Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Mar 15, 2023; 14(3): 313-342
Published online Mar 15, 2023. doi: 10.4239/wjd.v14.i3.313
Effectiveness and safety of traditional Chinese medicine decoction for diabetic gastroparesis: A network meta-analysis
Yu-Xin Zhang, Yan-Jiao Zhang, Run-Yu Miao, Xin-Yi Fang, Jia-Hua Wei, Yu Wei, Jia-Ran Lin, Jia-Xing Tian
Yu-Xin Zhang, Yan-Jiao Zhang, Run-Yu Miao, Xin-Yi Fang, Yu Wei, Jia-Ran Lin, Jia-Xing Tian, Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
Run-Yu Miao, Xin-Yi Fang, Yu Wei, Jia-Ran Lin, Graduate College, Beijing University of Chinese Medicine, Graduate College, Beijing University of Chinese Medicine, Beijing 100029, China
Jia-Hua Wei, Graduate College, Changchun University of Chinese Medicine, Changchun 130117, Jilin Province, China
Author contributions: Zhang YX contributed to conceptualization, software, data curation, writing-Original draft preparation; Tian JX contributed to conceptualization, methodology, funding acquisition; Zhang YJ contributed to data curation, validation; Fang XY contributed to visualization, investigation; Miao RY contributed to software, validation; Wei JH contributed to writing- reviewing and editing; Wei Y contributed to data curation and validation; Lin JR contributed to reviewing and editing.
Supported by CACMS Outstanding Young Scientific and Technological Talents Program, No. ZZ13-YQ-026; Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences, No. CI2021A01601; Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine, No. ZYYCXTD-D-202001; Open Project of National Facility for Translational Medicine, No. TMSK-2021-407; and GAMIMD Special Fund, 2022DXBZX012.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jia-Xing Tian, PhD, Academic Editor, Doctor, Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange, Xicheng District, Beijing 100053, China. tina_yai@126.com
Received: December 2, 2022
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

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).

Research methods

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.

Research results

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.

Research conclusions

TCM decoction combined with WM is more effective than WM alone in treating patients with DGP.

Research perspectives

These NMA findings may aid in the development of DGP treatments and, as a consequence, enhance treatment effectiveness and patient wellbeing.