Data Mining And Analysis Of Chinese Medicine For The Treatment Of Type 2 Diabetes Based On Information Processing

1 Purpose1.1 To analyze and identify hot topics and researching forefront in the field of traditional Chinese medicine(TCM)treatment of type 2 diabetes(T2DM),and to find relevant high cited and high frequency interventions,for researchers to find the best solution.1.2 To obtain the evidence of the efficacy and safety of TCM for T2DM,screening out high-quality prescriptions into the network meta analysis,and to analyze the shortcomings of the current randomized controlled trials of TCM by assessing the quality of the literature.1.3 To find the best treatment solution for T2DM using TCM and sort other different treatment regimens.2 Method2.1 Web of ScienceTM was searched for published articles for TCM of T2DM(Date:January 1st,2002?July 6th,2016);CNKI(Date:January 1st,2001?October 24th,2016).Knowledge maps of the international and domestic TCM for T2DM were visualized by using overlay maps,word frequency analysis(Institution and Journal),keyword co-occurrence clustering analysis and document co-citation clustering analysis with CiteSpace V.2.2 The relative randomized clinical trials(RCTs)of Chinese medicines for T2DM were searched from PubMed,Web of Science,Cochrane Library,CNKI,CBM and Wanfang databases ranging from their inception to February 2017,respectively.We performed Systematic Review using RevMan 5.3 software.2.3 We used the prescriptions of hot topics revealed in the first part,as well as high-quality prescriptions assessed by systematic review in the second part,as key words and searched from PubMed,Web of Science,Cochrane Library,CNKI,CBM and Wanfang databases ranging from their inception to February 2017,respectively.We performed Network Meta analysis using STATA13.0 software.3 Results3.1 Through the search of English database and Chinese database,we drew knowledge map of the domestic and international literature of the traditional Chinese medicine treatment of T2DM based on CiteSpaceV,analyzed the literature of this field systematically,and found that Universidad Nacional Autonoma de Mexico was the institution with the highest number of published papers that had been cited in this field,while China had four institutions among the top 10.The journal of the highest frequency of co-cited journal was Diabetes Care,a core one in the field.Keywords co-occurrence network was composed of 185 nodes,541 lines,and divided into 10 clusters.Co-citation network of co-reference was composed of 407 nodes,1199 lines,and divided into 20 clusters.The hot topics of the field are as follows:using traditional Chinese medicine to improve insulin resistance,the research on blood glucose control using traditional Chinese medicine and affinal drug and diet;the traditional Chinese medicine treatment of diabetic nephropathy and hypertension complications of T2DM.The emerging trend contains four aspects:one is the development and of incretin,the second is the development and application of Chinese medicine hypoglycemic drugs,the third is the control of oxidative stress using traditional Chinese medicine,the fourth is the application law of Qi-replenishing Yin-nourishing and Blood-activating throughout the whole process of the disease.Highly cited interventions are Liuwei Dihuang Pill,Jinlida,and Xiaoke Pill.3.2 This systematic review searched 21146 literatures,and with the strict inclusion and exclusion criteria finally included 45 randomized controlled trials literatures,and totally 4406 cases of patients.The types of the included literatures are as follows:traditional Chinese medicine versus placebo(7),Chinese medicine combined with western medicine versus placebo combined with western medicine(6),Chinese medicine combined with western medicine versus western medicine(24),Chinese medicine plus basic therapy(only diet and exercise)versus western medicine plus basic therapy(8).There are only two kinds of Chinese medicines used the same control methods,respectively,and according to the Meta analysis:There is no statistically significant difference in reducing fasting blood glucose(FBG),glycosylated hemoglobinAlc(HbAlc),total cholesterol(TC)and triglyceride(TG)between Liuweidihuang Soft Capsule plus Ginkgo Leaf Tablets and western medicine plus placebo;neither does cinnamon versus placebo.In the study of traditional Chinese medicine versus placebo,7 articles reported of FBG,and 1 of which showed that there was statistically significant difference between traditional Chinese medicine combined with placebo;4 articles reported of P2BG,and 2 of which showed that there was statistically significant difference between traditional Chinese medicine combined with placebo;7 articles reported of HbAlc,and 3 of which showed that there was statistically significant difference between traditional Chinese medicine combined with placebo;3 articles reported of BMI,and of which showed that there was statistically significant difference between traditional Chinese medicine combined with placebo;5 articles reported of TC,and 1 of which showed that there was statistically significant difference between traditional Chinese medicine combined with placebo;6 articles reported of TG,and of which showed that there was statistically significant difference between traditional Chinese medicine combined with placebo;only one study reported of Fins,which showed that there was no statistically significant difference between traditional Chinese medicine combined with placebo.In the study of Chinese medicine combined with western medicine versus placebo combined with western medicine,1 articles reported of total effective indicators which showed that there was statistically significant difference between Chinese medicine combined with western medicine and western medicine combined with placebo;6 articles reported of FBG,and 3 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine combined with placebo;5 articles reported of 2hPG,and 4 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine combined with placebo;6 articles reported of HbA1c,and 3 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine combined with placebo;2 articles reported of BMI,and 1 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine combined with placebo;4 articles reported of TC,and 1 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine combined with placebo;4 articles reported of TG,and 2 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine combined with placebo.In the study of Chinese medicine plus western medicine versus western medicine alone,11 articles reported of total effective indicators,and 6 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine;23 articles reported of FBG,and 14 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine;21 articles reported of 2hPG,and 14 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine;16 articles reported of HbA1c,and 10 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine;16 articles reported of BMI,and 4 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine;8 articles reported of TC,and 5 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine;9 articles reported of TG,and 6 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine;6 articles reported of Fins,and 4 of which showed that there was statistically significant difference between traditional Chinese medicine combined with western medicine and western medicine.In the study of traditional Chinese medicine plus basic therapy(only diet and exercise)versus western medicine plus basic therapy,3 articles reported of total effective indicators,and 2 of which showed that there was statistically significant difference between traditional Chinese medicine plus basic therapy and western medicine plus basic therapy;8 articles reported of FBG,and 2 of which showed that there was statistically significant difference between traditional Chinese medicine plus basic therapy and western medicine plus basic therapy;8 articles reported of 2hPG,and 4 of which showed that there was statistically significant difference between traditional Chinese medicine plus basic therapy and western medicine plus basic therapy;7 articles reported of HbAlc,and 2 of which showed that there was statistically significant difference between traditional Chinese medicine plus basic therapy and western medicine plus basic therapy;4 articles reported of BMI,and 3 of which showed that there was statistically significant difference between traditional Chinese medicine plus basic therapy and western medicine plus basic therapy;7 articles reported of TC,and 2 of which showed that there was statistically significant difference between traditional Chinese medicine plus basic therapy and western medicine plus basic therapy;6 articles reported of TG,and 2 of which showed that there was statistically significant difference between traditional Chinese medicine plus basic therapy and western medicine plus basic therapy;3 articles reported of Fins,and 1 of which showed that there was statistically significant difference between traditional Chinese medicine plus basic therapy and western medicine plus basic therapy.There were 24 articles(53.33%)reported of adverse events,of which 16 articles had liver and kidney function tests,and three had detailed reports in the form of three-line table;3 articles reported a hypoglycemic response;one article reported an adverse reaction of cold;one reported of adverse reaction of headache,9 reported loss of appetite,vomiting,abdominal pain and other gastrointestinal adverse reactions.Seven articles have listed adverse reactions(symptom,number of cases,duration)of the treatment group and the control group in detail.There were two articles that simply refer to the causes that may lead to adverse reactions,but were no further analysis or deep discussion.The high-quality Chinese medicine prescription selected from the literatures were Jiawei Qingxin Lianzi Decoction,Linggui Zhugan Decoction,Xiaoke Pill,Tianmai Xiaoke Pill,and Jinlida.3.3 This network meta-analysis searched 1758 articles and eventually 11 were included with 1244 patients.The methodological quality of most included trials had a high and moderate risk of bias.The control measure was metformin.The results of network meta-analysis suggested that,among the included six prescriptions selected from the hot topics and systematic review,and ranked by probability,Xiaoke Pill plus metformin has the highest probability in lowing glycosylated hemoglobin,and the effect is significantly better than that of other prescriptions;the rank of other prescriptions probability is:Linggui Zhugan Decoction plus metformin,Jin Li Da plus metformin,Tianmai Xiaoke Pill plus metformin,Jiawei Qingxin Lianzi Decoction plus metformin,Liuwei Dihuang Pill plus metformin.Ranked by probability,Jinlida plus metformin has the highest probability in lowing FBG;the rank of other prescriptions probability is:Tianmai Xiaoke Pill plus metformin,Jiawei Qingxin Lianzi Decoction plus metformin,Linggui Zhugan Decoction plus metformin,Xiaoke Pill plus metformin,Liuwei Dihuang Pill plus metformin.4 Conclusion and significance4.1 This paper used the method of co-citation analysis to visualize the literatures of TCM treatment of T2DM,reveal the development context,knowledge structure,research hotspots,research frontier,development trend and specific relevant intervention measures,and explain the key problem solving ideas of TCM treatment of T2DM,which is the key links of comparative study of different treatment programs' effect.4.2 This paper used evidence-based medicine methodology to do the systematic review of the RCT of TCM treatment of T2DM,determining the effectiveness of prescription,and screening out the higher quality and better therapeutic methods for preparation.The results showed that Chinese medicine treatment has the potential in the total efficiency,FBG,HbA1c,BMI,TC,TG,Fins,its significant advantage especially can be seen in the comparison between the traditional Chinese medicine plus Western medicine and Western medicine treatments.4.3 Under the circumstance of facing of a variety of interventions and the lack of direct evidence,Meta-analysis cannot carry out,therefore,the Network Meta-analysis is introduced and used indirect comparison technology to evaluate and sort various interventions at the same time.This has a very important practical significance for the clinicians to carry out medication and drug health economics evaluation in clinical practice for different patients.The results at the macro level,directly relate to the clinician's choice of merit;while at the micro level,they can provide a basis for further study of the mechanism of pharmacodynamic effects.