Effect of Chinese herbal compounds on ocular fundus signs and vision in conventional treated-persons with non-proliferative diabetic retinopathy: A systematic review and meta-analysis

Abstract

BackgroundChanges in fundus signs and loss of visual acuity are an important basis for screening and treating diabetic patients with retinopathy, and conventional Western medicine is moderately effective in treating diabetic retinopathy(DR),To systematically evaluate the effectiveness and safety of Chinese herbal compounds(CHCs) in the combined treatment of diabetic retinopathy.MethodSix electronic databases, including PubMed, were searched to screen eligible literature. Randomized controlled trials of non-proliferative diabetic retinopathy(NPDR) were included, in which the control group was treated with conventional Western-based drugs or retinal laser photocoagulation, and the intervention group was treated with CHCs in combination based on the control group.The Cochrane Risk of Bias Assessment Tool was used to evaluate the quality of the literature, and the RevMan 5.4 software was used for statistical analysis.ResultsCompared with Conventional group alone,CHCs group was superior at improving clinical efficacy [RR=1.29, 95%CI=(1.23, 1.36),P<0.01] and best corrected visual acuity(BCVA) [MD=0.10,95%CI=(0.09,0.12),P<0.01],it was also superior at reducing the number of microangiomas [MD=-2.37, 95%CI=(-3.26, -1.49),P<0.01], microangioma volume [MD=-4.72, 95%CI=(-5.14, -4.29), P<0.01], hemorrhagic spots [MD=-2.05, 95%CI=(-2.51,-1.59), P<0.01], hemorrhagic area [MD=-0.76, 95%CI=(-1.06, -0.47), P<0.01], hard exudates [MD= -1.86, 95%CI=(-2.43, -1.28), P<0.01], cotton lint spots [MD= -0.93, 95%CI= (-1.31, -0.55), P<0.01], central macular thickness(CMT) [SMD=-1.52, 95%CI=(-1.85, -1.19),P<0.01], Chinese medicine evidence score [SMD=-1.33,95%CI=(-1.58, -1.08),P<0.01], fasting blood glucose (FBG) [SMD=-0.47, 95%CI=(-0.61,-0.33),P<0.01], 2h postprandial blood glucose(2hPBG) [SMD=-0.87, 95% CI=(-1.06, -0.67), P<0.01], glycosylated hemoglobin (HbAlc) [SMD=-0.76, 95%CI=(-1.16, -0.3),P<0.01], total cholesterol(TC) [SMD=-0.33,95%CI=(-0.51,-0.16),P<0.01],and CHCs group with less adverse events occurred [RR=0.46, 95%CI=(0.29, 0.74),P<0.01].ConclusionCHCs combined with conventional medicine for NPDR has better clinical efficacy and higher safety, but the above findings need further validation in more large sample, multicenter, and low-bias RCTs due to the limitation of the quality and quantity of included literature.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022342137.

The effectiveness and safety of Chinese patent medicines plus calcium dobesilate for the treatment of diabetic retinopathy: A network meta-analysis

“…The previously published meta-analysis [ 9 , 11 , 48 , 49 ] proved that CPMs combined with western medicine is better than western medicine alone in the treatment of DR. However, the curative effects of various CPMs were not horizontally compared and ranked.…”

The Role of Natural Products in Diabetic Retinopathy

“…For example, polysaccharide compounds from algae were shown to be non-toxic at concentrations ranging from 100 μg/mL to the minimal effective dose of 0.1 μg/mL [ 172 ]. Furthermore, a meta-analysis by Li et al reported of the safety of Chinese herbal compounds for the treatment of DR, with a significantly lower probability of adverse risks than in the conventional treatment group [ 173 ]. However, cellular and animal models may not fully predict human toxicological outcomes.…”

An evidence mapping study based on systematic reviews of TCM for diabetic retinopathy

“…Calcium Dobesilate ROB Wang Y,2023 [30] 26 2047 CDDP Usual care/placebo Jadad Scale Sun W,2022 [31] 45 9503 TCM Usual care ROB Li XD,2022 [32] 27 2144 TCM+Control Usual care ROB Zhao SY,2022 [33] 1549 Integrated Traditional Chinese and Western Medicine…”