从肝论治方药治疗2型糖尿病有效性和安全性的系统评价
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国家自然科学基金项目(81973980);中国博士后科学基金项目(2018M641285);北京中医药大学青年教师项目(2019-JYB-JS-008)


Systematic Review on the Efficacy and Safety of the Prescription for the Treatment from Liver on Type 2 Diabetic Mellitus
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    目的:系统评价运用从肝论治理念治疗2型糖尿病的方药的有效性和安全性。方法:计算机检索数据库Pubmed、Embase、Cochrane library、Web of Science、万方、CNKI、SinoMed中从肝论治方药治疗T2DM的随机对照试验(RCT)(时限:建库至2020年4月28日)。2名研究者独立对文献进行筛选、提取,偏倚风险评价;运用Rev Man 5.3软件进行统计学分析。结果:共纳入RCT 13个,患者1 275例。Meta分析结果显示:从肝论治方药治疗T2DM在降低糖化血红蛋白(HbA1c)[MD=-0.61,95%CI(-0.95,-0.27),P=0.000 5],空腹血糖(FBG)[MD=-0.90,95%CI=(-1.19,-0.61),P<0.000 01],改善体质量指数(BMI)[MD=-0.80,95%CI=(-1.29,-0.32),P=0.001],中医证候积分[MD=-3.29,95%CI=(-4.36,-2.22),P<0.000 01]等方面均优于对照组;但2组在改善总胆固醇(TC)[MD=-0.22,95%CI=(-0.66,0.22),P=0.33]和三酰甘油(TG)[MD=-0.07,95%CI=(-0.39,0.26),P=0.68]及不良反应方面差异均无统计学意义。结论:当前证据提示从肝论治方药能有效降低HbA1c、FBG,改善BMI和中医证候积分,且安全性较好;然而因纳入研究质量和数量情况,所得结论仍需更多质量高设计严谨的研究验证。

    Abstract:

    To systematically evaluate the efficacy and safety of the prescription for the treatment from liver on type 2 diabetic mellitus(T2DM).Methods:Databases including PubMed,EMbase,the Cochrane Library,Web of Science,WanFang,CNKI and SinoMed Data were searched by computer to collect randomized controlled trials(RCTs)on the prescription for the treatment of T2DM(Time limit:from inception to April 28th 2020).A total of 2 researchers screened,extracted the literature,and assessed the risk of bias.And then the statistical analysis was performed by using software RevMan5.3.Results:A total of 13 RCTs involving 1275 patients were adopted.The Meta-analysis results demonstrated that,compared with control group,the prescription of the treatment from liver on T2DM group was better in reducing glycosylated hemoglobin(HbA1c)(MD=-0.61,95%CI(-0.95,-0.27),P=0.000 5),fasting blood glucose(FBG)(MD=-0.90,95%CI=(-1.19,-0.61),P<0.00001),and improving body mass index(BMI)(MD=-0.80,95%CI=(-1.29,-0.32),P=0.001),and TCM syndrome scores(MD=-3.29,95% CI=(-4.36,-2.22),P<0.00001).However,total cholesterol(TC)(MD=-0.22,95% CI=(-0.66,0.22),P=0.33),triglycerides(TG)(MD=-0.07,95%CI=(-0.39,0.26),P=0.68)and adverse reactions.The differences were not statistically significant.Conclusion:Current evidence suggests that the prescription and drugs from liver treatment could decrease HbA1c and FBG,improve BMI and TCM syndrome scores,with good safety.However,on account of the situation of the included studies(quantity and quality),more high quality studies and rigorous designed research are required to verify the above conclusions.

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胡佳卉,钱会南,杨凤,黄兆涵,白雪芳.从肝论治方药治疗2型糖尿病有效性和安全性的系统评价[J].世界中医药,2020,(18).

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  • 收稿日期:2020-04-30
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  • 在线发布日期: 2020-09-29
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