Long-term efficacy and safety of Huangqi ()-based Traditional Chinese Medicine in diabetic peripheral neuropathy: a Meta-analysis of randomized controlled trials.

OBJECTIVE: To assess the long-term effectiveness of Huangqi (Radix Astragali Mongolici, HQ)-based Traditional Chinese Medicine (TCM) in the treatment of diabetic peripheral neuropathy (DPN). METHODS: Nine databases were searched to retrieve available randomized controlled trials that compared HQ-based TCM and Western Medicines in the treatment of DPN. The methodological quality of the included studies was assessed using the Cochrane bias risk tool, and RevMan 5.4 was used for data analysis. The effect estimates of interest were risk ratio (RR), mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI). RESULTS: The results from 48 available studies assessing 3759 patients demonstrated that cases administered HQ-based TCM [RR = 1.30, 95% CI (1.21, 1.40), P < 0.000 01] or HQ-based TCM combined with Western Medicines [RR = 1.25, 95% CI (1.19, 1.31), P < 0.000 01] exhibited higher total efficacy rates than individuals who received Western Medicine alone. The results showed that the HQ-based TCM group had decreased Toronto Clinical Scoring System scores [MD =－1.50, 95% CI (－1.83, －1.17), P < 0.000 01], and reduced serum interleukin 6 [SMD = －0.57, 95% CI (－0.87, －0.27), P = 0.0002] and tumor necrosis factors-α levels [SMD = －0.60, 95% CI (－0.95, －0.25), P = 0.0009]. In addition, both HQ-based TCM and HQ-based TCM combined with Western Medicine increased nerve conduction velocity and decreased glycaemia compared with Western Medicine alone. In terms of blood lipids, oxidative stress and adverse drug reactions, there were no significant differences between the HQ-based TCM groups and the Western Medicine control group. CONCLUSION: The current Meta-analysis revealed that HQ-based TCM yields higher efficacy and safety than Western Medicine alone for the treatment of DPN, although further well-designed RCTs are required to validate these findings.

Clinical evaluation of the consistency between two diagnostic criteria for diabetic peripheral neuropathy / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the consistency between the clinical diagnostic criteria and the ascertained diagnostic criteria for diabetic peripheral neuropathy (DPN) in the Preventive and Treatment Guidelines of Diabetes in China (2013) and explore an economic, convenient, and accurate approach to DPN diagnosis.</p><p><b>METHODS</b>The patients with type 2 diabetes admitted in our department from April to June, 2014 were examined for nerve conduction velocity, 10 g nylon silk, vibration threshold value, sense of temperature and pain, and ankle reflex. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and Kappa value were calculated to assess the diagnostic power of the two diagnostic criteria.</p><p><b>RESULTS</b>Of the 151 patients enrolled, 106 (70.2%) had a diagnosis of DPN consistent with the ascertained diagnostic criteria, as compared to 86 (56.95%) who were diagnosed according to the clinical diagnostic criteria; the latter patients accounted for 81.13% of former cases. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and Kappa value of the clinical diagnostic criteria were 80.19%, 97.78%, 98.84%, 67.69%, 77.97%, and 0.69, respectively, which were highly consistent with those of the ascertained diagnostic criteria; the sensitivity to compression showed a poor consistency between the two diagnostic criteria. In the 5 screening tests, the combined test of temperature sensation, vibration perception, and ankle reflex showed the highest AUC value among their different combinations.</p><p><b>CONCLUSION</b>The clinical diagnostic criteria for DPN show good consistency with the ascertained diagnostic criteria, and for patients with clinical symptoms or with only one positive sign, combination of the two diagnostic criteria can achieve the maximum diagnostic power.</p>

The performance evaluation of the five inspection methods in the diagnosis of peripheral neuropathy in diabetes / 西安交通大学学报(医学版)

Objective To evaluate the diagnostic value of the 10 g nylon silk,vibration threshold value,sense of temperature,pain sense and ankle reflex in the diagnosis of diabetic peripheral neuropathy (DPN)and to search an exact diagnostic method of DPN not only economical but also easy to handle.Methods To carry out the measurements of the NCV,10 g nylon silk,vibration threshold value,sense of temperature,pain sense and ankle reflex on the patients who have been diagnosed with diabetes (DM)between April 2014 and June 2014 in the endocrinology department of our hospital.The sensitivity,specificity,positive forecast value,negative forecast value,Youden index and K value serve as assessments of the diagnostic efficiency of clinically diagnostic criteria. Results The sensitivity,specificity,positive forecast value,negative forecast value,Youden index and K value of the ankle reflex are 66.04%,95.56%,97.22%,54.43%,61.60%,and 0.5 1 in mediate accordance with the diagnostic criteria and it is the best one among the five methods.While the sensitivity and accordance of the pressure sense are of the least accordance with the diagnostic criteria.The correspondent value of the combination of vibration threshold sense,temperature sense and ankle reflex are respectively 86.79%,91.11%,95.83%,74.55%, 77.90% and 0.73,in positive accordance with the diagnostic criteria.Conclusion Among the five methods the consistency between the combination of vibration threshold sense,temperature sense and ankle reflect and diagnostic criteria is of positive accordance and can be applied in screening DPN clinically.