Discussion On The Intervention Study Of Wendan Decoction On The Pre-Diabetes Based On The "Sanjiao Qihua" Theory

PurposeBased on the theory of " syndrome differentiation and treatment " and "Sanjiao Qihua" of Chinese medicine,the representative prescription of "Fenxiao Zouxie " method-Wendan Decoction was applied to intervene in patients with spleen deficiency and phlegm-dampness syndrome in prediabetes combined with the basic lifestyle intervention,we observed before and after intervention in patients with the change of clinical symptoms and the related indicators data,analysis the data to evaluate the clinical curative effect of the treatment plan,and try to explore the clinical mechanism;Provide new idea for traditional Chinese medicine treatment of pre-diabetes.MethodsIn this study,60 cases of pre-diabetes with spleen deficiency and phlegm-dampness syndrome who met the inclusion criteria of Chinese medicine and Western medicine were selected from the adult chronic diseases and risk factors monitoring and investigation population in Jiangxi Province in 2018,they were divided into treatment group and control group with 30 cases in each group by random number table method.Both groups received pre-diabetic lifestyle intervention,and the treatment group also received Wendan Decoction.The clinical symptoms and the related indicators of the two groups before and after intervention were taken as observation indicators,including TCM syndrome scores and fasting blood glucose(FPG),laboratory indicators such as 2 hour postprandial glucose(2h PG),glycosylated hemoglobin(Hb A1c),total cholesterol(TC),triglyceride(TG),low density lipoprotein-cholesterol(LDL-C)and obesity indicators such as waist circumference(WC),body mass index(BMI),chinese visceral adipose index(CVAI).Intervention time is 8 weeks,the patients were followed up for 32 weeks by telephone and Wechat or outpatient visits.The change of above observation indexes before and after 8 weeks intervention were compared between the two groups,objective evaluation was made on the clinical efficacy of two intervention programs.Results(1)In terms of TCM syndromes,the intra-group comparison results showed that both the two groups after intervention can significantly improve the syndrome integration of Chinese medicine(P<0.001),and compared with the control group,the treatment group improved significantly(P<0.001).(2)In terms of the comprehensive curative effect of TCM syndrome,the total effective rate of the treatment group was 93.33%;The total effective rate of control group was 60.00%.Comparison between groups showed that the curative effect of treatment group was significantly better than control group(P<0.01).(3)In terms of blood glucose levels,intra-group comparison results showed that blood glucose levels decreased in both groups after intervention,and significantly decreased in the treatment group(P<0.001),while FPG and Hb A1 c decreased in the control group before and after intervention,but there were no statistically significant difference in the decrease values in the control group after intervention(P ≥ 0.05).Comparison between groups showed that the reduction of FPG,2h PG and Hb A1 c in the treatment group was significantly better than that in control group(P<0.05).(4)In terms of blood lipid levels,intra-group comparison showed that the TC,TG and LDL-C of the two groups were decreased after intervention,and the therapeutic effect of all indicators in the treatment group was significantly improved(P<0.001),the TC and LDL-C of the control group were decreased compared with that before intervention,but there were no statistical significance before and after intervention(P>0.05).Comparison between groups indicated that the improvement of TC,TG and LDL-C in the treatment group were better than that in control group(P<0.05).(5)In terms of obesity index,intra-group comparison showed that the WC,BMI and CVAI of the two groups were decreased after intervention(P < 0.05),and the WC,BMI and CVAI of the treatment group were significantly improved(P<0.001).The comparison between the two groups suggested that the improvement of WC and CVAI in the treatment group were significantly better than that in the control group(P<0.01),but there were no statistical significance after intervention in the decreased difference of BMI between the two groups.(P>0.05).(6)In terms of the total effective rate,the total effective rate was 86.67% in the treatment group.The total effective rate of the control group was 56.67%,and the total curative effects of the treatment group were better than that of the control group(P<0.05).ConclusionThis study found that,guided by the theory of " syndrome differentiation and treatment " and "Sanjiao Qihua" of Chinese medicine,the representative prescription "Fenxiao Zouxie" method of Wendan Decoction in the treatment of prediabetic patients with spleen deficiency and phlegm-dampness syndrome has significant clinical efficacy.This treatment plan can effectively improve TCM syndrome integral and regulate glucose and lipid metabolism;There were no adverse reactions such as hypoglycemia,palpitation,bloating,nausea or allergy during the treatment,no adverse effects such as liver and kidney damage were observed.Related security indicators are normal.It is worth clinically promoting applications.