Meta-analysis Of Spleen-strengthening And Dampness-removing Method In The Treatment Of Metabolic Syndrome And Analysis Of Clinical Medication Rule

Purpose: Systematic evaluation and meta-analysis were conducted on the treatment of metabolic syndrome by invigorating spleen and dampness by TCM compounds using evidence-based methods.The medication rules of TCM compounds with the main effect of invigorating spleen and dampness in the treatment of metabolic syndrome were analyzed through the cloud platform of ancient and modern medical records,providing more reliable evidence-based basis for the clinical application of the academic idea of "treating metabolic syndrome from the spleen".Material and method: 1.Comprehensively searched the RCTS studies on the treatment of MS by TCM compounds with the main effect of invigorating spleen and dampening.Chinese databases included CNKI,WANFANGDATA,VIP and Sinomed.Foreign language databases include Pub Med,Embase,Web of Science,Cochrane library.The retrieval time is from the self-built database of each major database to December 2022.The included studies were reviewed using the "bias Assessment tool" in the Cochrane Manual.Data were entered using Stata17.0 software and meta-analysis was performed.2.All the literatures retrieved in the first part were screened twice according to the exclusion standard,and then Excel was used to establish a drug use law database and input it into the cloud platform of ancient and modern medical records.The data analysis module of the cloud platform was used to summarize the drug use law.Results:1.The study eventually included 17 studies,involving 1656 patients with metabolic syndrome,including 821 patients in the control group with routine western medicine treatment as the intervention measure,and 833 patients in the test group with the combination of traditional Chinese medicine for invigorating the spleen and removing dampness on the basis of the control group.The meta-analysis results of each indicator are as follows:1)Clinical total effective rate: [OR=3.76,95%CI(2.70,5.23),P<0.05];2)TCM syndrome score: [SMD=-0.96,95%CI(-1.23,-0.69),P<0.05];3)BMI: [SMD=-0.98,95%CI(-1.31,-0.65),P<0.05];4)WC: [SMD=-0.33,95%CI(-0.47,-0.20),P<0.05];5)Systolic blood pressure: [SMD=-0.82,95%CI(-1.24,-0.44),P<0.05];6)Diastolic blood pressure: [SMD=-0.86,95%CI(-1.36,-0.36),P<0.05];7)TG: [SMD=-0.84,95%CI(-1.17,-0.52),P<0.05];8)TC: [SMD=-0.71,95%CI(-1.00,-0.42),P<0.05];9)LDL-c: [SMD=-0.98,95%CI(-1.36,-0.61),P<0.05];10)HDL-c: [SMD=0.62,95%CI(0.20,1.03),P<0.05];11)FBG: [SMD=-0.65,95%CI(-0.81,-0.49),P<0.05];12)2h PG: [SMD=-0.70,95%CI(-0.82,-0.59),P<0.05];13)Hb A1c: [SMD=-0.65,95%CI(-0.95,-0.36),P<0.05];14)FINS: [SMD=-0.68,95%CI(-1.03,-0.34),P<0.05];15)HOMA-IR: [SMD=-0.86,95%CI(-1.12,-0.61),P<0.05];All the above differences were statistically significan.2.The frequency of traditional Chinese medicine in the literature on the treatment of metabolic syndrome with the combination of traditional Chinese medicine prescriptions for Jianpi huashi therapy and conventional Western medicine therapy was analyzed.The frequently used traditional Chinese medicines were Atractylodes macrocephala,Poria cocos,Pinellia ternata,Glycyrrhiza uralensis,Alisma orientalis,tangerine peel,Cinnamomum cassia twig,and Astragalus membranaceus.3.After screening,78 studies were in line with the analysis conditions of drug inclusion law,involving 137 TCM,with a cumulative use frequency of 761 times.The most frequently used TCM were atractyloides,poria cocos,Astragalus membranaceus,tangerine peel,alisma alisma,etc.The drugs included in the study were mainly warm and flat,and their tastes were mainly sweet,sweet and bitter,mostly belonging to the spleen,lung and stomach channels.The results of drug compatibility combination analysis showed that the combinations with strong support were Atractyloplasty-Poria cocos,atractyloplasty-alismatia,poria cocos-Tangerine peel,Poria cocos-Pinellia pinellia and tangerine peel-pinellia pinellia.Conclusion:1.Jianpi huashi Chinese medicine compound combined with conventional western medicine has a definite effect on metabolic syndrome,which can improve the clinical symptoms of patients and regulate the body weight,blood pressure,blood lipids,blood glucose and insulin of indicators patients,with good safety.Due to the influence of various factors,there is still a certain distance between the standard of clinical research and RCT for MS,both in scientific research thinking and blinding implementation.More high-quality clinical RCTS are needed to confirm the above conclusions.2.The drugs used in invigorating spleen and dampening metabolic syndrome mainly belong to warm and flat class,and their tastes are mainly sweet,xin and bitter,which mostly belong to spleen,lung and stomach channels.The combinations of common drug pairs were atractylodes-Poria,atractylodes-alisma,poria-Tangerine peel,poria-pinellia,tangerine peel-pinellia pinellia.