Ooi Cheow Peng, Yassin Zaitun, Hamid Tengku-Aizan
Institute of Gerontology, University Putra Malaysia, 3rd floor, Faculty of Medicine and Health Sciences, Serdang, Selangor Darul Ehsan, Malaysia, 43400.
Cochrane Database Syst Rev. 2010 Feb 17(2):CD007845. doi: 10.1002/14651858.CD007845.pub2.
Momordica charantia is not only a nutritious vegetable, but is also used in traditional medical practices to treat type 2 diabetes mellitus. Experimental studies with animals and humans suggested that the vegetable has a possible role in glycaemic control.
To assess the effects of mormodica charantia for type 2 diabetes mellitus.
Several electronic databases were searched, among these The Cochrane Library (issue 4, 2009), MEDLINE, EMBASE, CINAHL, SIGLE and LILACS (all up to November 2009), combined with handsearches. No language restriction was used.
Randomized controlled trials that compared momordica charantia with a placebo or a control intervention with or without pharmacological or non-pharmacological interventions were included.
Two authors independently extracted the data. Risk of bias of trials was evaluated using the parameters of randomization, allocation concealment, blinding, completeness of outcome data, selective reporting and other potential sources of bias. A meta-analysis was not performed given the quality of data and the variability of preparations of momordica charantia used in interventions (no similar preparation was tested twice).
Three randomised controlled trials with up to three months duration and investigating 350 participants met the inclusion criteria. Risk of bias of these trials (only one study was published as a full peer-reviewed publication) was generally high. Two RCTs compared the effect of preparations from different parts of the momordica charantia plants and placebo on the glycemic control in type 2 diabetes mellitus. There was no statistically significant difference compared to placebo. The effects of preparation from the leaves of the plant and glibenclamide were comparable in the third trial. No serious adverse effects were reported in all the trials. There were no documentations of death from any cause, morbidity, (health-related) quality of life and costs.
AUTHORS' CONCLUSIONS: There is insufficient evidence to recommend momordica charantia for type 2 diabetes mellitus. Further studies are therefore required to address the issues of standardization and the quality control of preparations. For medical nutritional therapy, further observational trials evaluating the effects of momordica charantia are needed before RCTs are established to guide any recommendations in clinical practice.
苦瓜不仅是一种营养丰富的蔬菜,还被用于传统医学实践中治疗2型糖尿病。对动物和人类的实验研究表明,这种蔬菜在血糖控制方面可能发挥作用。
评估苦瓜对2型糖尿病的影响。
检索了多个电子数据库,其中包括考克兰图书馆(2009年第4期)、医学索引数据库、荷兰医学文摘数据库、护理学与健康领域数据库、灰色文献数据库和拉丁美洲及加勒比地区健康科学数据库(均截至2009年11月),并结合手工检索。未设语言限制。
纳入比较苦瓜与安慰剂或对照干预措施(有无药理学或非药理学干预)的随机对照试验。
两位作者独立提取数据。使用随机化、分配隐藏、盲法、结局数据完整性、选择性报告以及其他潜在偏倚来源等参数评估试验的偏倚风险。鉴于数据质量以及干预措施中使用的苦瓜制剂的变异性(没有类似制剂进行过两次测试),未进行荟萃分析。
三项持续时间长达三个月、涉及350名参与者的随机对照试验符合纳入标准。这些试验的偏倚风险(只有一项研究作为完整的同行评审出版物发表)普遍较高。两项随机对照试验比较了苦瓜植株不同部位的制剂与安慰剂对2型糖尿病血糖控制的效果。与安慰剂相比,差异无统计学意义。在第三项试验中,该植物叶子的制剂与格列本脲的效果相当。所有试验均未报告严重不良反应。没有任何原因导致的死亡、发病率、(与健康相关的)生活质量和成本的记录。
没有足够的证据推荐使用苦瓜治疗2型糖尿病。因此,需要进一步研究解决制剂标准化和质量控制问题。对于医学营养治疗,在开展随机对照试验以指导临床实践中的任何建议之前,需要进一步进行观察性试验来评估苦瓜的效果。