Traditional Chinese Medicine Injections in the Treatment of Diabetic Foot: A Systematic Review and Meta-Analysis

Context. The role of traditional Chinese medicine injections (TCMIs) in diabetic foot (DF) has not been well estimated. Objective. To evaluate the clinical effective rate, safety, and the financial cost of TCMIs in treating DF and ulcer wound healing. Methods. We searched PubMed, Embase, CENTRAL, China National Knowledge Infrastructure (CNKI), VIP database, and Wanfang database from inception to May 2018 to find all randomized control trials (RCTs) related to TCMIs in DF treatment. The search items were “Traditional Chinese Medicine Injection” AND “Diabetic foot or Diabetic foot ulcer” AND “random”. Study Selection and Synthesis. Only RCTs of TCMIs combined conventional therapies versus conventional therapies and that can be quantitatively synthesized were included. Finally, 17 studies and 1294 participants were included after extraction. Two investigators independently extracted and analyzed the data using RevMan5.3 software. Results. The overall clinical effective rate of TCMI groups is higher than that of control groups [RR=1.27, 95CI % (1.20, 1.34), P<0.00001] based on fixed effect model analysis. Regarding motor nerve conduction velocity of median nerve and peroneal nerve, TCMI group showed a significant improvement (MD=3.84[2.28, 5.41], P