The Overviews Of Traditional Chinese Medicine Treatment On Pre-diabetes And The Data Mining And Research Of Professor Wei Zixiao’s Experiences

Pre-diabetes including impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) is a metabolic state between normal glucose and diabetes mellitus (DM). The 2008 epidemiological survey of China showed that the prevalence rate of type 2 diabetes mellitus (T2DM) was 9.7%, and the prevalence rate of IGT was 15.5%. It has been reported that 5%-10% of people with pre-diabetes developed into T2DM, and the diabetic micro-vascular and macro-vascular complications have occurred in pre-diabetes. The 2014 "Chinese society of Endocrinology expert consensus on T2DM prevention in Chinese adults" pointed out that pre-diabetes can be regarded as a symbol or a watershed, which marks the high risk of suffering cardio-cerebral-vascular disease, DM, micro-vascular disease, cancer and dementia in the future. So it is very important to correct the state of abnormal glucose metabolism and prevent pre-diabetes changing into diabetes. Traditional Chinese medicine (TCM) treatment for pre-diabetes has its own advantages and characteristics, and a large number of clinical studies have confirmed the TCM curative effect in the treatment for pre-diabetes.Summarizing and inheriting the experience of veteran doctor of TCM is helpful to pre-diabetes treatment clinically. With the development of evidence-based medicine, TCM practitioners started to think that how to make use of evidence-based medicine in TCM clinical research, and how to combine evidence-based medicine with the experience of veteran doctor of TCM.This research has done the reevaluation on systematic assessment of TCM for pre-diabetes, and mined and summarized the academic experiences on the pre-diabetic treatment of Professor Wei Zixiao, aiming to provide references for the treatment of pre-diabetes.1. The overviews of Traditional Chinese medicine treatment on pre-diabetesObject:To reevaluation the systematic assessment and meta analysis of TCM treatment on pre-diabetes.Method:Formulate the inclusion and exclusion criteria. Collect the systematic reviews that focused on the TCM treatment on pre-diabetes in the databases including Cochrane Library, PubMed, CBM, CNKI and Wanfang Med Data. The AMSTAR was used to evaluate the methodology quality of the collected reviews, and the GRADE system was used to evaluate the quality of evidence of the main outcome index. The major overview indexes include mortality rate, incidence of DM and FBG normalization, and the secondary indexes include fasting blood glucose (FBG),2h postprandial blood glucose (2hPBG), glycosylated hemoglobin Alc(HbAlc), adverse reaction rate.Results:2 documents were finally selected, one was English article of the Cochrane System evaluation, and the other one was Chinese article of degree thesis. AMSTAR scores were 11 and 9 points respectively. The evidence qualities were medium and low by GRADE partly. According to the evaluation of the main outcome indexes by GRADE, the English article was medium quality, and the Chinese article is low in the incidence of DM; the English article was medium in FBG normalisation; and the Chinese article is low in FBG,2hPBG and HbAlc.Conclusion:Herbal medicine plus lifestyle modification have better clinical effect in helping blood glucose return to normal and reducing the incidence of DM than lifestyle modification alone, but there may have no significant effect. The effect of herbal medicine combined wih lifestyle modification is not significant probably in the control of FBG,2hPBG and HbAlc compared with lifestyle modification alone. TCM may play a useful role in getting blood glucose of patients with pre-diabetes right and reducing the incidence of DM.2. Experience summary on the pre-diabetic diagnosis and treatment of Professor Wei based on data miningObject:To mine and summarize the academic experiences on pre-diabetic treatment of Professor Wei.Method:Collect 147 outpatients with pre-diabetes treated by Professor Wei and 341 visits totally. Use clinical data collection System designed by China Academy of Chinese Medical Sciences to data mine the TCM diagnoses, symptoms, syndromes, therapeutic principles and Chinese medicinal herbs. Summarize the academic experiences by human-computer cooperation.Results:Data mining results:The main TCM diagnoses:wasting thirst (94.4%),depression zheng (15.8%),gastric distention (5.9%),perspiration zheng (4.1%),diarrhea (3.8%); The main symptoms:feeble (19.6%), hidrosis (19.6%),delayed menorrhea (15.2%),dizziness (13.2%),abdominal distension (12%),drowsiness (12%),dry stool (11.1%);The main syndrome:blood stasis (60.4%),spleen asthenia (60.1%),liver qi depression (27%),yin deficiency (25.8%),qi asthenia (23.8%),sputum (22.9%),blood-deficiency (14.7%),kidney asthenia (12%); The main therapeutic principle:activating blood circulation (59.8%) strengthening spleen (57.8%),soothing liver (32.8%) nourishing yin (27.3%),benefiting vital energy (25.5%),descending the turbid (23.8%).clearing heat (21.4%) nourishing blood (16.7%); The main Chinese medicinal herbs: Chuanxiong, Danshen, Niuxi, Chaihu, Gegen, Gianghuang, Danggui, Haizao, Sheng Shanzha, Honghua, Sheng Huangqi, Huanglian.Conclusion:Professor Wei believes that pre-diabetes is asthenia in origin and asthenia in superficiality. Spleen asthenia, qi deficiency and yin deficiency are the basis of the pre-diabetes, and phlegm dampness, blood stasis and gastric hest are the signs of the pre-diabetes. It should be treated by strengthening spleen, activating blood circulation, dissipate phlegm and supplementing qi and nourishing yin. The main formula:Si Junzi Tang, Liu Junzi Tang and Liuwei Dihuang Tang. The commonly used medicinal herbs for activating blood circulation are Danshen, Chishao, Chuanxiong, Honghua, Jianghuang, Ezhu. The commonly used medicinal herbs for dissipating phlegm and descending the turbid are Fa banxia, Zexie, Danxing, Haizao, Kunbu.Clinical train of thought of Professor Wei in treating pre-diabetes include "syndrome differentiation in 6 steps", making a definite diagnosis-grasping the main symptoms- distinguishing principal and subordinate- syndrome differentiating-forming the basic formula-modifying the formula according to symptoms, and "prevention treatment of disease", which is reflected in the prevention of DM by curing patients with pure pre-diabetes and controlling over the pre-diabetic relevant factors.