| ObjectiveStudy the literatures of traditional Chinese medicine combined with insulin pump in the treatment of type 2 diabetes mellitus by using the meta analysis method of evidence-based medicine, evaluate their quality, using meta analysis method to analyze the clinical effect of traditional Chinese medicine combined with insulin pump in the treatment of type 2 diabetes mellitus and insulin pump intensive treatment of type 2 diabetes, To provide an evidence supporting for the treatment of type 2 diabetes mellitus with traditional Chinese medicine combined with insulin pump.Methodsaccording to the relevant search words, Search clinical studys of randomized controlled trial of traditional Chinese medicine combined with insulin pump in the treatment of type 2 diabetes mellitus in the database (including CNKI, CBM, wanfang, VIP and Foreign language database), and manual retrieval of journal databases of the Guangzhou University of Chinese Medicine library as a supplement. According to the risk of bias evaluation standard of Cochrane Handbook (5.1.2 version), evaluate the quality of the included studies, and Study on the extraction of data, and then use Reman5.3 software to heterogeneity test, meta analysis, publicate bias and evaluate the Security of studies.Results13 studies,916 subjects were included in the study, and the results of meta analysis showed that:1、In blood glucose control, Compared with insulin pump therapy, Chinese medicine combined with insulin pump treatment can get a significantly reduce in the control of the fasting glucose level (p=0.0004) and postprandial 2H blood glucose level (p=0.0004); and blood glucose up to the standard time is shorter than the control group (p=0.02); the incidence of hypoglycemia was less than that in the control group during treatment (p=0.002), follow-up results included 3 studies indicated patients of the combined treatment group control their blood glucose better than the control group after a period of time of treatment;2、Compared with insulin pump treatment, the traditional Chinese medicine combined with insulin pump therapy have same curative effect of improved HbAlc (P= 0.42), fasting insulin (p=0.53), postprandial 2H insulin (P= 0.19) and Homa-0 (P= 0.08), the difference was not statistically significant;3、Compared with insulin pump treatment, the traditional Chinese medicine combined with insulin pump therapy can get a better reduce of reduced HOMA-IR (P< 0.00001) and enhanced insulin sensitivity (P=0.03) and decreased the average dosage of insulin during the treatment (P< 0.00001);4、Compared with insulin pump treatment, the traditional Chinese medicine combined with insulin pump therapy have same curative effect of improved triglyceride and total cholesterol, the difference was not statistically significant;5、Compared with insulin pump treatment, the traditional Chinese medicine combined with insulin pump therapy can better improve the patient’s clinical symptoms (P clinical=0.003, Ptcm=0.002), to make patients get better and more intuitive clinical treatment experience;6、5 studies reported adverse drug reactions, in addition to Hypoglycemic reaction, the two treatment options wasn’t reported other serious adverse reactions;7、Analysis of Chinese medicine prescription and Single Chinese herbal medicine use frequency, most of the doctors think that TCM Syndrome Types of most early diabetic patients take spleen weakness as original cause and Phlegm dampness and stagnant blood evil is the superficial cause. So the treatment should be on the basis of nourishing the spleen qi, and then balance weight of Phlegm dampness and stagnant blood priorities and selectively before prescribe medication.ConclusionThe meta analysis results show that compared with insulin pump treatment, traditional Chinese medicine combined with insulin pump therapy have a better clinical curative effect. But in the future, still need to more high quality, large sample, multi center randomized controlled clinical trials, to further enhance the credibility of conclusion. |
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