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Efficacy and safety of hyperbaric oxygen therapy for diabetes peripheral neuropathy: A systematic review and meta-analysis

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Efficacy and safety of hyperbaric oxygen therapy for diabetes peripheral neuropathy: A systematic review and meta-analysis

Research Article: Systematic Review and Meta-Analysis
Medicine 103(36):p e39699, September 06, 2024. |
DOI: 10.1097/MD.0000000000039699
Author
Weng, Jiyan MMa; Ren, Haiyong MMb; Guo, Qiaofeng MMb; Huang, Kai PhDb; Ding, Liqing MMc,*

aRehabilitation Department, Tongde Hospital of Zhejiang Province, Hangzhou, China

bDepartment of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, China

cDepartment of Endocrinology, Tongde Hospital of Zhejiang Province, Hangzhou, China.

Received: 15 May 2023 / Received in final form: 13 August 2024 / Accepted: 23 August 2024

This study was supported by the Zhejiang Province Public Welfare Technology Application Research Project (LGF21H270004), the Natural Science Foundation of Zhejiang Province (LY20H270002), the Medical science and technology project of Zhejiang Province (2020RC048, 2021KY600), and the Chinese Medicine Research Program of Zhejiang Province (2020ZQ006, 2021ZB060, 2022ZB082).

Ethical approval is not necessary since this systematic review will be based on published research. The results of this review will be disseminated through peer-reviewed journal articles and conference presentations.

The authors have no conflicts of interest to disclose.

All data generated or analyzed during this study are included in this published article [and its supplementary information files].

How to cite this article: Weng J, Ren H, Guo Q, Huang K, Ding L. Efficacy and safety of hyperbaric oxygen therapy for diabetes peripheral neuropathy: A systematic review and meta-analysis. Medicine 2024;103:36(e39699).

JW and HR contributed equally to this work.

*Correspondence: Liqing Ding, Department of Endocrinology, Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
(e-mail: dingliqing8120@163.com).

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
Background
Diabetes peripheral neuropathy (DPN) is mainly treated with diabetes as a whole, and there is no targeted treatment. Some studies have reported that adjuvant hyperbaric oxygen therapy (HBOT) for DPN has achieved a good effect, our study aimed to evaluate the clinical efficacy and safety of HBOT for DPN and provide reference for the clinic by using a systematic review and meta-analysis.
Methods
A comprehensive search was conducted across several databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Internet Database, Chinese BioMedical Database, China Scientific Journal Database, and Wanfang Database, for relevant randomized controlled trials published before July 2022. The population, intervention, comparison, outcomes, study design criteria were used to guide the selection of studies. Meta-analysis was performed using RevMan 5.4 and STATA 14.0, with odds ratios and mean differences along with 95% confidence intervals serving as measures of effect size.
Results
Fourteen randomized controlled trials were included in the final analysis, comprising 675 patients in the HBOT group and 648 in the standard therapy (ST) group. The HBOT group demonstrated a significantly higher effective treatment rate compared to the ST group (P < .001). Additionally, the HBOT group showed significant improvements in motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNVC) across multiple nerves: median nerve (PMNCV < 0.001, PSNCV = 0.001), ulnar nerve (PMNCV = 0.02, PSNCV < 0.001), peroneal nerve (PMNCV < 0.001, PSNCV < 0.001), and tibial nerve (PMNCV = 0.001, PSNCV = 0.008). Six adverse events were reported in the HBOT group, while no adverse events occurred in the ST group, with no significant difference between the 2 groups. Publication bias was identified in some outcome variables through funnel plots, Begger test, and Egger test.
Conclusion
HBOT significantly enhances treatment efficacy and nerve conduction velocity in patients with DPN, with few adverse events, making it a safe and effective adjunctive therapy for DPN.