CHENG Ting 1 , TANG Qi 1 , YU Dongdong 2 , LI Geng 3 , WEN Zehuai 3,4
  • 1. Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, P. R. China;
  • 2. First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, P. R. China;
  • 3. Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, P. R. China;
  • 4. Science and Technology Innovation Center of Guangzhou University of Chinese Medicine, Guangzhou 510405, P. R. China;
LI Geng, Email: ligeng@gzucm.edu.cn; WEN Zehuai, Email: wenzh@gzucm.edu.cn
Diabetes; Guidelines; Chinese medicine; Evidence; Question
10.7507/1672-2531.202312069
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Objective To systematically analyze the distribution of research evidence on diabetes in current clinical practice guidelines of Chinese medicine (CM). Methods The PubMed, EMbase, Cochrane Library, CBM, WanFang Data, CNKI, VIP databases and related guideline website were electronically searched to collect clinical practice guidelines for CM in diabetes published before December 2023. We systematically reviewed the distribution of evidence in these guidelines. Results The content of 27 CM guidelines on diabetes mainly covered syndrome differentiation and treatment, specific disease-specific drugs, diet, external therapies, and traditional exercises. The included guidelines used three different levels of evidence grading, with most of the evidence falling into the low-to-moderate level (67.3%). However, guidelines on diabetes-related osteoporosis, diabetic cardiomyopathy, prediabetes, and diabetic peripheral neuropathy had a relatively low proportion of high-level evidence, accounting for only 7.2%, 7.6%, 13.2%, and 13.3% respectively. Only guidelines on diabetic nephropathy provided evidence on the toxicity of Chinese herbal medicine, while other guidelines did not cover this aspect. Acupuncture, Tai Chi, Baduanjin, and other characteristics therapies had varying levels of evidence for different types of complications. Low-level evidence mainly focused on syndrome differentiation and treatment, symptom-based treatment, sign-based treatment, indicator-based treatment, Chinese patent medicine, specific disease-specific formulas, etc., for diabetes and related complications. Conclusion Currently, topics supported by low/no evidence, new themes, inconsistent content between guidelines, evidence sources for overlapping targets, classical formulas, toxicity of Chinese herbal medicine, and characteristic CM therapies can provide directions for future research on CM in diabetes. We advocate addressing important issues related to diabetes specifically, to improve research value, eliminate unnecessary duplication of studies and resource waste, and promote the healthy development of CM research in the field of diabetes.