Efficacy and safety of Mudan granules for treatment of diabetic peripheral neuropathy: a multicenter, double-blind, placebo-controlled, randomized, clinical trial

ETHNOPHARMACOLOGICAL RELEVANCE: Mudan granules are Chinese patented medicines approved by the National Medical Product Administration, used to treat diabetic peripheral neuropathy (DPN) with Qi deficiency and collateral obstruction syndrome. However, placebo-controlled studies definitively establishing efficacy and safety are lacking. AIM OF THE STUDY: To evaluate the efficacy and safety of Mudan granules as an adjunct treatment for DPN with qi deficiency and collateral obstruction syndrome. METHODS: This multicenter, placebo-controlled, double-blind, randomized, controlled clinical trial recruited patients from 13 clinical centers in mainland China. 400 participants were randomly assigned in a 1:1 ratio to either the Mudan (Mudan granules + mecobalamin) or control group (placebo + mecobalamin), and were reassessed after the 24-week intervention. The primary outcome was the Michigan Diabetic Neuropathy Score (MDNS). RESULTS: The complete analysis set comprised 357 participants. The mean baseline MDNS of the Mudan and control groups were 9.69 and 9.43, respectively. The mean change in MDNS from baseline to week 24 was -4.80 in the Mudan and -2.66 in the control group. Using a covariate-adjusted analysis of covariance model, the least squares mean for the Mudan and control groups were -4.74 (-5.33 to -4.15) and -2.72 (-3.33 to -2.11), respectively. There was a statistically significant difference between the two groups. After 24 weeks of follow-up, the Mudan group showed a significant improvement in MDNS compared to the control group. CONCLUSION: These findings suggest that Mudan granules may improve the clinical symptoms of DPN. Given this, Mudan granules may be helpful in the management of DPN.