Direct and Indirect Therapeutic Effect of Traditional Chinese Medicine as an Add-on for Non-proliferative Diabetic Retinopathy: A Systematic Review and Meta-analysis
Background:Diabetic retinopathy (DR) is the leading cause of blindness in many countries. The current treatment for non-proliferative DR (NPDR) using Western medicine (WM) alone is insufficient. At present, the combination of NPDR treatment with traditional Chinese medicine (TCM) and WM is universally applied. We aimed to evaluate the effectiveness and safety of TCM as an add-on for NPDR using a systematic review and meta-analysis.
Method: Data from randomized controlled trials (RCTs) of TCM for NPDR treatment along with WM before July 6, 2019, were collected from the China National Knowledge Infrastructure, Wanfang Database, China Biomedical Database, Pubmed, Embase, and Cochrane Library. Relevant data were extracted by two reviewers. I2 statistics was adopted to appraise heterogeneity. If I2<50% the fixed-effects model was employed, otherwise a random-effect model was employed. (PROSPERO: CRD42019134947)
Result: Eighteen RCTs (1522 patients) were included based on the inclusion and exclusion criteria. The results showed that compared with WM alone, TCM (including Compound Xueshuantong Capsule, Qiming Granule, and others) combined with WM for NPDR could improve the overall effiicacy [n=1686,RR1.24(1.18,1.30), P<0.00001, I2=0%], and reduce the influence of risk factors related to NPDR, such as glycated hemoglobin level [n=360, MD -0.85(-1.28, -0.41), P=0.0001, I2=72%], triglyceride (P<0.00001), and total cholesterol (P=0.0008). Moreover, no serious adverse events were reported.
Conclusion: Compared with WM alone, TCM+WM could significantly improve NPDR and also reduce the correlation levels of risk factors, such as hyperglycemia, dyslipidemia. However, the small sample included in the study might lead to a publication bias, and therefore, our results should be treated with caution.
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Posted 11 Sep, 2020
On 17 Sep, 2020
On 10 Sep, 2020
On 10 Sep, 2020
On 09 Sep, 2020
On 09 Sep, 2020
Received 02 Sep, 2020
On 02 Sep, 2020
Received 31 Aug, 2020
On 21 Aug, 2020
On 21 Aug, 2020
Invitations sent on 18 Aug, 2020
On 02 Aug, 2020
On 01 Aug, 2020
On 01 Aug, 2020
On 30 Jul, 2020
Direct and Indirect Therapeutic Effect of Traditional Chinese Medicine as an Add-on for Non-proliferative Diabetic Retinopathy: A Systematic Review and Meta-analysis
Posted 11 Sep, 2020
On 17 Sep, 2020
On 10 Sep, 2020
On 10 Sep, 2020
On 09 Sep, 2020
On 09 Sep, 2020
Received 02 Sep, 2020
On 02 Sep, 2020
Received 31 Aug, 2020
On 21 Aug, 2020
On 21 Aug, 2020
Invitations sent on 18 Aug, 2020
On 02 Aug, 2020
On 01 Aug, 2020
On 01 Aug, 2020
On 30 Jul, 2020
Background:Diabetic retinopathy (DR) is the leading cause of blindness in many countries. The current treatment for non-proliferative DR (NPDR) using Western medicine (WM) alone is insufficient. At present, the combination of NPDR treatment with traditional Chinese medicine (TCM) and WM is universally applied. We aimed to evaluate the effectiveness and safety of TCM as an add-on for NPDR using a systematic review and meta-analysis.
Method: Data from randomized controlled trials (RCTs) of TCM for NPDR treatment along with WM before July 6, 2019, were collected from the China National Knowledge Infrastructure, Wanfang Database, China Biomedical Database, Pubmed, Embase, and Cochrane Library. Relevant data were extracted by two reviewers. I2 statistics was adopted to appraise heterogeneity. If I2<50% the fixed-effects model was employed, otherwise a random-effect model was employed. (PROSPERO: CRD42019134947)
Result: Eighteen RCTs (1522 patients) were included based on the inclusion and exclusion criteria. The results showed that compared with WM alone, TCM (including Compound Xueshuantong Capsule, Qiming Granule, and others) combined with WM for NPDR could improve the overall effiicacy [n=1686,RR1.24(1.18,1.30), P<0.00001, I2=0%], and reduce the influence of risk factors related to NPDR, such as glycated hemoglobin level [n=360, MD -0.85(-1.28, -0.41), P=0.0001, I2=72%], triglyceride (P<0.00001), and total cholesterol (P=0.0008). Moreover, no serious adverse events were reported.
Conclusion: Compared with WM alone, TCM+WM could significantly improve NPDR and also reduce the correlation levels of risk factors, such as hyperglycemia, dyslipidemia. However, the small sample included in the study might lead to a publication bias, and therefore, our results should be treated with caution.
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