Chinese Medicine Treatment Of Type 2 Diabetes Randomized Controlled Trials In Systematic Reviews

Diabetes are Chinese"Xiao Ke" category. Early in the《Nei Jin》and《Jin Gui Yao Lue》in the etiology, pathogenesis and treatment systems and formulas have discussed. It is the ancient Chinese practice of public physicians hard result is a product of theory and practice, is the precious treasure of our ancestors left us. The rapid expansion of the current diabetic population, and seriously endanger people's health. Although Chinese medicine has been widely used in China and its neighboring countries. But the lack of scientific, objective evidence, together with its theoretical system and treatment principles are not practiced medicine in the pathophysiology of the basis. So, it's difficult to understand and can't be accepted in Western countries. World Health Organization (WHO) initiated the tradition of evidence-based medicine (evidence-based traditional medicine) stressed that the drug directory developed from basic to clinical research and practice should be in accordance with evidence-based medicine approach to, in order to account for 80% of the traditional medical and health services provide scientific evidence. Evidence-based traditional medicine has become an unavoidable medical field development trend.The issue of systematic reviews using evidence-based medicine method of Chinese medicine treatment of type 2 diabetes mellitus and safety. This topic is divided into two parts:1 Literature Review: Summary of a Pathogenesis of diabetes research, expounded theory of Chinese medicine treatment of diabetes. Summary of evidence-based medicine and the second describes the close relationship between medicine and the integration of the two conditions.2 Research parts:traditional Chinese medicine treatment of type 2 diabetes systematic review of randomized controlled trials[Objective]Systematic reviews using evidence-based medicine approach, on the traditional Chinese medicine treatment of type 2 diabetes in the clinical literature of randomized controlled trials of the system order to explore the Chinese medicine treatment of type 2 diabetes, the efficacy and safety, and by the quality of included studies randomized controlled evaluation of Chinese herbal medicine test deficiencies.[Methods]1 Document retrieval:The paper on the following database of electronic retrieval:The Cochrane Library (2010.3); Pubmed(2010.3); Chinese biomedical journals database (2009.9); Chinese Academic Journal (2009.9); China Science and Technology Periodical Database (2009.9); Chinese Biomedical Database (2009.9); of "China Academic Conference Paper Database" (2009.9); of "China's dissertation database" (2009.9); Dissertation of Beijing University of Chinese Medicine Database (2009.9).2 The literature included in the standard:study Type:All randomized controlled trials (this study included only randomized the use of the appropriate methods for using computer software, calculator, random number table, coin toss, dice method, the patient ballot law randomized trials). Study:diagnosis of type 2 diabetes. Treatments:one group treated with the Chinese (including Chinese herbal compound syndrome differentiation, single herb, Chinese herb extracts, Chinese proprietary medicines and Chinese food therapy, etc.), control measures, including placebo, western medicine, the basic treatment (including health education, diet control and Exercise therapy and symptomatic treatment western medicine).Outcome Assessment:At least one report of diabetes-related outcome measures:clinical inefficiency diabetes, fasting glucose,2-hour postprandial blood glucose, glycated hemoglobin, insulin sensitivity index, thirst, polyphagia, polyuria and weight loss symptoms inefficiency3 The literature selection:by reading the title and summary, according to inclusion criteria for screening, the literature is difficult to clear the scope of the first fall into the literature; obtain the full text should be included in the literature, by reading the text of the final decision whether to include; over the selection process by the two Name investigators independently.4 Data collection and quality evaluation:Two reviewers independently literature data extraction, quality assessment, documentation of each one according to Schulz and Jadad quality assessment criteria, the literature is divided into A, B, Cthree levels. A-level standards to meet the high quality of all:there is less bias; B-class standards to meet the part of the quality of the medium:medium bias exists; C-class does not meet all the criteria for the low quality of research:high bias exists.5 Data analysis:If there is at least two randomized clinical trials have the same drug, control measures and report the same outcome measures, then consider revman5.0 statistical software for quantitative analysis. Binary data using relative risk (RR) and 95% confidence interval that the continuous variable data using weighted mean difference and the standardized mean difference. Can not do quantitative analysis of qualitative data analysis methods can be used to describe the findings and integrated.【Results】 This systematic review of 3706 literature search, and finally 87 were included literature, a total of 8149 patients. A level of quality evaluation results for the A-level 0, B-level 87, C-level 0. Into the control types include Herbal medicine plus supportive therapy versus placebo plus supportive therapy (5), Herbal medicines versus Western medicine(12), Herbal medicines plus basic therapy versus Western medicine plus basic therapy (22), Herbal medicines plus basic therapy versus basic therapy (33), Herbal medicine versus another Herbal medicine (7), Herbal medicine plus basic versus another Herbal medicine plus basic (10).Only two articles were two kinds of traditional Chinese medicine uses the same control, Meta analysis:Xiaokean Capsule reducing the number of treatment ineffective, fasting plasma glucose level was not significant compared with gliclazide. Pancreatic Su Ling plus basic treatment than metformin plus basic treatment to reduce the clinical inefficiency of significant differences, RR95% CI 0.43 [0.24,0.80]; pancreatic Su Ling plus basic treatment compared with metformin plus basic treatment to improve insulin sensitivity index significantly different MD95% CI for the 0.49 [0.390.58].Herbal medicine plus supportive therapy versus placebo plus supportive therapy:in three clinical inefficiency,2 studies show that the treatment of Traditional Chinese Medicine, based on the basis of therapy compared with placebo plus significant; 2 studies reported in which a fasting blood glucose show that the treatment of Traditional Chinese Medicine, based on the basis of therapy compared with placebo plus significant; four studies reported a two-hour postprandial blood glucose of which 3 articles that compared with placebo treatment of Traditional Chinese Medicine, based on the basis of therapy significantly increases; two reports in the literature of the glycosylated hemoglobin including a literature that treatment of Traditional Chinese Medicine, based on the basis of therapy compared with placebo plus significant; aliterature of the insulin sensitivity index showed that treatment of Traditional Chinese Medicine, based on the basis of therapy compared with placebo plus no significant difference.Herbal medicines versus Western medicine:the study of 10 studies reported the clinical inefficiency of which four documents show that traditional Chinese medicine than western medicine therapy significantly; 11 studies reported fasting blood glucose of which four documents show that traditional Chinese medicine than western medicine therapy significantly; five studies reported a two-hour postprandial blood glucose are that traditional Chinese medicine than western medicine therapy was no significant difference; three studies reported that glycated hemoglobin are effective traditional Chinese medicine than western medicine was no significant difference in treatment; four studies reported improvement of symptoms thirsty inefficiency in which a traditional Chinese medicine than western literature shows that a significant treatment effect; two studies reported no symptom improvement over the efficiency of food are that traditional Chinese medicine than western medicine therapy was no significant difference.Herbal medicines plus basic therapy versus Western medicine plus basic therapy: study of 10studies reported the clinical inefficiency of which four documents show that Chinese medicine combined with basic therapy compared with Western medicine combined with basic therapy significantly; 22 studies reported fasting blood glucose where 6documents show that Chinese medicine combined with basic therapy compared with Western medicine combined with basic therapy significantly; 16 studies reported postprandial two-hour glucose of which three documents show that Chinese medicine combined with basic therapy compared with Western medicine combined with basic therapy significantly; 12 Documents reported glycosylated hemoglobin in which three documents show that Chinese medicine combined with basic therapy compared with Western medicine combined with basic therapy significantly; 10 reports in the literature of the insulin sensitivity index of which 4articles showed that traditional Chinese medicine combined with basic therapy compared with Western medicine combined with basic therapy significantly; eight studies reported improvement of symptoms thirsty inefficiency which two documents show that the basic treatment of Chinese medicine combined with western medicine combined with a more significant basis for therapy;five studies reported no symptom improvement over the efficiency of water in which a literature suggests that the basis of traditional Chinese medicine combined with the basis of combined therapy compared with Western medicine therapy significantly; 5 studies reported more symptoms of urinary inefficiency literature of which four basic treatment that combined traditional Chinese medicine combined with Western medicine based on a more efficacious treatment.Herbal medicines plus basic therapy versus basic therapy:study of 23 studies reported the clinical inefficiency of which eightliterature suggests that traditional Chinese medicine combined with basic treatment more based therapy significantly; 29studies reported fasting blood glucose,16 articles that Chinese Herbs with basic treatment more based therapy significantly; 21 studies reported postprandial 2 hours glucose,16 articles showed that Chinese medicine combined with basic treatment more based therapy significantly; nine studies reported glycosylated hemoglobin in which five documents show that Chinese Herbs based therapy compared with basic therapy significantly; six reports in the literature of the insulin sensitivity index in which four documents show that Chinese medicine combined with basic treatment more based therapy significantly; four studies reported thirst to improve the inefficiency of which a document that Chinese Herbs based therapy compared with basic therapy significantly; a literature reports a number of food to improve the inefficiency that traditional Chinese medicine combined with basic treatment more based therapy was no significant difference; two studies reported polyuria improve inefficiencies are that traditional Chinese medicine combined with basic treatment than based therapy significantly;Herbal medicine versus another Herbal medicine:research studies reported insix clinical inefficiency of which three Chinese literature suggest a more efficacious alternative medicine; 10 studies reported fasting blood glucose,6 articles suggest a medicine than the other traditional Chinese medicines are significant; 10 studies reported a two-hour postprandial blood glucose in which four more Chinese literature indicates a significant other traditional Chinese medicines; four studies reported of which two glycosylated hemoglobin Chinese literature suggest a more efficacious alternative medicine; two studies reported thirst to improve the inefficiency that a kind of Chinese medicine are compared with other traditional Chinese medicines are not significantly different; three studies reported more than one food to improve the efficiency of a literature suggests a kind of medicine than the other traditional Chinese medicines are significant; two studies reported polyuria improve the efficiency of which a free literature suggests a kind of medicine than the other traditional Chinese medicines are significant; three studies reported no weight loss to improve the efficiency of all that a kind of medicine than the other traditional Chinese medicines are not significantly different;Herbal medicine plus basic versus another Herbal medicine plus basic:four studies reported the inefficiency of which two clinical literature suggests a kind of Chinese Herbs with basic treatment than another based on traditional Chinese medicine combined therapy significantly; 10studies reported fasting blood glucose of which 4 articles suggest a more basic treatment of Chinese medicine combined with another medicine based therapy combined with significantly; eight reports in the literature a two-hour postprandial blood glucose of 7 articles suggest a basis for Chinese medicine combined with traditional Chinese medicine treatment than another based on combined therapy significantly; six reports in the literature of the glycosylated hemoglobin in which four Chinese medicine combined with literature suggest a more basic treatment Another basis of Chinese medicine combined therapy significantly; a literature of the insulin sensitivity index indicate a more basic treatment of Chinese medicine combined with alternative medicine therapy combined with a significant base; four studies reported no thirst to improve the efficiency of three studies reported no more food to improve the efficiency of three studies reported no improvement over the efficiency of urine, two studies reported no weight loss to improve the efficiency of both indicate a more basic treatment of Chinese medicine combined with alternative medicine therapy in conjunction with the foundation no significant difference.44 articles (50.6%) had adverse reactions, of which 25 articles were only briefly mentioned in the text "no adverse reaction", and there 7 is mentioned in the discussion; one all the cases reported in the literature The adverse reactions did not explain the treatment group or control group; 32 treatment group reported in the literature no adverse reactions.Reported adverse reactions include dizziness, fatigue, edema, hypoglycemia, and nausea, vomiting, diarrhea and other gastrointestinal symptoms and allergic skin rashes, etc., did not report serious adverse reactions. No adverse reactions to an article on why there may be related to drug analysis.【Conclusion】1 Chinese medicine treatment of type 2 diabetes randomized controlled trials need to be improved the quality of the clinical literature, particularly in sample size estimation, random hidden, blind, fell off and lost aspects to be taken seriously enough.2 Traditional Chinese medicine treatment of type 2 diabetes may be ineffective in reducing the clinical, fasting blood glucose level,2-hour postprandial blood glucose, glycated hemoglobin and improved insulin sensitivity and there is potential to improve diabetes symptoms, in particular the basis of traditional Chinese medicine combined with western medicine alone treatment than those Western medicine therapy may be more significant difference. However, because of the systematic review literature published by the same amount of medicine too small, so the use of traditional Chinese medicine the effectiveness of treatment of type 2 diabetes can not draw definite conclusions yet, still need more and more, large sample, well-designed randomized controlled trials verify the results.3 Less adverse reaction reports and brief reports. Suggested that future research focus of adverse reactions medicine to provide evidence of the safety of Chinese medicine.