Traditional Chinese medicine for diabetic peripheral neuropathy: a network meta-analysis

Area of Science:

• Neurology
• Integrative Medicine
• Pharmacology

Background:

• Diabetic peripheral neuropathy (DPN) is a common, debilitating complication of diabetes mellitus.
• Traditional Chinese Medicine (TCM) offers multi-targeted mechanisms for symptom relief and functional improvement in DPN.
• Systematic evaluation of TCM efficacy and safety for DPN is needed.

Purpose of the Study:

• To provide evidence-based medicine for DPN treatment using TCM therapies.
• To systematically evaluate the efficacy and safety of various TCM therapies for DPN via network meta-analysis (NMA).

Main Methods:

• A comprehensive literature search of nine databases up to November 2024.
• Inclusion of 95 randomized controlled trials (RCTs) involving 8194 patients.
• Quality assessment using risk of bias tools and GRADE; NMA performed using RevMan, Stata, and R Studio.

Main Results:

• TCM Decoration + Acupuncture ranked highest for common peroneal nerve motor conduction velocity (SUCRA=0.81).
• TCM Decoration + Chinese Herbal Footbath showed the best improvement in overall clinical symptoms (SUCRA=0.85).
• Specific TCM therapies demonstrated superior efficacy in improving various nerve conduction velocities.

Conclusions:

• TCM therapies demonstrate preliminary effectiveness and safety for DPN treatment.
• Clinical stratification based on study results can guide treatment selection.
• Further high-quality research with larger sample sizes is recommended.