Published online Mar 15, 2023. doi: 10.4239/wjd.v14.i3.313
Peer-review started: December 2, 2022
First decision: December 19, 2022
Revised: December 29, 2022
Accepted: February 22, 2023
Article in press: February 22, 2023
Published online: March 15, 2023
Processing time: 103 Days and 14.1 Hours
Diabetic gastroparesis (DGP) has a negative impact on the quality of life of patients. Although conventional western medicine gastric motility drugs like domperidone and metoclopramide can alleviate gastrointestinal (GI) pain, they also have some unfavorable side effects, and patients are easy to relapse after drug withdrawal.
The GI symptoms in DGP patients can be improved by several Traditional Chinese Medicine (TCM) decoctions, which have been shown to be effective in treating the disease.
The goal of this study is to analyze the efficacy of several TCM decoctions in the treatment of DGP based on Bayesian network meta-analysis (NMA).
PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure, The China Biology Medicine DVD, Wanfang, and CQVIP were searched from the databases’ inception to September 17, 2022 to gather randomized controlled trials about TCM decoctions for DGP. The main outcomes were symptom scores and clinical effects. The secondary outcomes included motilin (MOT), somatostatin (SS), gastrin (GAS), gastric emptying rate, gastric emptying time, and adverse medication events.
NMA and the surface under the cumulative ranking curve studies demonstrated that, using western medicine (WM) as a common control, the Banxia Xiexin Decoction (BXXD) + WM was the most effective in the improvement of early satiety scores; the Simo decoction (SMD) + WM was the most effective in improving nausea and vomiting scores, anorexia scores, and bloating scores; the Chaishao Liujunzi Decoction (CSLJD) was the most effective for MOT; the Zhishi Xiaopi Decoction (ZSXPD) was the most effective for improving SS and emptying rate; the Jianpi Xiaozhi Decoction was the most effective for GAS; and the CSLJD + WM was the most effective in improving gastric emptying time.
TCM decoction combined with WM is more effective than WM alone in treating patients with DGP.
These NMA findings may aid in the development of DGP treatments and, as a consequence, enhance treatment effectiveness and patient wellbeing.