Meta-analysis Of Invigorating Spleen And Removing Dampness Herbs In Obese Type 2 Diabetes Mellitus

Objective:To evaluate the clinical efficacy of invigorating spleen and removing dampness herbs in the treatment of obese type 2 diabetes through meta-analysis,and to provide evidence-based medical basis for clinical promotion of invigorating spleen and removing dampness herbs in the treatment of obese type 2 diabetes.Summarize the commonly used traditional Chinese medicines for obese type 2 diabetes,such as invigorating spleen and resolving dampness,to provide ideas and methods for the follow-up treatment of obese type 2 diabetes.Methods:According to the established retrieval strategy,we searched the clinical randomized controlled studies on the treatment of obese type 2diabetes with Chinese herbs of invigorating spleen and removing dampness included in the databases of CNKI,Wanfang,VIP,CBM,Pub Med,Embase,and The Cochrane Library for meta analysis.The retrieval time was from the database establishment to November 2022.Use Note Express3.5 software to eliminate duplicate studies,read the title,abstract,and full text for manual screening,and determine the final inclusion in the study’s extracted data and quality assessment.Stata 16.0 software was used to analyze data on fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin,body mass index,waist hip ratio,fasting insulin level,insulin resistance index,and TCM syndrome efficacy indicators.The risk of publication bias was evaluated for indicators with more than 10 articles included in the literature,and an Egger chart was drawn.And summarize the traditional Chinese medicine commonly used to treat obese type 2 diabetes.Results:According to the literature retrieval strategy and inclusion and exclusion criteria,a total of 19 articles were included,published between 2012and 2022.A total of 1627 patients were included,including 814 patients in the control group and 813 patients in the treatment group.Meta analysis results:1.Changes in fasting blood glucose:17 articles were included,with I~2=67.4%,P=0.000,SMD:-0.78,95%CI[-0.98,0.58],P<0.01,showing significant statistical significance.2.Changes in 2-hour postprandial blood glucos:16 articles were included,with I~2=79.4%,P=0.000,SMD:-0.94,95%CI[-1.20,0.68],P<0.01,showing significant statistical significance.3.Changes in glycosylated hemoglobin:10 articles were included,with I~2=56.0%,P=0.015,SMD:-0.75,95%CI[-0.97,-0.53],P<0.01,showing significant statistical significance.4.Changes in body mass index:14 articles were included,and I~2=95.0%,P=0.000.SMD:-1.07,95%CI[-1.65,-0.50],P<0.01,with significant statistical significance.5.Changes in waist to hip ratio:Six articles were included,with I~2=89.7%,P=0.000,SMD:-0.86,95%CI[-1.50,-0.23],P<0.01,with significant statistical significance.6.Changes in fasting insulin levels:Seven articles were included,with I~2=54.0%,P=0.042,SMD:-0.68,95%CI[-0.94,-0.41],P<0.01,with significant statistical significance.7.Changes in insulin resistance index:Nine articles were included,with I~2=77.9%,P=0.000,SMD:-1.21,95%CI[-1.55,-0.88],P<0.01,with significant statistical significance.8.TCM efficacy:Six articles were included,with I~2=0%,P=0.781,RR:1.32,95%CI[1.19,1.47],P<0.01,with significant statistical significance.9.Bias analysis:There may be a risk of publication bias in fasting blood glucose and 2-hour postprandial blood glucose data,while there is no significant risk of publication bias in glycosylated hemoglobin and body mass index data.10.Statistical treatment of obese type 2 diabetes invigorating spleen and resolving dampness herbs commonly used in traditional Chinese medicine,Poria cocos Atractylodes macrocephala,tangerine peel,Rhizoma alismatis,astragalus,Yam,Pinellia ternata,Coix seed,Magnolia officinalis,Atractylodes lanceolata,Codonopsis pilosula are the most common.Conclusion:1.The treatment of obese type 2 diabetes with invigorating spleen and removing dampness herbs is superior to metformin alone in terms of fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin,body mass index,waist hip ratio,fasting insulin level,insulin resistance index,and TCM symptoms.2.The traditional Chinese medicines commonly used in obesity type 2diabetes are Poria cocos,Atractylodes macrocephala,tangerine peel,Alisma orientalis,Astragalus membranaceus,Chinese yam,Pinellia ternata,Coix seed,Magnolia officinalis,Atractylodes lanceolata,Codonopsis pilosula.