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Drug-related problems among type II diabetes mellitus patients with hypertension: a cross-sectional study
J. Nzayisenga, N. Njau Ngomi, J. Nyiligira
90Life Research    2020, 3 (1): 1-14.
Abstract PDF (637KB)  

Introduction: Patients with type II diabetes mellitus (T2DM) and hypertension (HTN) are at increased threat for long experiencing various problems related to medicine as they frequently received different medications for managing their condition. Recently, there were no studies done locally on drug-related problems (DRPs) among T2DM patients with HTN. Thus, this study aims to assess the DRPs among T2DM patients with HTN admitted at Kibuye Referral Hospital (KRH). DRPs were drug safety problems, drug effectiveness problems and other drug problems. 

Methods: A retrospective cross-sectional study involved patients' files with T2DM and HTN, who were admitted at KRH from January 2013 to December 2017. The identification and classification of DRPs were based on pharmaceutical care network Europe (PCNE) classification system version 8.02. A simple random sampling technique was used to choose study participants from the target population. Data that met inclusion and exclusion criteria were analyzed using STATA version 13. The Fisher exact test (bivariate analysis) and logistic regression (multivariate) were used to test association and p-value ≤ 0.05 was considered as statistically significant. An adjusted odd ratio (AOR) with a confidence interval (CI) of 95% was determined using binary logistic regression. 

Results: Findings revealed that the prevalence of DRPs was 81.29% (313/385) and most of them each patient had at least two DRPs (69.05%). The patients aged above 55 years old were more likely to develop DRPs than those with age below 35 years (AOR = 1.2; P = 0.02; 95% CI: 0.2–2.3). Nevertheless, there was no significant association between DRPs and middle age (between 35 and 54 age of old). The patients who  consumed more than or equal to 5 drugs were 2.4 times more likely to develop DRPs than those who took the number of medicines less than 5 (AOR = 15.4; P < 0.001; 95% CI: 8.8–26.8). Also, traditional medicines use ((AOR = 1.9; P = 0.016; 95% CI: 1.1–3.5) and having drug-related complication (AOR = 2.4; P < 0.001; 95% CI: 1.9–3) had shown significant associations. The total causes of DRPs identified were 1626 and most causes of DRPs were arisen from drug use (45.01%) and prescribing (37.83%). The drug/dose selections were the most frequent causes of DRPs (36.97%). 

Conclusions: Since the prevalence of DRPs were relatively high, various factors influencing DRPs were established and most causes of DRPs were arising from drug use & drug prescribing among T2DM patients with HTN. Early detection needed to enhance patient’s life quality. Conducting studies in other hospitals needed to establish the national planning of DRPs to eradicate DRPs among patients T2DM with HTN.

Correlation of Commonly Used Anthropometric Parameters with FPG, FPG-CV and HbA1C
Ya-Nan Zhao , Rui-Hua Wang , Li-Juan Zhang , Qiang Xu, Yan-Fen Li
8Food Therapy and Health Care    2019, 1 (1): 2-7.
Abstract PDF (330KB)  
Objective: To investigate the relationship between body mass index (BMI), waist circumference (WC), hip circumference (HC), 
waist-hip ratio (WHR), waist height ratio (WHtR), fasting blood glucose (FPG), fasting blood glucose variation (FPG-CV) and 
glycosylated hemoglobin (HbA1C) to provide a reference for predicting the risk and development trend of diabetesmellitus. Methods: From October 2016 to December 2017, 111 subjects from the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were selected to measure their height and weight. BMI, WHR and WHtR were calculated and the concentrations of FPG and HbA1C were detected. Statistical analysis was carried out with SPSS21.0 software, and the data were processed by multiple linear regression analysis.Results: The concentration dependence of WHtR, FPG, FPG-CV and HbA1C were more closely related. There was a significant difference between WHtR and FPG, FPG-CV and HbA1C by multiple linear regression analysis (t = 8.531, 6.910 and 6.905, respectively, P < 0. 01), and the correlation coefficient was 0. 633, 0.552 and 0. 552 respectively (P < 0. 01). Conclusion: There is a significant correlation between WHtR and FPG, FPG-CV and HbA1C. Therefore, measuring the height and waist circumference for the predictive potential of diabetes needs 
to be emphasized and intensified.
A meta-analysis of randomized controlled trials of combined treatment with DGSN and western medicine on diabetic peripheral neuropathy
Xiaoke Feng
5TMR Clinical Research    2019, 2 (1): 8-19.
Abstract PDF (775KB)  
Objective: To systematically study the clinical effects of combined treatment with Dang gui si ni tang (DGSN) and western medicine (WM) on diabetic peripheral neuropathy. Methods: Seven databases, including Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), Wanfang full-text database, VIP Database for Chinese Technical Periodicals, MEDLINE, PubMed, Embase, were retrieved. Related references about randomized controlled trials on the combination of DGSN and WM on diabetic peripheral neuropathy published during January 2012 up to now(recent 5 years)were reviewed. Related grey literatures were also reviewed according to the selected articles. RevMan5.3 software was used to analyze the publish bias, and to compare the total clinical effects of the combination of DGSN and WM with WM alone. Results: Ultimately, 19 randomized controlled trials with 1690 patients were incorporated. The results of meta-analysis showed that combined treatment of diabetic peripheral neuropathy with DGSN and WM showed better general efficacy compared with control group, with a statistically significant difference (P <0. 05). The results of study showed homogeneity (P = 0.94 > 0.05). The general efficacy of combined treatment with DGSN and WM was significantly higher than that of control group (P < 0.00001, OR = 3.98, 95% CI: 3.01 ~ 5.27). Conclusion: Compared with treatment with WM alone, combined treatment of diabetic peripheral neuropathy with DGSN and WM is more effective. Meanwhile, due to the limited literature samples and low quality of literatures, large samples and high quality of multi-center randomized controlled double-blind trials are needed to verify these results.
Clinical observation on TCM fumigation and washing for treatment of diabetic peripheral neuropathy by self-made water-washing footbath
Lu Gan
5TMR Clinical Research    2019, 2 (1): 37-42.
Abstract PDF (204KB)  
Diabetic peripheral neuropathy (DPN) is common in clinic which cause great discomfort to patients and affect the quality of life seriously, and even lead to more servere complications. On the base of the well-controlled blood glucose, improving the symptoms of both lower limbs timely will has positive significance for enhancing the life quality of patients and preventing complications of limbs. This article makes a comprehensive study on the application of self-made water-washing footbath in the treatment of DPN by Chinese medicine fumigation. From March 2018 to April 2018 in our hospital 20 cases of DPN patients were collected and they were divided into observation group (treated by self-made water-washing footbath with herbs) and control group( treated by conventional barrels) , 10 cases in each. The results showed that Chinese medicine fumigation on both lower limbs has clinical curative effect to improve the symptoms of arthromyodynia caused by diabetes. It provide an alternative method of external treatment for DPN patients with numbness in both lower limbs which could alleviate their suffering and improve the quality of life significantly.
A Meta analysis of characteristics of median nerve and sural nerve injury in patients with diabetic peripheral neuropathy
Zhao Qi, Guo Wei
TMR Integrative Medicine    2018, 2 (1): 39-47.
Abstract HTML PDF (992KB)  

Objective: A meta-analysis of randomized trials was performed to assess the injured degree of median nerve and sural nerve in patients with diabetic peripheral neuropathy (DPN).Methods: we searched Pubmed Database, China Biomedical Literature Database, VIP Database, ChinaNet for studies. Then evaluated these studies in order to find the researches in line with the requirements of the study; Each relevant research was carefully read to extract relevant data; The current perception threshold (CPT) value of median nerve and sural nerve were compared at 2000Hz, 250Hz and 5Hz between patients with DPN and the normal control group.Results: Finally 10 articles that meet the standards were included, with 1054 cases in the patient group and 719 cases in the normal group. The CPT values of median nerve and sural nerve at 2000 Hz, 250 Hz and 5 Hz of patients group were higher than those of normal control group (P<0.05 for all). Conclusion: Systematic reviews showed that the sensitivity of the median nerve and sural nerve in DPN patients was generally reduced. Sensory nerve quantitative detector could detect nerve damage early, accurately and monitor the effect treatment in patients with DPN.

The efficacy and safety of Chinese herbal medicine combined with ACEI/ARB for treatment of incipient diabetic nephropathy: A meta-analysis
Qi-Yan Zheng, Wei-Jing Liu, Wei-Wei Sun, Yao-Xian Wang, Hong-Fang Liu, Lu-Ying Sun
2TMR Integrative Medicine    2018, 2 (1): 7-29.
Abstract HTML PDF (1365KB)  

Objective: This meta-analysis evaluated the efficacy and safety of Chinese herbal medicine (CHM) combined with angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin-receptor blockers (ARBs)for treatment of incipient diabetic nephropathy(IDN). Methods: Nine data bases were searched for randomized controlled trials of Chinese herbal medicine(CHM) and ACEI/ARB for treatment of IDN. Included articles were published between January2006 and December 2016. All studies were divided into prescriptions containing both Astragali Radix and Rehmanniae Radix (i subgroup), Astragali Radix(Huangqi) or Rehmanniae Radix(Dihuang) (ii subgroup), neither Astragali Radix nor Rehmanniae Radix (iii subgroup). Review Manager 5.3was used for subgroup analysis. Results: In total, 28 RCTs with 2017 patients were included. The results showed 1)the urinary albumin excretion rate (UAER) can be reduced significantly using CHM with ACEI or ARB for treatment of IDN compared to ACEI or ARB alone, and reduction of the UAER of the i subgroup was superior to that of the other two subgroups;2)serum creatinine (Scr) levels can be reduced significantly using CHM combined with ACEI or ARB, and reduction of Scr in the ii subgroup was superior to that in the iii subgroup;3)reduction of BUN in group A was not better than that in group B. Conclusion: In summary, CHMs combined with ACEI/ARB can decrease UAER and Scr significantly compared to the use of ACEI/ARB during IDN treatment. The effect was more significant in the CHM group containing Astragali Radix or Rehmanniae Radix. The application of Astragali Radix and Rehmanniae Radix should be emphasized in third stage diabetic nephropathy.

Meta-analysis of clinical efficacy and safety of the treatment of impaired glucose tolerance by Tianqijiangtang Capsule
Cheng-Ya Wu, Ke Li
TMR Integrative Medicine    2018, 2 (2): 68-75.
Abstract PDF (448KB)  
Objective: To evaluate the clinical efficacy and safety of Tianqijiangtang Capsule (TG) during the treatment of impaired glucose tolerance (IGT). Methods: With Chinese words of “impaired glucose tolerance, abnormal glucose tolerance, IGT” and “TG” as search terms, China National Knowledge Infrastructure, VIP, Wanfang Data and Pubmed were searched up from database inception until October 2017. All the controlled clinical research concerning the treatment of impaired glucose tolerance by TG meeting the inclusion and exclusion criteria were retrieved and analyzed by Review Manager 5.3 software provided by Cochrane cooperation Network. Results: A total of 7 articles including 1082 participants were enrolled. Meta-analysis showed that the OR value of inversion rate was 2.17, 95% CI (1.65, 2.84). WMD value of fasting plasma glucose was -0.25, 95% CI (-0.39, -0.11). After 2 h on empty stomach, the WMD value of serum glucose was -0.73, 95% CI (-0.96, -0.51), all of which were better than these of control group. The OR value of progression rate (type 2 diabetes mellitus) was 0.44, 95% CI (0.32, 0.59), less than the control group. All of the differences were statistically significant. No hepatic and renal toxicity case was reported. Only 1 article reported adverse reactions in the course of treatment. Conclusion: TG could treat IGT effectively, delay and even invert the progress of IGT, but its security still needed further discussion.
Progress in the study of diabetic retinopathy
Lei Xiao, Jun-Guo Duan
TMR Integrative Medicine    2018, 2 (2): 62-67.
Abstract PDF (247KB)  
Diabetic retinopathy (DR) is one of the microvascular complications of diabetes, which could be divided into non-proliferative DR and proliferative DR according to the severity of retinopathy. Diabetic microangiopathy not only affects the eyesight of patients with diabetes, but also endanger the lives of patients and draws more and more attention from domestic and foreign scholars. The etiology and treatment of diabetes are reviewed to explore ways of treating diabetic retinopathy.
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