Research Of Systematic Review And Clinic Trial About IGT Treated By Chinese Herb Based On Pi And Wei Centre Shaft Theory

ObjectiveTo evaluate the effective of traditional Chinese medicine which can tonify spleen and explore the rule between these therapies, in the other hand, to provide evidence in treat IGT.To observe therapeutic effect and security of treating IGT patients with transporting centre shaft and effect a permanent cure as well, based on the pathogenesis of IGT, which means’insufficiency of splenogastric qi, but yang qi deficiency’Methods1. According to inclusion and exclusion criteria, search the RCT about IGT from electronic database (The Cochrane library, Pubmed, CNKI and CBM, Wanfang and VIP) and the library, by The method of health intervention IGT, extract the basic information and the data, evaluate the quality of method according to the Jadad score evaluation and use the RevMan5.2 software for the meta analysis.2. This trial was RCT. We recruited IGT people, Who see a doctor in the first affiliated hospital of GZUCM, according to the inclusion and exclusion criteria from June in 2013 to December in 2014. With the LSI, group 1 were treated with herbal soup, group 2 were treated with metformin. The human subjects were treated with 3 months. After the treatment, we observed the FPG,2hPG, HbAlc, FINS, IRI, TC, TG, HDL-C, LDL-C, BMI, symptoms scores and security. All of the data calculated using SPSS18.0 software.Results1. Systematic ReviewQuality and general information about those RCTs:We totally intaked 29 RCTs. According to the Jadad score standard,7 of them were high quality.26 RCTs were treated both with LSI and herbal soup, which could tonify spleen. 15 RCTs were treated only with LSI.4 RCTs’group 2 were treated with placebo and LSI, and 7 RCTs’group 2 were treated with Western hypoglycemic drugs. The therapies of group 1 included’invigorating spleen and activating blood’,’invigorating spleen, eliminating dampness and phlegm’,’invigorating spleen, eliminating dampness and phlegm, clearing away heat and nourishing yin’,’invigorating spleen, clearing away heat and nourishing yin’,’invigorating spleen, eliminating dampness’, ’invigorating spleen, promoting digestion’and so on, totally 18 therapies.The results of meta analysis showed that:Spleen-strengthening herbs conbined with LSI VS LSI could improve the FPG,2hPG, HbAlc, FINS, TC, TG, IR, BMI, WHR and the efficient, NGT recovery rate of group 1 compaired with group 2. Spleen-strengthening herbs conbined with LSI VS LSI conbined with placebo, could improve FPG,2hPG, HbAlc, FINS, IR, TG and improve efficiency, reduce the incidence of DM group 1. Spleen-strengthening herbs VS placebo could improve TG, HDL-C. Spleen-strengthening herbs conbined with LSI VS LSI conbined with hypoglycemic drugs, could improve FPG,2hPG, HbAlc, FINS, TC, TG, BMI, WHR, and the efficient, the NGT recovery rate of group 1. Spleen-strengthening herbs VS hypoglycemic drugs could improve TG, HDL, LDL-C of group 1. Spleen-strengthening herbs conbined with hypoglycemic drugs and LSI VS LSI conbined with hypoglycemic drugs, could improve FPG,2 HPG, HbAlc, FINS, IR of group 1. The 2 groups had no significant variation in other index. Adverse reactions indicated that Spleen-strengthening herbs were safe.2. Clinical StudyThe clinical study included 54 IGT patients, randomly divided into 2 groups, 51 of them finally completed the test. The Chinese medicine group had 26 subjects,14 male,12 female, the control group had 25 subjects,14 male,11 female. The two groups had no statistical difference in gender, age, course of the disease, local, complicating disease and blood sugar, insulin, blood lipid, symptom scores (P> 0.05). The end results showd that, about FPG the two groups had a significant statistical significance compared before (P< 0.01).The final effect about the groups’FPG had no significant difference (P> 0.05). About 2hPG the two groups had a significant statistical significance compared before (P< 0.01). The final effect about the groups’ 2hPG had significant difference (P< 0.01). About HbAlc the two groups had a significant statistical significance compared before (P< 0.01). The final effect about the groups’HbAlc had no significant difference (P> 0.05). About FINS the two groups had a significant statistical significance compared before (P< 0.01). The final effect about the groups’FINS had no significant difference (P> 0.05). About IR the two groups had a significant statistical significance compared before (P< 0.01). The final effect about the groups’ IR had no significant difference (P> 0.05). About TC the two groups had a significant statistical significance compared before (P< 0.01). The final effect about the groups’TC had no significant difference (P> 0.05). About TG the two groups had a significant statistical significance compared before (P< 0.01). The final effect about the groups’TG had significant difference (P< 0.05). About HDL-C the two groups had a significant statistical significance compared before (P< 0.01). The final effect about the groups’ HDL-C had significant difference (P< 0.01). About LDL-C the two groups had a significant statistical significance compared before (P< 0.01). The final effect about the groups’LDL-C had no significant difference (P> 0.05). About symptom the two groups had a significant statistical significance compared before (P< 0.01). About BMI the two groups had a significant statistical significance compared before (P< 0.01). The final effect about the groups’ BMI had no significant difference (P> 0.05). The final effect about the groups’symptom had significant difference (P< 0.05). About effective rate of the two groups had a significant statistical significance compared before (P< 0.01).The Chinese medicine and western medicine group’s symptom effective rate had significant difference (P< 0.01), but the hyperglycemic effective rate had no significant difference (P>0.05). After the therapy, the Chinese medicine and western medicine group’s outcome had no significant difference (P> 0.05).6 months later, the Chinese medicine and western medicine group’s outcome had significant difference (P<0.05). During the trial, Chinese medicine group without adverse reactions, Western medicine group and 1 cases with mild decreased appetite, loose stools,1 case of patients with abdominal distension. Two groups of patients had no abnormal with the three routine inspection, liver and kidney function.Concl usion1. Lifestyle intervention as a basic intervention method, which can regulate glucose and lipid metabolism, reduce insulin secretion and IR, play a role in lose weight. On the basis of LSI, drug could be put to good use. With tonifying spleen, supplemented by soothing liver, promoting the circulation of qi, relieving depression, reducing phlegm, clearing damp, promoting blood circulation to remove blood stasis and clearing heat, IGT can be treated comprehensively. Besides spleen deficient, depression of qi, blood, phlegm, heat, moisture and feed was proved to exist. Due to most researches’ quality of were not high, the sample size were small and the course of treatment were not long, so there still need more large sample, multicenter, high quality tests.2. Under the guidance of the circular motion theory, treat IGT with LSI and yun pi gu zhong soup has a positive effect, and has no adverse reactions. Yun pi gu zhong soup might be reduce 2hPG, HDL-C, TG, relieve clinical symptoms compared with metformin. In regulating FPG, TC, HbAlc, FINS, IR, LDL-C, BMI they were equal. Therefore, under the guidance of the circular motion theory to the treatment of IGT can yet be regarded as a good way to treat IGT.