Ji-Ya Sun, Qiong-Yang Zhou, Chao Cheng, Zhi-Heng Zhao, Gui-Tong Zhou, Yi-Hua Fan, Xin-Ju Li*

A study of medication rules of traditional Chinese medicine in the treatment of pre diabetes based on data mining

Ji-Ya Sun1#, Qiong-Yang Zhou1#, Chao Cheng1, Zhi-Heng Zhao2, Gui-Tong Zhou1, Yi-Hua Fan3, Xin-Ju Li1*

1Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;2The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China;3The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China.

To summarize the concerted application and prescription rules of traditional Chinese medicine in the treatment of pre diabetes.Microsoft Excel 2010 was used to summarize the categories, nature, flavour and channel tropism of drugs. The cluster analysis of high-frequency drugs was carried out by SPSS 22.0, and the association rules of high-frequency drugs were analyzed by Apriori algorithm provided by SPSS modeler 14.0.One hundred and forty-six references were included, including 153 prescriptions and 131 drugs. Their frequency of use is listed in the following order. The top 3 categories of drugs were “Tonifying, Heat-Clearing”, diuresis and “Diffusing Dampness” drugs. The top 5 drugs were Huangqi (), Fuling (), Huanglian (), Shanyao (), Gegen (). The top 3 channel tropism of drugs were spleen, stomach and lung. The top 3 nature of drugs were cold, warm and calm. The top 3 flavour of drugs were sweet, bitter and pungent. The cluster analysis of high-frequency drugs showed that it could be classified into 4 categories: “Benefiting Qi” for promoting production of fluid, “Clearing Heat” and “Eliminating Dampness”, “Nourishing Yin” and “Clearing Heat”, and “Invigorating Spleen” for “Diffusing Dampness”. The results of association rule analysis showed that the combination with the highest degree of confidence and support was-Chenpi ()-Banxia ()-Baizhu () and the combination with the highest frequency was-.The pre diabetes is due to deficiency. The disease location is spleen and stomach and the pathological factor is phlegm-damp, that is why benefiting qi and invigorating spleen is regarded as the key link of clinical treatment.

Pre diabetes, Traditional Chinese medicine, Medication rules, Data mining

1. All the prescriptions used in this paper are from the published effective clinical research on the treatment of pre-diabetes. Most of the prescriptions are based on the experience of clinicians, and the curative effect is reliable.

2. In this paper, 153 prescriptions were analyzed by data mining method. The results showed that Huangqi (), Fuling (), Huanglian (), Shanyao () and Gegen () were high-frequency drugs for the clinical treatment of pre-diabetes. The drug compatibility and prescription rules were summarized. It was concluded that the disease nature of pre-diabetes was deficiency, the disease location was in the spleen and stomach, the pathological factor was phlegm dampness, and the key link of clinical treatment was “Yiqijianpi”, which has a guiding role in clinical practice.

Background

Pre diabetes refers to the development from normal glucose regulation to impaired glucose regulation (IGR), with elevated blood glucose but not yet up to the diagnostic criteria for diabetes, including impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). The 2 can occur alone or in combination. The clinical symptoms are not typical generally, feeling sweet in the mouth, thirst, strong appetite, abdominal distension and enlargement and fatigue are the main symptoms [1]. Studies have shown that: it is estimated that by 2030, there will be 470 million people with pre diabetes worldwide, and 70% of them will develop diabetes in different time periods[2–4]. In 2013, the International Diabetes Federation pointed out that the intervention treatment of impaired glucose regulation is an important means to prevent and delay the occurrence and development of diabetes [5]. With the deepening of relevant studies, the clinical efficacy and advantages of traditional Chinese medicine in the treatment of pre diabetes are becoming more and more obvious. Modern medical practitioners often use methods of “Qingrequshi” (“Clearing Heat” and “Eliminating Dampness”)[6, 7], “Kusuantongtiao” (treat with mainly bitter and sour drugs) [8] and “Jianpishugan” (“Invigorating Spleen” and “Dispersing Stagnated Liver Qi”) [9, 10]. Based on modern clinical research literature, this paper analyzes the medication rules and characteristics of traditional Chinese medicine in the treatment of pre diabetes, in order to provide reference for clinical application and scientific research design.

Materials and methods

Literature retrieval

With the subject words “pre diabetes”, “impaired glucose tolerance”, “abnormal glucose tolerance”, “impaired glucose regulation”, “impaired fasting glucose”, “Pidan” (a heat syndrome of the “Spleen”), “traditional Chinese medicine”, “Chinese patent medicine”, “herbal medicine” and “clinical observation”, the related literature of China National Knowledge Infrastructure, VIP and Wanfang Data were retrieved from the built of database to December 31, 2019.

Inclusion criteria for literature

(1) Journal papers have been published. (2) The literature types include randomized controlled trials, case-control trials and case reports. (3) The research objects meet the diagnostic criteria of “pre-diabetes” in traditional Chinese medicine and western medicine: traditional Chinese medicine diagnostic criteria: obesity, abnormally high waist-hip ratio and body mass index, strong appetite, strong bodywithpoor endurance; Western medicine diagnostic criteria: 6.1 mmol /L ≤ fasting plasma glucose ≤ 7.0 mmol /L with impaired glucose tolerance, 7.8 mmol/L ≤ 2 h plasma glucose < 11.1 mmol/L [11–12]. (4) The intervention measures are mainly traditional Chinese medicine prescriptions with definite drug composition. (5) Traditional Chinese medicine is effective in clinical treatment in their studies, excluding exercise, diet, acupuncture and other factors.

Exclusion criteria for literature

(1) The research object is a pregnant women. (2) The same studies have been published repeatedly and the different studies with the same prescription should be included only once with the latest publication year. (3) The full-text literature cannot be obtained.

Data entry and standardization

Microsoft Excel 2010 was used to extract the key information of the included literature, such as article title, year of publication, author, prescription medication, etc., and the data was extracted and collated by 2 personnel respectively. Referring to the 2015 edition ofthe names of Chinese medicine the original database were standardized, such as Shenghuangqi () was unified as Huangqi (), and Xianlingpi () was unified as Yinyanghuo ().

Statistical analysis

In this study, descriptive statistics, cluster analysis and association rule analysis were used.(1) Descriptive statistics: Microsoft Excel 2010 was used to conduct frequency statistics on categories, nature, flavour and channel tropism of drugs. (2) Cluster analysis: the system cluster analysis method in SPSS22.0 was used. (3) Association rules method: the Apriori algorithm provided by SPSS modeler 14.0 was used to analyze the association rules of high-frequency drugs in prescriptions.

Results

Literature retrieval results

In this study, a total of 906 related literatures were retrieved and 178 repetitive literatures were deleted by Noteexpress 3.2.0 document management software. According to the inclusion and exclusion criteria of literature, the title and abstract were read for initial screening, and the remaining was downloaded and read for rescreening. Finally, 146 literatures and 153 prescriptions were included.

Categories and frequency of traditional Chinese medicine in the treatment of pre diabetes

Among the 153 prescriptions included, there were 16 categories of drugs involving 131 drugs, which were used 1,337 times in total. The top 3 categories were “Tonifying, Heat-Clearing, Regulating Qi”-flowing drugs according to the literature analysis. The cumulative frequency of use from high to low showed that tonifying drugs ranked first, with 419 times, accounting for 31.3%. It was followed by heat-clearing drugs, which were used 243 times, accounting for 18.2%. The top 5 drugs were(80 times), Fuling () (67 times), Huanglian () (52 times), Shanyao () (51 times) and Gegen (). Details of the top 10 drugs were listed in Table 1.

Table 1 Categories and frequency of traditional Chinese medicine in the treatment of pre diabetes

Table 1 Categories and frequency of traditional Chinese medicine in the treatment of pre diabetes (continued)

The channel tropism, nature and flavour of traditional Chinese medicine in the treatment of pre diabetes

In order to facilitate the analysis, when recording the nature and flavour of drugs, the “cold”, “great cold” and “slight cold” ones should be uniformly recorded as “cold” and the “bitter” and “slight bitter” ones should be classified as “bitter” for statistics. The results showed that the top 3 channel tropism of drugs were spleen (792), stomach (576) and lung (557). The top 3 nature of drugs were cold, warm and calm. The top 3 flavour of drugs were sweet, bitter and pungent, as shown in Figure 1.

Cluster analysis of high frequency traditional Chinese medicine in the treatment of pre diabetes

Drugs with frequency ≥ 20 were selected as high-frequency drugs [13]. The results of drug frequency analysis showed that there were 21 high-frequency drugs, with 795 times in total, accounting for 59.5%. Microsoft Excel 2010 was used to establish a high-frequency drug database for these 21 drugs. Drugs appearing in various literature were counted as “1” and drugs not appearing as “0”. SPSS 22.0 was used for cluster analysis, with the clustering method as intergroup link and distance type as Euclidean distance, as shown in Figure 2. Based on the analysis of clinical practice, it was concluded that the clustering results (Table 2) showed well when the clustering reached four categories.

Figure 1 Frequency of the channel tropism, nature and flavour of traditional Chinese medicine in the treatment of pre diabetes

Figure 2 Cluster analysis of high frequency traditional Chinese medicine (frequency ≥ 20) in the treatment of pre diabetes. Note: the abscissa represents the relative distance.

Association rule analysis of high frequency traditional Chinese medicine in the treatment of pre diabetes

Apriori algorithm by SPSS modeler 14.0 was used to analyze the association rules of the high-frequency drugs with frequency ≥ 20. The minimum support degree was set as 6%, the minimum confidence degree was set as 100%, and the maximum number of the preceding items was 5 to obtain 11 association rules of drugs (Table 3). Among them, the support degree refers to the frequency of the concerted application in all prescriptions, the confidence degree reflects the possibility of the occurrence of the latter item if the former item appears, and the promotion degree > 1 indicates that all combinations are statistically effective[14]. The drug combinations with frequency > 25 is shown in Table 4. The association network diagram constructed by high-frequency drugs is shown in Figure 3, which can intuitively reflect the degree of association between drugs. The thicker the line in the figure is, the higher the degree of association is. Combined with Table 4, it can be seen that-has the highest correlation degree.

Figure 3 Association network diagram of high-frequency traditional Chinese medicine in the treatment of pre diabetes

Table2 Cluster analysis of high frequency traditional Chinese medicine in the treatment of pre diabetes

Table 3 Association rules of high frequency traditional Chinese medicine in the treatment of pre diabetes

Table 3 Association rules of high frequency traditional Chinese medicine in the treatment of pre diabetes(comtinued)

Note: the confidence is 100%.

Table 4 Combinations of drugs with frequency > 25 in the prescription of traditional Chinese medicine in the treatment of pre diabetes

Discussion

(a book on the basic theory of traditional Chinese medicine, written by many medical practitioners in the Warring States period to the Western Han Dynasty) says: “What is the problem if one feels sweet in his mouth and how it causes? This is because the essence of food is overflowing from the mouth. This disease is called Pidan. It is considered that pre diabetes belongs to the category of “Pidan” in traditional Chinese medicine combined with relevant clinical symptoms[15].(a book of traditional Chinese medicine prescriptions written under the auspices of the government by Zhao Jie and others in the Song Dynasty) says: “Food through the spleen’s transportation and transformation, can promote “Yang Qi”. So eating too much greasy, sweet and highly-flavored food which causes “Endogenous Heat” and flatulence will lead to excessive “Yang Qi” in the body, and this excess “Yang” is called “Dan”. It overflows and makes you feel sweet in your mouth. The above process is called “Pidan”. If not treated for a long time, the disease will develop into “Xiaoke” (a syndrome with thirst as the main symptom)”, which records the etiology, pathogenesis, main symptom and deteriorated case of “Pidan”. Combined with the research results, the clinical medication rules for modern treatment of pre diabetes are analyzed as follows.

Analysis of the medication rules

Combined with the statistical results of drug categories, it was found that among the prescriptions for the treatment of pre diabetes, tonifying drugs were used most (31.3%), which contained the most drugs, indicating that the pre diabetes is due to deficiency. Professor Wei Zixiao also believed that pre diabetes was the syndrome of intermingled deficiency and excess, including the vital “Qi” deficiency and the pathogenic “Qi” excess. Vital “Qi” deficiency includes “Spleen Deficiency”, “Qi Deficiency” and “Yin Deficiency”, and pathogenic “Qi” includes “Blood Stasis”, “Phlegm-Turbidity” and “Stomach Heat” [16]. The above data shows thatis most frequently used of all drugs, and as a kind of benefiting qi drug, it can expell pus, relieve pain and strengthen body, used for the treatment of the carbuncle and deep-rooted carbuncle for a long time with chronic ulcer, hemorrhoid and fistula, and also many diseases of children, as(written by Shennong between about 200 and 250 CE.) says. Modern pharmacological studies suggest thatmainly contains astragalus polysaccharide, flavonoids and triterpenes, among which astragalus polysaccharide, as a macromolecular compound, has relatively strong biological activity and may be the main component of lowing blood glucose [17]. Geng Ying observed the intervention effect of point injection withon pre diabetes, and the results showed that it could improve the patients’ blood glucose level [18]. As a characteristic of traditional Chinese medicine, channel tropism is a localization and orientation theory of drugs acting on a “Zang-Fu” viscera, meridian or specific part. In the treatment of pre diabetes, the results showed that the spleen meridian and stomach meridian drugs were used most. At the same time, combined with the nature and flavour analysis, it was found that the drugs nature for the treatment of pre diabetes was mainly sweet, bitter and pungent, and the flavour was mainly cold and warm, which were both used. Therefore, the concerted application of drugs conforms to the characteristics of “Xinkaikujiang” (using pungent and bitter medicine to regulate “Qi” movement) and “Hanrepingtiao” (using cold and warm medicine to mildly regulate cold and heat), which can restore the function of spleen and stomach. As Wu Jutong advocated, the focus of the treatment of “Middle Jiao” disease" is to let “Spleen Qi” ascend and “Stomach Qi” descend. Therefore, the location of pre diabetes is spleen and stomach, which is also made clear in(written by Zhang Xichun in the Qing dynasty). Modern medical practitioners have also made achievements in treating patients with pre diabetes from spleen [19–21]. Therefore, “Dysfunction of Spleen” in transportation because of deficiency is an important link in the pathogenesis of “Pidan”.

Analysis of cluster results

Cluster analysis is a statistical method to study “birds of a feather flock together”, which is classified according to the quantity of drugs and the similarity between them [22]. According to the cluster analysis, 4 clustering prescriptions for the treatment of pre diabetes were obtained. Prescription 1:,., as an important drug for “Invigorating Spleen-Stomach” and “Replenishing Qi”, it is also conducive to the essence transportation from spleen up to lung by promoting an upward movement of “Spleen Qi”., with white inner and sweet flavour, acts on the stomach and lung meridian. It can also promote an upward movement of “Spleen Qi”, and “Benefit Qi” for promoting production of fluid together with. Prescription 2:, with yellow flower, fruit and root, it has cold nature and bitter flavour. The channel tropism of it is “Spleen Meridian”, “Stomach Meridian” and “Large Intestine Meridian”., is good at “Clearing Heat” in the heart and stomach, and it is regarded as an important medicine to “Clear Heat” and “Eliminate Dampness”, which is also the prescription 2’s function. Prescription 3:, Danshen (), Zexie (), Chaihu (), Xuanshen (), Chuanxiong (), Shengdihuang (), Tianhuafen (), Maidong (), Shanzhuyu (), Zhimu (). Among these drugs,,,together withwhich is good at “Clearing Accumulated Heat” in lung and stomach, can relieve thirst caused by “Xiaoke” by “Clearing Heat”, “Promoting Fluid Production” and “Nourishing Yin”. There is also, which is good at “Nourishing Lung and Stomach Yin”, compatible withfor “Nourishing Liver and Kidney Yin”, to strengthen the effect of “Nourishing Yin” and “Clearing Heat”. Prescription 4:, Cangzhu (), Gancao (),, Dangshen (), Chenpi (), Banxia (). It is to add, Baizhu () andon the basis of the Classic ancient prescription Erchen decoction, which is about getting recovery of spleen's function of governing transportation and transformation to transport essence all over the body, especially lung and stomach. Combined with the above analysis of pre diabetes disease location, the spleen, as a “Zang”-viscera in “Middle Jiao”, works better under the action of aromatic and warm-natured drugs which can “Eliminate Dampness”. Food, through “the Receiving by Stomach and the Transportation by Spleen”, can be transformed into essence and then transported to the whole body, meeting its metabolic needs. If the spleen and stomach function is impaired, especially if the spleen can not transport essence, food and essence will stagnate and turn into phlegm-damp, which accumulates for a long time will generate heat and consume “Qi” and “Yin”. This is also the meaning expressed in. Some experts[23]believe that most patients with pre diabetes have phlegm-damp diathesis. So regulating the biased diathesis can not only prevent the occurrence of impaired glucose regulation, but also prevent the further development of impaired sugar regulation into type 2 diabetes. Therefore, it can be considered that the main pathological factor of pre diabetes is phlegm-damp. The treatment should be based on the recovery of the spleen’s function to let “Spleen Qi” ascend and “Stomach Qi” descend normally. The core is to eliminate dampness and phlegm. At the same time, according to the specific situation of patients, “Clearing Heat”, “Benefiting Qi” and “Nourishing Yin” drugs should be used.

Analysis of association results

According to the association rule analysis, the combination of commonly used drugs often mutually promote and enhance [24]. The results of association analysis of drugs in the treatment of pre diabetes showed that, under the condition of 100% confidence, the combination of high-frequency drugs mostly contained the drugs of “Benefiting Qi”, “Nourishing Yin” and “Clearing Heat”, which suggested that these kinds of drugs should be taken seriously in the treatment of pre diabetes. In addition, the most supportive drug combination---, also contains drugs that “Benefit Qi” and “Invigorate Spleen”, and “Eliminate Phlegm-Damp”, which is exactly in line with the above results about the pathogenesis, disease location and pathological factor of pre diabetes. Further analysis of high-frequency drug combinations showed that the combinations ofand other drugs were most common, and the most common combination was-, which was consistent with the prescription1 in the above cluster analysis. In this combination,can helpto “Invigorate Spleen-Stomach” and “Replenish Qi” and promote an upward movement of it. It can be seen that “Benefiting Qi” and “Invigorating Spleen” is an important link in the treatment of pre diabetes.

To sum up, it can be considered that the pathogenesis is mainly the syndrome of “Phlegm-Dampness” due to “Spleen Deficiency”, and “Phlegm-Dampness” is the pathological basis, on which some pathological factors such as “Damp-Heat”, “Qi Stagnation”, “Stasis Blood” and “Intermingled Phlegm” are produced, forming a state of intermingled deficiency and excess [25]. Therefore, the clinical treatment should focus on the recovery of spleen and stomach function, through “Benefiting Qi” and “Invigorating Spleen”, “Eliminating Dampness and Phlegm”, “Nourishing Yin” and “Clearing Heat”, so as to make the essence transportation normally. This is similar to promoting insulin secretion and making it better involved in glucose metabolism to regulate blood glucose [26]. In order to achieve the purpose of “Invigorating Spleen-Stomach”, “Clearing Heat” and “Eliminating Dampness”, we should take tonifying medicine as the basis, using cold and warm nature drugs together, and satisfying the spleen's appetite with bitter and sweet flavour drugs. At the same time, drugs in the prescription should be added and deleted according to different pathogenesis. For example, in order to “Clear Heat” and “Eliminate Dampness”, “Nourish Yin” and “Produce Fluid”, the drugs with bitter cold and sweet cold flavor should be used more. If the course of disease is too long to affect blood vessels and cause blood stasis, the drugs for “Activating Blood and Resolving Stasis” should be properly added to eliminate blood stasis, so that blood vessels are unobstructed. However, “Benefiting Qi” and “Invigorating Spleen” is still the key treatment.

1. Fang Z, Tong XL, Duan JG, et al. Guidelines for evidence-based clinical practice of traditional Chinese medicine in pre diabetes. J Tradit Chin Med 2017, 58: 268–272.

2. Bigna JJ, Nansseu JR, Katte JC, et al. The Prevalence of pre diabetes and diabetes mellitus among adults residing in Cameroon: a systematic review and meta-analysis. Diabetes Res Clin Pract 2018, 137: 109–118.

3. Glauber H, Vollmer W, Nichols GA. A simple model for predicting two-year risk of diabetes development in individuals with pre diabetes. Perm J 2012, 23: 22–50.

4. Weiss R, Santoro N, Giannini C, et al. Pre diabetes in youth-mechanisms and biomarkers. Lancet Child body Health 2017, 1: 240–248.

5. Qian C, Ding LY, Wu F, et al. Research progress of traditional Chinese medicine in improving abnormal glucose regulation. Hebei J Tradit Chin Med 1900, 41: 1900–1904.

6. Yang D, Wu QL, Liang XC. Liang XC’s experience in the treatment of pre diabetes from the perspective of damp-heat. Beijing J Tradit Chin Med 2019, 38: 890–892.

7. Li WR, Peng BH, Li ZQ. Experience in the treatment of pre diabetes from damp-heat due to spleen deficiency. Tradit Chin Med Res 2019, 32: 51–53.

8. Tian H, Pu CL. A case study on the treatment of pre diabetes with Bitter and sour drugs. Cardio Dis Electronic J Integr Tradit Chin West Med 2019, 7: 140.

9. Shao MS, Bi CR, Yao MT, et al. Professor Pu CL’s experience in the treatment of pre diabetes from the syndrome of stagnation of liver “Qi” and spleen deficiency. Cardio Dis Electronic J Integr Tradit Chin West Med 2019, 7: 142–158.

10. Li HR, Ma RF, Wei YL, et al. Chief physician Lu Shaomin’s clinical experience in the treatment of pre diabetes based on the theory of eliminating old-“Qi” and dispersing stagnated liver “Qi” in(the earliest medical classics in China, written by many people in different periods). Asia-Pacific Tradit Med 2012, 14: 120–122.

11. Tong XL, Ni Q, Wei JP, et al. Traditional Chinese medicine diagnosis and treatment standards of pre diabetes. World J Integr Tradit West Med 2011, 6: 446–449.

12. Chinese Diabetes Association, Medical Association. Chinese guidelines for the prevention and treatment of type 2 diabetes (2013 edition). Chin J Diabetes 2014, 22: 2–42.

13. Ma BR.. Beijing: People’s Med Publishing House, 2010.

14. Xiong P.. Beijing: Tsinghua Univ Press, 2011.

15. Tong XL.(2016 edition). Beijing: Science Press, 2016.

16. Shao X. Systematic evaluation and reevaluation of the treatment of pre diabetes with traditional Chinese medicine and an in-depth study of Professor Wei ZX’s experience. China Academy Chin Med Sci, 2015.

17. Wen JJ. Discussion on the therapeutic effect of Huang Qi) on diabetes. Electronic J Clinical Med Literature 2017, 4: 17805–17807.

18. Geng Y. Clinical Study on the intervention of point Injection with Huang Qi () on pre diabetes. Yunnan Univ Tradit Chin Med, 2013.

19. Wang YF, Wang D. Treatment of PIDAN (a heat syndrome of the spleen) from spleen deficiency and fire stagnation. J Tradit Chin Med 2017, 58: 2144–2146.

20. Ma SJ. Discussion on treatment of pre diabetes from spleen. Nei Mongol J Tradit Chin Med 2019, 38: 130–131.

21. Li WR, Peng BH, Li ZQ. Experience in the treatment of pre diabetes from damp-heat due to spleen deficiency. Tradit Chin Med Res 2019, 32: 51–53.

22. Chen YY, Ren L, Xie NL, et al. Study on Zhu WM’s medication rule for lung cancer based on data mining. J Shandong Univ Tradit Chin Med 2019, 43: 456–461.

23. Meng XH, Li LR, Li YS, et al. Analysis of the correlation between pre diabetes and phlegm-damp constitution. Acta Chin Med 2019, 34: 460–463.

24. Yin XY, Zhang DQ, Tang CJ, et al. Study on the medication rules of diabetes based on association rules and complex system entropy clustering. Chin J Experi Tradit Med Formulae 2015, 21: 212–215.

25. Duan CM, Hu YD, Li N. Research progress of Chinese medicine intervention on pre diabetes. Hunan J Tradit Chin Med 2019, 35: 161–163.

26. Ma SJ. Discussion on treatment of pre diabetes from spleen. Nei Mongol J Tradit Chin Med 2019, 38: 130–131.

10.12032/MDM2020123003

#Authors contributed equally to this article.

Xin-Ju Li. Tianjin University of Traditional Chinese Medicine, No.403, Jinqin Park, No.10 Poyang Lake Road, West Area of Tuanbo New Town, Jinghai District, Tianjin 301617, China. Email: mars402498971@126.com.

:

IGR, impaired glucose regulation; IFG, impaired fasting glucose; IGT, impaired glucose tolerance.

:

The authors declare that they have no conflict of interest.

:

Ji-Ya Sun, Qiong-Yang Zhou, Chao Cheng, et al. A study of medication rules of traditional Chinese medicine in the treatment of pre diabetes based on data mining. Medical Data Mining 2020, 3 (4): 166–176.

:Yu-Ping Shi.

:03 October 2020,

01 December 2020,

:30 December 2020