A Systematic Review Of The Effect Of Traditional Chinese Medicine On Pancreatic Islet Function In Patients With Type 2 Diabetes Mellitus And An Analysis Of Medication Rules

Purpose:Systematic evaluation of the effect of traditional Chinese medicine on pancreatic islet function in patients with type 2 diabetes based on the method of Meta analysis,and to explore its core medication rules,to provide a theoretical basis for future clinical treatment of type 2 diabetes.Material and method:Use computers to search major databases such as Wanfang Database,Weipu Information Database,Chinese Academic Journal Full-text Database,Pubmed and so on.The time is set from the establishment of each database to October 2020,to retrieve clinical RCT studies on the improvement of pancreatic islet function in patients with T2 DM treated with traditional Chinese medicine.Read the full text carefully,extract the basic information of the literature and evaluate its quality,and use the Review Manager 5.3software provided by the Cochrane Collaboration for Meta analysis.And apply ancient and modern medical records cloud platform to analyze its medication rules,including drug frequency statistics,association analysis,cluster analysis,etc.,to explore the core medication rules of traditional Chinese medicine to improve pancreatic islet function in patients with type2 diabetes.Results:1 Meta analysis results(1)A total of 56 RCT studies that met the inclusion criteria were finally screened out,including a total of 4847 patients.(2)Traditional Chinese medicine improves the islet function of T2 DM patients significantly better than the control group,HOMA-IR: [MD=-0.64,95% CI(-0.71,-0.57),Z = 18.33(P<0.00001)];HOMA-β: [SMD=1.09,95% CI(0.85,1.32),Z = 9.21(P<0.00001)];HOMA-IS: [SMD=0.86,95% CI(0.58,1.15),Z = 5.93(P <0.00001)].(3)Traditional Chinese medicine improves the blood glucose of T2 DM patients significantly better than the control group.Fasting blood glucose: [MD=-1.09,95% CI(-1.24,-0.93),Z =13.98(P<0.00001)];2h blood glucose: [MD=-1.15,95% CI(-1.46,-0.84),Z = 7.32(P <0.00001)];glycosylated hemoglobin: [MD=-0.69,95% CI(-0.8,-0.58),Z =12.1(P <0.00001)].(4)The improvement of T2 DM patients ’ blood lipids by traditional Chinese medicine was significantly better than that of the control group.Total cholesterol: [MD=-0.8,95% CI(-1.05,-0.56),Z=6.46(P<0.00001)];triglyceride Ester: [MD=-0.46,95% CI(-0.68,-0.24),Z=4.05(P<0.00001)];low-density lipoprotein: [MD=-0.54,95% CI(-1.03,-0.05),Z=2.18(P=0.03)];High-density lipoprotein: [MD=0.17,95% CI(0.08,0.26),Z=3.55(P=0.0004)].(5)The total clinical effective rate of T2 DM patients with traditional Chinese medicine is significantly better than that of the control group: [OR=5.64,95% CI(4.45,7.16),Z=14.22(P<0.00001)].(6)The safety analysis found that the main adverse reactions were hypoglycemia and mild gastrointestinal reactions,and the difference between the two groups was not statistically significant.2 Analysis results of medication ruleA total of 56 documents were included for this study,including 71 Chinese medicine prescriptions,involving 129 Chinese medicines.Frequency analysis of traditional Chinese medicine: A total of 18 traditional Chinese medicines with a frequency of ≥10 are used,and the top 5 in the order of frequency are astragalus,coptis,yam,pueraria,and licorice.Analysis of Four Qi and Five Flavors: Cold medicines are used most frequently,with 145 times of use,and sweet medicines are used most frequently,with 372 times of use.Analysis of the meridian of the drug: The meridians of the drugs from high to low frequency of use are respectively the lung meridian,spleen meridian,stomach meridian,and kidney meridian.Analysis of association rules of traditional Chinese medicine: the top 5 drug compatibility is yam-astragalus,Pueraria lobata-astragalus,Radix rehmanniae-Astragalus,Scutellaria-Coptis,Trichosanthes-Astragalus.Cluster analysis: Draw four common drug groups that improve islet function in T2 DM patients.Conclusion:1.Comprehensive treatment of traditional Chinese medicine can effectively promote insulin secretion in patients with T2 DM and improve insulin resistance.2.Comprehensive treatment of traditional Chinese medicine can improve the islet function of patients and reduce blood sugar levels such as FPG,2h PG,Hb1 Ac,etc.3.Comprehensive treatment of traditional Chinese medicine can effectively improve the blood lipids of patients with T2 DM and delay the progression of the course of T2 DM.4.Comprehensive treatment of traditional Chinese medicine improves the total effective rate of treatment of T2 DM patients and improves the symptoms of T2 DM patients by lowering blood sugar and adjusting blood lipids.5.The comprehensive treatment of T2 DM patients with traditional Chinese medicine is safer.6.The core drugs to improve T2 DM are Astragalus,Coptis,Chinese Yam,Pueraria,and Licorice.Traditional Chinese medicine treatment of T2 DM mainly focuses on clearing heat and purging fire,replenishing qi and nourishing yin,and the meridian of the medicine is mainly based on the lung,spleen and stomach,and kidney meridian,which conforms to the principle of the treatment of upper,middle and lower three eliminations of diabetic diseases by doctors of the past generations.