The Effectiveness of Leech Therapy in the Severity of Diabetic Neuropathy:  A Randomized Controlled Trial

Farshad Alemi; Maryam Azimi; Reihaneh Moeini; Hoda Shirafkan; Mohammadali Bayani; Morteza Mojahedi; Haleh Tajadini

doi:10.18502/tim.v7i4.11488

Farshad Alemi Neuroscience Research Center, Institute of Neuropharmacology, Department of Traditional Medicine, Faculty of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran
Maryam Azimi Gastroenterology and Hepatology Research Center, Kerman University of Medical Sciences, Kerman, Iran
Reihaneh Moeini Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
Hoda Shirafkan Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
Mohammadali Bayani Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
Morteza Mojahedi Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
Haleh Tajadini Neuroscience Research Center, Institute of Neuropharmacology, Department of Traditional Medicine, Faculty of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran

DOI: https://doi.org/10.18502/tim.v7i4.11488

Keywords: Diabetes; Gabapentin; Iran; Leech therapy; Neuropathy; Persian medicine

Abstract

Diabetic peripheral neuropathy is one of the most common causes of disability in diabetic patients. Applying a method to achieve the highest therapeutic effect in patients is desirable. Therefore, this study aimed to evaluate the impact of leech therapy on diabetic neuropathy of lower limbs in comparison to gabapentin as a standard method. This randomized controlled parallel-group clinical trial was conducted among 40 patients with type II diabetes who were diagnosed with lower limb diabetic neuropathy and referred to specialized outpatient clinics in Babol, Mazandaran province, Iran from 23 September 2020 to 17 March 2021. The patients were randomly divided into two groups. One group was treated with leech therapy and the other group was treated with gabapentin as the standard method. The severity of neuropathy was assessed every 15 days until the 45^th day. The Visual Analog Scale (VAS), Neuropathy Symptom Score (NSS), Neuropathy Disability Score (NDS), and Nerve Conduction Velocity (NCV), and Electromyography (EMG) were used for assessing the study outcomes. The repeated measure and Friedman tests were used by SPSS.V.23. The results of our study indicated that pain (P value:0.03), numbness (P value˂0.0001), and paranesthesia (P value:0.01) significantly reduced in patients undergoing leech therapy versus patients taking gabapentin on the 45^th day. The total NSS (P value˂0.0001) and total NDS (P value˂0.0001) improved significantly for patients with leech therapy over 45 days compared to the patients with gabapentin. The results of our study showed that using leech therapy for patients with diabetic neuropathy was more effective in improving clinical symptoms and the functions of lower limb muscles and nerves in comparison to gabapentin. The severity and symptoms of neuropathy greatly improved for the patients treated with leech therapy versus patients taking gabapentin.