Clinical Efficacy And Medication Rule Of TCM In The Treatment Of Diabetes Mellitus-induced Erectile Dysfunction:A Systematic Review And Data Mining

Objective A study was conducted to systematically evaluate the clinical efficacy and safety of TCM in the treatment of Diabetes Mellitus-induced Erectile Dysfunction(DMED)from the perspective of evidence-based medicine.And based on data mining technology,the medication characteristics and prescription compatibility rules of TCM in the treatment of DMED were analyzed to provide basis and reference for the clinical treatment and optimization of DMED.Method In terms of systematic review,clinical randomized controlled trials of TCM in the treatment of DMED were retrieved from Chinese and English databases,and screened according to the inclusion and exclusion criteria.The selected literature was subjected to data extraction and literature quality evaluation.Meta-analysis was performed using Revman5.4 and Stata MP 14 software.In terms of data mining,the literature on the treatment of DMED by TCM was retrieved from the Chinese database,and the DMED prescription information database was established.Excel software was used to count the frequency of drug use,taste,meridian tropism and drug category.SPSS Modeler 18.0 software was used to analyze drug association rules,and the core drug co-occurrence network was constructed by Cytoscape 3.9.1 software.SPSS Statistics 26.0 software was used for cluster analysis of core drugs to analyze the characteristics and prescription rules of TCM in the treatment of DMED.Results In terms of systematic review,18 literatures were finally included,with a sample size of 1560 cases,including 817 cases in the experimental group and 743 cases in the control group.Meta-analysis results :(1)Clinical efficacy : The combined effect size RR = 1.36,95 %CI [ 1.27,1.45 ],P < 0.00001 < 0.05,the difference was statistically significant,and the results showed that the clinical efficacy of TCM treatment was better than that of the control group.(2)IIEF-5 score : the combined effect size MD = 4.57,95 % CI [ 3.54,5.61 ],P < 0.00001 < 0.05,the difference was statistically significant.The results showed that Chinese medicine treatment was superior to the control group in improving the IIEF-5 score of DMED patients.(3)The incidence of adverse reactions :the combined effect size RR = 0.67,95 % CI [ 0.38,1.18 ],P = 0.16 >0.05,the difference was not statistically significant,indicating that there was no evidence to support the incidence of adverse reactions in the experimental group lower than the control group,on the other hand,it can be said that the use of TCM in the treatment of DMED can improve the efficiency without increasing the incidence of adverse reactions.In terms of data mining,96 articles were included,including 119 prescriptions,involving 172 drugs,with a total frequency of 1398 times.The most frequently used drugs are angelica,epimedium,prepared rehmannia root,yam,cornus officinalis,medlar,achyranthes bidentata,chuanxiong,salvia miltiorrhiza,astragalus,centipede,dodder,etc.The distribution of five flavors of drugs is mainly sweet,pungent and bitter.Four gas distribution is given priority to with warm,flat,cold;the meridian distribution is mainly based on the liver,kidney,spleen and heart meridians.In terms of drug categories,tonic drugs,blood-activating and stasis-resolving drugs,and heat-clearing drugs are the main ones.Commonly used drug combinations are cornus officinalis-yam,chuanxiong-angelica,bupleurum-angelica,cornus officinalis-rehmannia-yam,medlar-yam-rehmannia,red peonychuanxiong-angelica,etc.The cluster analysis of the core drugs obtained five cluster combinations,namely :(1)angelica,chuanxiong,red peony,achyranthes bidentata,centipede,bupleurum,white peony;(2)epimedium,cistanche;(3)radix rehmanniae preparata,rhizoma dioscoreae,fructus corni,fructus lycii,semen cuscutae,fructus schisandrae chinensis;(4)salvia miltiorrhiza,astragalus;(5)rehmannia,poria,licorice.Conclusion Chinese medicine treatment of DMED has a more significant effect on the premise of ensuring safety.Modern Chinese medicine pays attention to the simultaneous regulation of liver,spleen,kidney and heart.The treatment is mainly based on tonifying kidney and activating blood,supplemented by soothing liver and invigorating spleen,calming heart and tranquilizing mind,clearing heat and nourishing yin,benefiting qi and nourishing blood.In order to achieve the state of yin and yang,we should use both warm and cold,sweet,pungent and bitter,based on the whole,both tonification and tonification,both deficiency and excess,and balance yin and yang.The preliminary analysis of the medication rules of TCM in the treatment of DMED provides a basis and reference for the clinical treatment and optimization of DMED to a certain extent.