Compound Danshen Dripping Pill for Treating Nonproliferative Diabetic Retinopathy: A Meta-Analysis of 13 Randomized Controlled Trials.

Wenjing Huang,De Jin,Qi Bao,Fengmei Lian

doi:10.1155/2017/4848076

Abstract

Objective We assess the clinical effect of compound Danshen dripping pill (CDDP) for treating diabetic retinopathy (DR). Methods Electronic databases were searched from January 2001 to October 2016 to locate randomized controlled trials (RCTs). Efficacy was measured as main outcome and microaneurysms, hemorrhage, exudate, vision, and fundus fluorescein angiography (FFA) were measured as second outcomes. Methodological quality for each study was evaluated, RevMan 5 software was used to assess treatment effects, and GRADE was used to rate quality of evidence. Results We located 13 RCTs and methodological quality was evaluated as high risk. Statistics indicated CDDP for treating DR was better than controls and DR risk was reduced 64% with CDDP (RR: 0.36, P = 0.68); retinal microaneurysms (MD = −4.32NO, P < 0.00001); retinal hemorrhages (MD = −0.70PD, P = 0.03); exudate improvements (MD = −0.09PD, P = 0.79); visual changes (MD = −0.12 letter, P = 0.006); FFA (RR: 0.40, P = 0.003). About GRADE, quality of evidence was “low.” Conclusion. CDDP may be safe and efficacious for treating or delaying DR and may improve vision or delay vision loss.

Highlights

Diabetic retinopathy (DR) is a major microvascular complication of diabetes that can lead to retinal detachment and blindness
CDDP uses multiple sites, multiple pathways, and multitargets. It is characterized by convenient taking, rapid onset of action, and no obvious toxicity or adverse reactions. From this meta-analysis, we find that CDDP can be safe and efficacious retarding the progression of DR and delaying vision loss; it may be considered as an alternative way to treat DR
Many participants were lost and not followed-up! There are five proposals: first, record in detail data of participants who were lost to follow-up or quit midway; second, record long followup and record important clinical outcomes after treatment, such as progression of retinopathy to proliferative diabetic retinopathy (PDR) or sustained visual loss; third, methodological quality of clinical studies

Summary

Introduction

Diabetic retinopathy (DR) is a major microvascular complication of diabetes that can lead to retinal detachment and blindness. One-quarter of DR patients develop severe visual impairment, attributed to diabetic macular edema and proliferative diabetic retinopathy (PDR) [4]. Once proliferation begins, it causes irreversible visual impairment. Blindness for diabetics in China is 25 times more frequent than in nondiabetics [5, 6] and about 20 million diabetics reside in China constituting the second largest diabetes population worldwide [7]. Preventing DR and reducing diabetic-induced visual impairment are key concerns

Methods

Results

Conclusion