年5月24日发表的研究。提取了有关研究特征、结果和偏倚风险的相关数据。分别使用RevMan 5.3和TSA 0.9.5.10 beta进行荟萃分析和试验序贯分析（TSA）。风险比（RR）和均值差（MD）分别用作二分法和连续结果的效应量。用漏斗图和埃格检验评估发表偏倚。
本综述纳入了13项研究，共921名参与者。荟萃分析表明，与温水足浴相比，中药足浴显著提高了临床有效率（RR 1.42，95%CI 1.31 - 1.53，P < 0.00001）、踝肱指数（MD 0.19，95%CI 0.11 - 0.26，P < 0.00001）、腓总神经运动神经传导速度（MD 4.09，95%CI 2.41 - 5.77，P < 0.00001）、腓总神经感觉神经传导速度（MD 3.83，95%CI 2.48 - 5.17，P < 0.00001）。糖化血红蛋白A1c（MD -0.15，95%CI -0.30 - 0.01，P = 0.04）和空腹血糖水平（MD -0.28，95%CI -0.54 - 0.02，P = 0.04）显著降低。然而，餐后2小时血糖、总胆固醇、甘油三酯和不良事件方面未观察到显著差异（P > 0.05）。此外，除临床有效率外，其他结果无潜在发表偏倚。此外，数据挖掘确定足浴中使用的关键候选草药为[前胡]、[川芎]、[茵陈]、[地黄]、[艾叶]、[透骨草]和[伸筋草]。
中药足浴可改善瓦格纳分级为0或1级的糖尿病足患者的临床症状以及血管和神经功能，且不增加不良事件发生率。通过数据挖掘确定的7种草药为中药足浴配方提供了参考。然而，这些临床发现和草药组合的药理作用需要进一步验证。
www.crd.york.ac.uk/PROSPERO/view/CRD42024615181，CRD42024615181 。
