The effects of Chinese herbal medicines for treating diabetic foot ulcers: A systematic review of 49 randomized controlled trials

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Publisher: Elsevier B.V.
Document Type: Report
Length: 489 words

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Keywords Diabetic foot ulcer; Chinese herbal medicine; Randomized controlled trials; Systematic review; Meta-analyses Highlights * Systematic searches identified 49 randomized controlled trials on Chinese herbal medicine for treating diabetic foot ulcers. * Various herbal medicines composed of multiple herbs were tested as oral use or as foot bath or topical use for foot ulcers. * Weak evidence showed benefit of ulcer healing in patients with diabetic foot without serious adverse effects. Abstract Objective To assess the effects and associated risks of Chinese herbal medicine (CHM) for diabetic foot ulcer (DFU). Methods We systematically searched seven electronic databases for randomized controlled trials (RCTs) about Chinese herbal medicines for treating diabetic foot ulcers. The methodological quality of RCTs was assessed by the Cochrane risk of bias tool. Data was synthesized using review manager (RevMan) 5.3. Meta-analysis was conducted if the data were available. A summary of finding table was generated by The GRADEpro Guideline Development Tool (GDT) online. Results Forty-nine RCTs, all conducted in China, involving 3646 participants were included. Most of the included trials had unclear or high risk of bias. Twenty-six trials could be pooled in five Meta-analyses, the remaining trials could not be pooled due to the obvious clinical heterogeneity. Only low evidence showed CHM therapy may have 42%--60.4% participants healed completely after treatment, approximately twice (RR 1.42--1.76) as much as the healed rates in conventional therapy (or plus hot water foot bath) group. Majority of the included trials reported benefit of CHM group on shortening healing time (4--23 days) and reducing ulcer wound size (at least 2 cm.sup.2). No serious adverse events were reported related to the medication in all trials. Conclusion Weak evidence showed benefit of CHM as add-on treatment of conventional therapy on increasing number of ulcer heals in patients with DFU. That's about twice the healing rate of the conventional treatment (or plus hot water foot bath) group. With insufficient information, we could not draw confirmative conclusion on safety of CHM administration. These findings need to be tested in further large, rigorous trials. Author Affiliation: (a) Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China (b) School of acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China (c) Department of Endocrinology, Shuguang Hospital affiliated to Shanghai TCM University, Shanghai, 200020, China (d) School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China (e) Institute of Integrated Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, 510182, China * Corresponding author at: Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China. Article History: Received 24 December 2018; Revised 22 February 2019; Accepted 12 March 2019 (footnote)f The two authors contributed equally for this review. Byline: Ying Wang [2232759289@qq.com] (a,f), Hui-Juan Cao [700416@bucm.edu.cn] (a,f), Li-Qiong Wang [912131198@qq.com] (b), Chun-Li Lu [annyzhenni@163.com] (a), Yu-Qian Yan [tracyxing1214@163.com] (a), Hao Lu [luhao403@163.com] (c), Kang Zhang [astreae@163.com] (a), Hui-Min Zhang [zhanghm@bucm.edu.cn] (d), Jian-Ping Liu [Liujp@bucm.edu.cn] (a,e)

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Gale Document Number: GALE|A586246650