■本研究旨在系统评估葛根芩连汤治疗2型糖尿病的疗效和安全性。
■从创建之时到2023年3月20日,我们系统地搜索了总共9个数据库。使用Cochrane手册中的偏倚风险评估工具评估文献质量。RevMan5.3和Stata14.0进行荟萃分析。
■总共17项研究,包括1476名患者,包括在研究中。葛根芩连汤联合常规治疗可显著降低FBG(MD=-0.69mmol/L,95%CI-0.84至-0.55,p<0.01;I2=67%,p<0.01),2hPG(MD=-0.97mmol/L,95%CI-1.13至-0.81,p<0.01;I2=37%,p=0.09),HbA1c(MD=-0.65%,95%CI-0.78至-0.53,p<0.01;I2=71%,p<0.01),TC(MD=-0.51mmol/L,95%CI-0.62至-0.41,p<0.01;I2=45%,p=0.09),TG(MD=-0.17mmol/L,95%CI-0.29至-0.05,p<0.01;I2=78%,p<0.01),LDL-C(MD=-0.38mmol/L,95%CI-0.53至-0.23,p<0.01;I2=87%,p<0.01),HOMA-IR(SMD=-1.43,95%CI-2.32至-0.54,p<0.01;I2=94%,p<0.01),和改善HDL-C(MD=0.13mmol/L,95%CI0.09-0.17,p<0.01;I2=30%,p=0.24)。只有三项研究探讨了GQD单独治疗与常规治疗在改善糖脂代谢和胰岛素抵抗方面的疗效差异。和一些结果指标,例如2hPG和HDL-C,仅在一项研究中进行了检查。因此,GQD单独对糖脂代谢和胰岛素抵抗的影响不能完全确定,需要更多高质量的研究来验证。发表偏倚分析显示在纳入的研究中没有偏倚。
■葛根芩连汤在增强糖脂代谢和减轻胰岛素抵抗方面具有一定的疗效和安全性,可能作为2型糖尿病的补充治疗。严谨,大样本,需要多中心RCT来验证这一点。
■https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42023413758,PROSPEROCRD42023413758。
The study aims to systematically assess the efficacy and safety of Gegen Qinlian decoction in the treatment of type 2 diabetes mellitus.
We systematically searched a total of nine databases from the time of creation to 20 March 2023. The quality of the literature was assessed using the risk of bias assessment tool in the Cochrane Handbook. RevMan 5. 3 and Stata 14.0 were applied to conduct meta-analysis.
A total of 17 studies, encompassing 1,476 patients, were included in the study. Gegen Qinlian decoction combined with conventional treatment was found to significantly reduce FBG (MD = -0.69 mmol/L, 95% CI -0.84 to -0.55, p < 0.01; I2 = 67%, p<0.01), 2hPG (MD = -0.97 mmol/L, 95% CI -1.13 to -0.81, p < 0.01; I2 = 37%, p=0.09), HbA1c (MD = -0.65%, 95% CI -0.78 to -0.53, p < 0.01; I2 = 71%, p<0.01), TC (MD = -0.51 mmol/L, 95% CI -0.62 to -0.41, p < 0.01; I2 = 45%, p=0.09), TG (MD = -0.17mmol/L, 95% CI -0.29 to -0.05, p < 0.01; I2 = 78%, p<0.01), LDL-C (MD = -0.38mmol/L, 95% CI -0.53 to -0.23, p < 0.01; I2 = 87%, p<0.01), HOMA-IR (SMD = -1.43, 95% CI -2.32 to -0.54, p < 0.01; I2 = 94%, p<0.01), and improved HDL-C (MD = 0.13 mmol/L, 95% CI 0.09-0.17, p < 0.01; I2 = 30%, p=0.24). Only three studies explored the differences in efficacy between GQD alone and conventional treatment in improving glucose-lipid metabolism and insulin resistance, and some of the outcome indicators, such as 2hPG and HDL-C, were examined in only one study. Therefore, the effect of GQD alone on glucose-lipid metabolism and insulin resistance cannot be fully determined, and more high-quality studies are needed to verify it. Publication bias analysis revealed no bias in the included studies.
Gegen Qinlian Decoction has certain efficacy and safety in enhancing glycolipid metabolism and alleviating insulin resistance, potentially serving as a complementary therapy for type 2 diabetes mellitus. Rigorous, large-sample, multicenter RCTs are needed to verify this.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023413758, PROSPERO CRD42023413758.