参苓白术散对2型糖尿病患者血糖及其相关指标影响的系统评价
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国家自然科学基金项目(2021-45-0389);河南省自然科学基金项目(212300410191);河南中医药大学苗圃项目(MP2020-04);河南省中医药传承与创新人才工程(仲景工程)中医药拔尖人才项目(CZ0237-02)


Systematic Evaluation of the Effect of Shenling Baizhu Powder on Blood Glucose and Related Indexes in Patients with Type-2 Diabetes
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    目的:系统评价参苓白术散对2型糖尿病患者血糖及其相关指标的治疗效果,为参苓白术散在2型糖尿病患者中广泛应用及作用机制研究提供依据。方法:计算机检索PubMed、Embase、Sinomed、Cochrane library、Web of Science、国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)等8个常用数据库,检索参苓白术散对2型糖尿病患者干预效果的随机对照试验(RCT),检索时限从建库至2021年4月20日。由两位研究人员根据纳入和排除标准独立进行文献筛选、资料提取、质量评价和风险评估。运用Review Manager 5.3软件进行Meta分析。结果:检索相关文献143篇,最终纳入24篇,共纳入2 131例患者。Meta分析结果显示,参苓白术散能降低患者空腹血糖(FBG)[加权均方差(MD)=-0.75,95%置信区间(CI)=-0.96~-0.53,P<0.01];降低患者餐后2 h血糖(2 h PG)(MD=-0.79,95%CI为-1.22~-0.35,P<0.01);降低患者糖化血红蛋白(HbA1c)(MD=-0.77,95%CI为-0.95~0.60,P<0.01);升高患者空腹胰岛素(FINS)(MD=-4.641,95%CI为-5.601~-3.67,P<0.01);还能显著影响患者的胰岛素抵抗指数(MD=-2.36,95%CI为-2.60~-2.11,P<0.01)、胰高血糖素样肽-1(GLP-1)(MD=5.25,95%CI为4.80~5.70,P<0.01)、抑胃肽(GIP)(MD=16.86,95%CI为14.27~19.45,P<0.01)、体质量(MD=-4.45,95%CI为-6.53~-2.37,P<0.01)和体质量指数(MD=-1.05,95%CI为-1.76~-0.33,P<0.01)。结论:该研究提示参苓白术散有降糖作用,此作用可能与GIP、GLP-1、体质量及升高血清胰岛素等因素有关。

    Abstract:

    To systematically evaluate the therapeutic effect of Shenling Baizhu Powder on blood glucose and related indexes in patients with type-2 diabetes and provide evidence for the extensive application of Shenling Baizhu Powder in patients with type-2 diabetes and its mechanism of action.Methods:Eight commonly used databases,including PubMed,Embase,Sinomed,Cochrane library,Web of Science,China national knowledge infrastructure(CNKI),China science periodical database(CSPD),and Chinese citation database(CCD),were searched by computer.Randomized controlled trials(RCTs) of intervention effects of Shenling Baizhu Powder on patients with type-2 diabetes were retrieved from the establishment of these databases to April 20,2021.Literature screening,data extraction,quality evaluation,and risk assessment were conducted independently by two researchers according to inclusion and exclusion criteria.Meta-analysis was performed by using Review Manager 5.3 software.Results:A total of 143 relevant literature was searched,and 24 of them were included,involving a total of 2 131 patients.Meta-analysis showed that Shenling Baizhu Powder could reduce fasting blood glucose(FBG) in patients [weighted mean difference(MD)=-0.75,95% confidence interval(CI) -0.96 to -0.53,P<0.01] and 2-hour post-meal blood glucose(2 h PG)(MD -0.79,95%CI -1.22 to -0.35,P<0.01).It could also reduce glycosylated hemoglobin of patients(HbA1c)(MD -0.77,95%CI -0.95 to 0.60,P<0.01) and improve fasting insulin(FINS)(MD -4.641,95%CI -5.601 to -3.67,P<0.01).In addition,it significantly affected the insulin resistance index(MD -2.36,95%CI -2.60 to -2.11,P<0.01),glucagon-like peptide-1(GLP-1)(MD 5.25,95%CI 4.80 to 5.70,P<0.01),gastric inhibitory peptide(GIP)(MD 16.86,95%CI 14.27 to 19.45,P<0.01),body weight(MD -4.45,95%CI -6.53 to -2.37,P<0.01),and body mass index(MD -1.05,95%CI -1.76 to -0.33,P<0.01).Conclusion:This study suggests that Shenling Baizhu Powder has a hypoglycemic effect,which may be related to GIP,GLP-1,body weight,and increased serum insulin.

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金小琴,刘晓敏,陈辉,燕树勋.参苓白术散对2型糖尿病患者血糖及其相关指标影响的系统评价[J].世界中医药,2023,(08).

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  • 收稿日期:2021-09-17
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  • 在线发布日期: 2023-05-17
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