scholarly journals Direct and Indirect Therapeutic Effect of Traditional Chinese Medicine as an Add-on for Non-proliferative Diabetic Retinopathy: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Xuedong an ◽  
de jin ◽  
liyun duan ◽  
shenghui zhao ◽  
rongrong zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Small Sample ◽  
Cochrane Library

Abstract 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.

scholarly journals Direct and indirect therapeutic effect of traditional Chinese medicine as an add-on for non-proliferative diabetic retinopathy: a systematic review and meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Xuedong An ◽  
De Jin ◽  
LiYun Duan ◽  
Shenghui Zhao ◽  
Rongrong Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Small Sample ◽  
Cochrane Library

Abstract 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, RR 1.24 (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.

scholarly journals Direct and Indirect Therapeutic Effect of Traditional Chinese Medicine as an Additional Drug on Non-proliferative Diabetic Retinopathy: A systematic review and meta-analysis of high-quality studies

2020 ◽  
Author(s):  
Xuedong an ◽  
de jin ◽  
liyun duan ◽  
shenghui zhao ◽  
rongrong zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Number Of Patients

Abstract Background Diabetic retinopathy (DR) is the leading cause of blindness in many countries. The current treatment of non-proliferative DR (NPDR) with Western medicine (WM) alone are still insufficient. At present, the treatment of NPDR with the combination of traditional Chinese medicine (TCM) and WM is universally applied, and we would evaluate the effectiveness and safety of TCM as an additional drug for NPDR with systematic reviews and meta-analysis. Method Data before July 6, 2019 were searched as randomized controlled trials (RCTs) of TCM for the treatment of NPDR with WM, which were collected from China National Knowledge Infrastructure , Wanfang Database , China Biomedical Database , Pubmed , Embase and Cochrane Library . Relevant data was extracted by two reviewers respectively. I 2 statistics was adopted to appraise the heterogeneity, if I 2 <50% then the fixed-effects model would be employed, otherwise the random-effect model would be employed. (PROSPERO: CRD42019134947) Result 18 RCTs (1522 patients) were included according to the inclusion criteria. The results showed that compared with WM, TCM (including Compound Xueshuantong Capsule, Qiming Granule, and others)+ WM for NPDR could improve overall efficiency [n=1686,RR1.24(1.18,1.30), P <0.00001, I 2 =0%], and reduce the level of risk factors related to NPDR, such as glycated hemoglobin level [n=360, MD -0.85(-1.28, -0.41), P =0.0001, I 2 =72%], triglyceride and total cholesterol, but not Qiming Granule. Moreover, no serious adverse events were reported. Conclusion Compared with WM alone, TCM+WM could significantly improve NPDR, and also reduced the correlation levels of risk factors, considering the sample size and the number of patients included in the study, there might be publication bias, so the corresponding results should be treated with caution.

scholarly journals Efficacy of Traditional Chinese Medicine Tonifying Kidney (Bushen) and Activating Blood (Huoxue) Prescription for Premature Ovarian Insufficiency: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Hui-Fang Li ◽  
Qi-Hong Shen ◽  
Wen-Jun Chen ◽  
Wei-Min Chen ◽  
Zhang-Feng Feng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Meta Analysis ◽  
Scientific Journal ◽  
Peak Systolic Velocity ◽  
Premature Ovarian Insufficiency ◽  
Cochrane Library ◽  
Ovarian Insufficiency

Context. Premature ovarian insufficiency (POI) is one of the difficult gynecological diseases with complex etiologies. Tonifying kidney (bushen) and activating blood (huoxue) prescription (TKABP) is a popular traditional Chinese medicine (TCM) therapy which is commonly applied for POI. However, its efficacy and safety are still controversial. Objective. We carried out this systematic review and meta-analysis to evaluate the effectiveness of TKABP on POI. Methods. The following eight databases were searched from the establishment to September 30, 2019, for randomized controlled trials (RCTs): PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), the Chinese BioMedical database (CBM), Chinese Scientific Journal Database (VIP), and the Wanfang database. The quality of evidence was estimated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results. Twenty-three RCTs involving 1712 patients with POI were included. Compared to hormone therapy (HT) groups, TKABP groups showed a significantly higher total effective rate (RR: 1.10; 95% CI: 1.04–1.17; P<0.01, I2 = 32%). In addition, TKABP groups revealed a better improvement in terms of serum follicle-stimulating hormone (FSH) levels, serum estradiol (E2) levels, peak systolic velocity (PSV) of ovarian stromal blood, and Kupperman index (KI) score. However, serum luteinizing hormone (LH) levels and ovarian volume (OV) showed no significant statistical difference. Subgroup analyses showed that herbal paste and 3 months of treatment duration had a greater effect on the improvement of hormone levels. Besides, the occurrence of related adverse events in TKABP groups was lower than that in HT groups. Conclusions. Our review suggests that TKABP appears to be an effective and safe measure for patients with POI, and the herbal paste may be superior. However, the methodological quality of included RCTs was unsatisfactory, and it is necessary to verify its effectiveness with furthermore standardized researches of rigorous design.

scholarly journals The Efficacy of Heat-Clearing (Qingre) and Detoxifying (Jiedu) Traditional Chinese Medicine Gargle for Chemotherapy-Induced Oral Mucositis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhixian Lin ◽  
Jiangfeng Chen ◽  
Sunya Han
Keyword(s):  
Systematic Review ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Oral Mucositis ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Systematic Evaluation ◽  
Cochrane Library ◽  
Randomized Controlled ◽  
Randomized Controlled Studies

Objective: Chemotherapy-induced oral mucositis (CIOM) is an extremely serious complication of cancer. In China, the heat-clearing (Qingre) and detoxifying (Jiedu) traditional Chinese medicine QRJD-TCM gargle has been widely used to treat CIOM. To date, no systematic evaluation has been conducted on the clinical efficacy of QRJD-TCM gargle in treating CIOM. The objective of this systematic review and meta-analysis was to evaluate the efficacy of QRJD-TCM gargle in the treatment of CIOM.Methods: Relevant randomized controlled trials (RCTs) comparing QRJD-TCM gargle with conventional Western medicine mouthwash (CWMM) for CIOM were confirmed by systematically searching PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Database, and Sinomed until October 20, 2020. Two researchers independently assessed the risk of bias according to the Cochrane risk-of-bias criteria. Excel 2010 was used in setting up a database of extracted information, and RevMan 5.3.0 was used in analyzing included trial data. The composition of the QRJD-TCM gargle was evaluated.Results: A total of 25 articles were included in this meta-analysis. Results showed that compared with CWMM, QRJD-TCM gargle can reduce the incidence of CIOM (OR = 0.23, 95% CI [0.18, 0.29], p &lt; 0.00001) and severity of CIOM (grade I–II: OR = 0.36, 95%CI [0.28, 0.46], p &lt; 0.00001; grade III–IV: OR = 0.15, 95%CI [0.09, 0.28], p &lt; 0.00001). In addition, QRJD-TCM gargle improved the effective rate of CIOM (OR = 15.91, 95% CI [7.93, 31.89], p &lt; 0.00001).Conclusion: QRJD-TCM gargle is effective in preventing and treating CIOM. However, more standard, double-blind, and multicenter randomized controlled studies are needed to further confirm the efficacy of QRJD-TCM gargle in the prevention and treatment of CIOM.

scholarly journals Acupuncture combined with traditional Chinese medicine for allergic rhinitis: A protocol for systematic review and meta-analysis

2021 ◽  
Author(s):  
Le Yan ◽  
Haocheng Gou ◽  
Jun Feng ◽  
Lintong Dai
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Nasal Congestion ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Life Questionnaire ◽  
Safety And Efficacy

Abstract Background Allergic rhinitis (AR) is a prevalent yet underappreciated inflammatory disorder of nasal mucosa, which is characterized by pruritus, sneezing, rhinorrhoea, and nasal congestion, some studies have pointed out that if combine Traditional Chinese medicine (TCM) with acupuncture, which can enhance the effect of acupuncture and moxibustion. However, safety and efficacy of acupuncture combined with traditional Chinese medicine for treating allergic rhinitis remain largely uncertain. In our study, we will perform the first systematic review and meta-analysis to explore the effectiveness and safety of acupuncture combined with TCM for AR. Methods We will search the randomized controlled (RCT) literatures involving acupuncture combined with TCM for treating AR in seven electric databases, including PubMed, Web of science, EMBASE, the Cochrane library, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), WanFang Database. We will define the total effective rate or cure rate, and recurrence rate as the primary outcomes. the rhinoconjunctivitis quality of life questionnaire (RQLQ) score, symptom score (nasal congestion, snot, sneezing) will be regarded as the secondary outcomes. Quality assessment of included studies will be independently performed according to the Cochrane Risk of Bias tool. Meanwhile, the level of evidence for results will be assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. All analysis will be conducted by using the RevMan software V5.4. Conclusion The conclusion of this study will confirm safety and efficacy of acupuncture combined with TCM in the treatment of allergic rhinitis, which can provide new evidence to guide appropriate interventions on AR with acupuncture combine with TCM in future. Systematic review registration: PROSPERO CRD42021247621

scholarly journals Ear mould for congenital auricular deformities: a protocol for systematic review and meta-analysis

2020 ◽  
Author(s):  
Jincheng Huang ◽  
Kun Zou ◽  
Ping Yuan ◽  
Longhao Zhang ◽  
Min Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Evidence Base ◽  
Small Sample ◽  
Cochrane Library ◽  
Random Effects Model ◽  
High Quality ◽  
Effectiveness Rate

Abstract Background: Congenital auricle deformities (CADs) not only affect the appearance, but may also result in social inferiority or difficulties, influence the hearing and mental health of the children. Although some studies have pointed out CADs have a natural improvement trend, there is still a lack of high-quality research to demonstrate the degree of that. Therefore, related studies agree that early treatment are necessary. Ear mold correction is currently main non-surgical treatment for CADs, but the existing research often involves a small sample size, and the research conclusions are inconsistent. More importantly, there is still no systematic review on ear mold correction for CADs. This study aims to systematically evaluate the effectiveness and safety of ear mold correction for CADs, so as to provide an evidence base for further research.Methods: The study has been designed according to the Preferred Reporting program for Systems Evaluation and Meta-analysis Protocol (PRISMA-P). We will search electronic literature databases of PubMed, Embase, Cochrane Library, Web of science, CBM, CNKI, Wanfang and VIP from their initiative to 1 June 2020 for interventional studies on ear mould for children with CADs. The study selection, data extraction and quality assessment will be performed by two authors. Meta-analysis will be conducted on primary outcome effectiveness rate of physician assessment and secondary outcomes of effectiveness rate of parents’ assessment, effectiveness score, hearing assessment, and adverse reactions using relative ratio or mean difference and their 95% confidence intervals. The heterogeneity of the included studies will be tested using Chi square test and I2, and random-effects model will be used when significant heterogeneity was found, otherwise, fixed-effects model will be used. Sensitivity analysis will be performed using trials with high quality and using alternative [1]models (fixed-effects or random effects model). Publication bias will be tested using funnel plot and Egger’s test. Discussion: This study will be the first to systematically evaluate the effectiveness and safety of ear mold correction for CADs, to provide evidence base for clinical guideline making, clinical decision and future research. Systematic review registration : CRD42020190982.

The incidence and risk factors of neovascular glaucoma secondary to proliferative diabetic retinopathy after vitrectomy

2020 ◽  
pp. 112067212098068
Author(s):  
Difang Sun ◽  
Yifan Lin ◽  
Rui Zeng ◽  
Zhenlan Yang ◽  
Xiaowen Deng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Cataract Surgery ◽  
Proliferative Diabetic Retinopathy ◽  
Meta Analysis ◽  
Vitreous Hemorrhage ◽  
Neovascular Glaucoma ◽  
Cochrane Library ◽  
P Value

Objective: The incidence and risk factors of neovascular glaucoma (NVG) secondary proliferative diabetic retinopathy (PDR) after pars plana vitrectomy (PPV) are unclear and reports in the published literature are inconsistent. Therefore, a systematic review and meta-analysis were conducted to clarify the risk factors associated with neovascular glaucoma. Methods: PubMed, Embase, and The Cochrane Library were systematically searched without language limitations for studies related to NVG after PPV in PDR patients. We used R software to fit the correlation between incidence and the date of publication for studies and performed a Spearman analysis. For binary and continuous variables, the odds ratios (ORs) with 95% confidence intervals (CIs) were pooled, respectively, using Review Manager 5.3 (The Cochrane Collaboration). Results: Twenty-six studies with 5161 patients were included in our meta-analysis. The overall pooled incidence of NVG after PPV in PDR patients was 6% (95% CI, 0.05–0.07, p-value < 0.00001). Pooled estimates indicated a positive correlation for NVG after PPV in PDR patients with higher baseline IOP (OR, 1.26; 95%CI,0.56–1.95, p-value = 0.0004), preoperative iris neovascularization (INV) (OR, 5.66; 95% CI, 2.10–15.23, p-value = 0.0006), preoperative or intraoperative combined cataract surgery (OR, 2.00; 95% CI, 1.15–3.46, p-value = 0.01), postoperative vitreous hemorrhage (VH) (OR, 3.53; 95% CI, 1.63–7.66, p-value = 0.001), and a negative correlation with age (OR, −2.90; 95%CI, −5.00 to −0.81, p-value < 0.007). Conclusion: Our systematic review and meta-analysis indicated that the main risk factors for NVG after PPV in PDR patients included higher baseline IOP, preoperative INV, preoperative or intraoperative combined cataract surgery, postoperative VH, and was negatively correlated with age.

scholarly journals Association Between Diabetic Retinopathy and Cognitive Impairment: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 13 ◽  
Author(s):  
Dihe Cheng ◽  
Xue Zhao ◽  
Shuo Yang ◽  
Guixia Wang ◽  
Guang Ning
Keyword(s):  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Cognitive Impairment ◽  
Odds Ratio ◽  
Observational Studies ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Microvascular Complications ◽  
Cochrane Library ◽  
Related Disorder

Diabetic retinopathy (DR) is one of the most common microvascular complications associated with diabetes mellitus. However, its correlation with another diabetes-related disorder, cognitive impairment, has not been well studied. This systematic review and meta-analysis aimed to explore the association between DR and cognitive impairment. MEDLINE (PubMed), the Cochrane Library, and EMBASE databases were searched for observational studies that reported an association between DR and cognitive impairment. Data from selected studies were extracted, and a meta-analysis was conducted using fixed-effects modeling. Fifteen observational studies were included in the systematic review, and 10 studies were included in the meta-analysis. The odds ratio of the association between DR and cognitive impairment was 2.24 (95% confidence interval [CI], 1.89–2.66; I2 = 0.8%). The hazard ratio of the association between DR and cognitive impairment was significant in four studies, ranging from 1.09–1.32. Minimal or mild DR was not significantly associated with cognitive impairment (odds ratio [OR], 2.04; 95% CI, 0.87–4.77). However, the association between proliferative DR and cognitive impairment (OR, 3.57; 95% CI, 1.79–7.12; I2 = 16.6%) was not stronger than the association between moderate or worse DR and cognitive impairment (OR, 4.26; 95% CI, 2.01–9.07; I2 = 0.0%). DR is associated with cognitive impairment, and screening for DR will be helpful for the early identification of individuals with cognitive impairment. Further studies are needed to confirm the association between proliferative DR and cognitive impairment.

scholarly journals Prevalence of retinopathy in prediabetes: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040997
Author(s):  
Varo Kirthi ◽  
Paul Nderitu ◽  
Uazman Alam ◽  
Jennifer Evans ◽  
Sarah Nevitt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Data Extraction ◽  
Meta Analysis ◽  
International Diabetes Federation ◽  
Current Data ◽  
Risk Of Bias ◽  
Fundus Photography ◽  
Primary Data ◽  
Cochrane Library

IntroductionThere is growing evidence of a higher than expected prevalence of retinopathy in prediabetes. This paper presents the protocol of a systematic review and meta-analysis of retinopathy in prediabetes. The aim of the review is to estimate the prevalence of retinopathy in prediabetes and to summarise the current data.Methods and analysisThis protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. A comprehensive electronic bibliographic search will be conducted in MEDLINE, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar and the Cochrane Library. Eligible studies will report prevalence data for retinopathy on fundus photography in adults with prediabetes. No time restrictions will be placed on the date of publication. Screening for eligible studies and data extraction will be conducted by two reviewers independently, using predefined inclusion criteria and prepiloted data extraction forms. Disagreements between the reviewers will be resolved by discussion, and if required, a third (senior) reviewer will arbitrate.The primary outcome is the prevalence of any standard features of diabetic retinopathy (DR) on fundus photography, as per International Clinical Diabetic Retinopathy Severity Scale (ICDRSS) classification. Secondary outcomes are the prevalence of (1) any retinal microvascular abnormalities on fundus photography that are not standard features of DR as per ICDRSS classification and (2) any macular microvascular abnormalities on fundus photography, including but not limited to the presence of macular exudates, microaneurysms and haemorrhages. Risk of bias for included studies will be assessed using a validated risk of bias tool for prevalence studies. Pooled estimates for the prespecified outcomes of interest will be calculated using random effects meta-analytic techniques. Heterogeneity will be assessed using the I2 statistic.Ethics and disseminationEthical approval is not required as this is a protocol for a systematic review and no primary data are to be collected. Findings will be disseminated through peer-reviewed publications and presentations at national and international meetings including Diabetes UK, European Association for the Study of Diabetes, American Diabetes Association and International Diabetes Federation conferences.PROSPERO registration numberCRD42020184820.

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