Meta-analysis Of The Treatment Of Diabetic Gastroparesis With Traditional Chinese Medicine

Objective:To evaluate the clinical effect of TCM therapy on diabetic gastroparesis(DGP)by using the method of eviden ce-based medicine.Methods:PubMed,Cochrane library,CHKD,CNKI,Wanfang data,VIP were searched for randomized controlled trials(RCTs)about traditional Chinese medicine in treating DGP comparison of western medicine program from2013.01.01~2017.12.31.Articles,having been filtrated according to the criteria for inclusion and exclusion,were evaluated for their quality through the modified Jadad score.Data including total effective rate of clinical treatment,cure rate,gastric emptying(gastric emptying rate,gastric emptying time),main symptom score(abdominal distention,belching,nausea and vomiting,anorexia,epigastric pain),blood glucose level(FPG,2hPG,HbAIc),adverse reactions incidence and recurrence rate were extracted for a Meta-analysis through the software RevMan5.3.5 that provided by Cochrane Collaboration.Results:40trials involving 3319 patients were included.Meta-analysis showed that compared with the control group,the traditional chinese medicine had superiority in many aspects such as total effective rate of clinical treatment[P<0.00001,OR=4.03,95%CI:3.24~5.00];cure rate[P<0.0001,OR=2.57,95%CI:1.85~3.55];gastric emptying rate[P <0.00001,OR=8.78,95%CI : 7.39 ~ 10.17];gastric emptying time[P <0.00001,OR=-26.94,95%CI :-29.92 ~-23.95];clinical symptom(abdominal distention,belching,nausea and vomiting,anorexia,epigastric pain)score[P<0.0001,OR=-3.36,95%CI:-3.46~-3.26]?[P<0.00001,OR=-0.42,95%CI:-0.51~-0.34]?[P<0.00001,OR=-0.37,95%CI:-0.43~-0.31]?[P<0.00001,OR=-0.41,95%CI:-0.47~-0.35]?[P<0.00001,OR=-0.33,95%CI :-0.42 ~-0.24] ? [P < 0.00001,OR=-0.38,95%CI :-0.48 ~-0.29];2hPG and HbAIc[P<0.00001,OR=-1.8,95%CI:-2.00~-1.61]?[P<0.00001,OR=-0.32,95%CI:-0.43~-0.21];adverse reactions rate[P=0.009,OR=0.39,95%CI:0.19~0.79];serum motilin and gastrin level[P<0.00001,OR=-96.87,95%CI:-101.81~-91.94]?[P<0.00001,OR=-33.55,95%CI:-37.36~-29.74]and so on.Conclusions: The conclusions of the preliminary analysis of this study are as follows:1.Traditional Chinese medicine for DGP is proved to be more effective than Western medicine.2.Traditional Chinese medicine for DGP in clinical efficiency is better than that of the corresponding domperidone,mosapride,cisapride and other Western medicine.3.Recurrence and adverse reaction rate of DGP patients after treating by the tradotional Chinese medicine is lower than that of the Western medicine alone.Altogether,the reliability of the conclusions in the study isn't completely enough and it needs going on to be evaluated with more large sample and high quality researchs.