| Objective:To analyze the effects and possible adverse effects of promoting blood circulation and removing stasis traditional Chinese medicine prescription's treatment on insulin-resistance-related diseases,taking insulin sensitivity index(ISI),fasting plasma glucose(FPG),blood pressure,blood lipid and so on as observation indexes.Methods:A computer-based online search of China national knowledge internet (CNKI) d atabase and VIP database was undertaken to identify the articles about the treatment for cases with insulin resistance between January 1994 and February 2008, and January 1989 and February 2008.Randomized controlled trials(RCTs) and quasi-randomized controlled trials(quasi-RCTs) of patients with insulin resistance were included.The quality of included therapy was evaluated and meta-analysis was performed by RevMan 4.2 software.Results:Thirteen RCTs or quasi-RCTs involving 860 patients were included.It was found that some Chinese medicinal formulae of promoting blood circulation and removing stasis might be effective for diseases related with insulin resistance to some extent.Firstly,they could reduce fasting plasma glucose.Meta-analysis based on 9 included studies(subgroupâ… ) suggested that the effects of lowering fasting blood glucose in treatment group(Chinese medicinal formulae of promoting blood circulation and removing stasis group) were superior to those in the control group with statistical significance(WMD -0.76,95%CI -1.31 to -0.22).Meta-analysis based on other 4 included studies(subgroupâ…¡) showed the similar result in the effects of lowering fasting blood glucose,but with no statistical significance(WMD -0.34,95%CI -1.10 to 0.42).Secondly,they could reduce fasting insulin.Meta-analysis based on 8 included studies(subgroupâ… ) suggested that the effects of lowering fasting insulin in treatment group were superior to those in the control group with statistical significance(SMD -1.41,95%CI -2.43 to -0.38).Meta-analysis based on other 4 included studies (subgroupâ…¡) showed the similar result in the effects of lowering fasting insulin,but with no statistical significance(SMD -0.74,95%CI -1.63 to 0.16).Thirdly,they could improve insulin sensitivity index.Meta-analysis based on 7 included studies(subgroupâ… ) showed that the treatment group was more effective to elevate ISI compared with the control group with statistical significance(WMD 0.86,95%CI 0.45 to 1.26). Meta-analysis based on other 4 included studies(subgroupâ…¡) told the similar result in the effects of improving ISI,but with no statistical significance(WMD 0.72,95%CI -0.03 to 1.48).Fourthly,they could decrease both systolic pressure and diastolic pressure.Meta-analysis based on 6 included studies(subgroupâ… ) suggested that the effects of lowering both systolic pressure and diastolic pressure in treatment group were superior to those in the control group with statistical significance,respectively is(WMD -0.63,95%CI -1.12 to -0.14) and(WMD -0.33,95%CI -0.62 to -0.04).Fifthly,they could reduce total cholesterol and triglyceride.Meta-analysis based on 4 included studies(subgroupâ… ) showed that the treatment group was more effective to reduce both total cholesterol and triglyceride compared with the control group with statistical significance,respectively is(WMD -0.68,95%CI -1.09 to -0.28) and(WMD -0.44, 95%CI -0.61 to -0.26).Meta-analysis based on other 4 included studies(subgroupâ…¡) also told the similar result in the effects of reducing total cholesterol and triglyceride. Both the differences had statistical significance as well,respectively is(WMD -0.59, 95%CI -1.16 to -0.01) and(WMD -0.15,95%CI -0.23 to -0.06).Sixthly,they could increase high density lipoprotein cholesterol(HDL-c).Meta-analysis based on 4 included studies(subgroupâ… ) showed that the treatment group was more effective to increase HDL-C compared with the control group,but with no statistical significance (WMD 0.11,95%CI 0.00 to 0.22).Meta-analysis based on other 3 included studies (subgroupâ…¡) told the similar result in the effects of increasing HDL-c with statistical significance(WMD 0.30,95%CI 0.03 to 0.57).Seventhly,they could decrease low density lipoprotein cholesterol(LDL-c).Meta-analysis based on 3 included studies (subgroupâ… ) and other 3 included studies(subgroupâ…¡) both showed that the treatment group was more effective to decrease LDL-c compared with the control group.Both the differences had statistical significance,respectively is(WMD -0.65,95%CI -0.97 to -0.32) and(WMD -0.59,95%CI -1.06 to -0.13).No obvious side effects or adverse reactions were noted.Conclusions:Promoting blood circulation and removing stasis therapy might be effective for diseases related with insulin resistance to some extent.The evidence is not strong enough because of poor quality of the included studies.Therefore,more high quality randomized controlled trials are required. |
PDF Full Text Request