Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand.
J Ethnopharmacol. 2011 Oct 11;137(3):1328-33. doi: 10.1016/j.jep.2011.07.059. Epub 2011 Aug 5.
A variety of herbs has been used in traditional medicine for the treatment of diabetes. However, evidence is limited regarding the efficacy of individual herbs for glycemic control. We performed a systematic review and meta-analysis to evaluate the effect of herbal supplement on glycemic control in type 2 diabetes.
Randomized controlled trials were identified through electronic searches (MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials) up until February 2011, historical searches of relevant articles and personal contact with experts in the area. Studies were included in the meta-analysis if they were (1) randomized placebo-controlled trial of single herb aimed at assessing glycemic control in type 2 diabetes, (2) of at least 8 weeks duration, and (3) reporting HbA(1c). Treatment effect was estimated with mean difference in the final value of HbA(1c) and FBG between the treatment and the placebo groups.
Nine randomized, placebo-controlled trials (n = 487 patients) were identified. Ipomoea batatas, Silybum marianum and Trigonella foenum-graecum significantly improved glycemic control, whereas Cinnamomum cassia did not. The pooled mean differences in HbA(1c) were -0.30% (95% CI -0.04% to -0.57%; P = 0.02), -1.92% (95% CI -0.51% to -3.32%; P = 0.008), and -1.13% (95% CI -0.11% to -2.14%; P = 0.03), respectively, for Ipomoea batatas, Silybum marianum, and Trigonella foenum-graecum. The corresponding values for FBG were -10.20mg/dL (95% CI -5.32 mg/dL to -15.08 mg/dL; P<0.0001) and -38.05 mg/dL (95% CI -9.54 mg/dL to -66.57 mg/dL; P = 0.009), respectively, for Ipomoea batatas and Silybum marianum.
The current evidence suggests that supplementation with Ipomoea batatas, Silybum marianum, and Trigonella foenum-graecum may improve glycemic control in type 2 diabetes. Such effect was not observed with Cinnamomum cassia. Given the limitations of the available studies and high heterogeneity of the study results for milk thistle and fenugreek, further high quality, large controlled trials using standardized preparation are warranted to better elucidate the effects of these herbs on glycemic control in type 2 diabetes patients.
许多草药已被用于传统医学中以治疗糖尿病。然而，关于单一草药在血糖控制方面的疗效证据有限。我们进行了系统评价和荟萃分析，以评估草药补充剂对 2 型糖尿病患者血糖控制的影响。
通过电子搜索（MEDLINE、EMBASE 和 Cochrane 对照试验中心注册），直至 2011 年 2 月，以及对相关文章的历史搜索和与该领域专家的个人联系，确定了随机对照试验。如果研究符合以下标准，则纳入荟萃分析：（1）针对 2 型糖尿病患者血糖控制的单一草药的随机安慰剂对照试验，（2）至少 8 周的疗程，以及（3）报告糖化血红蛋白（HbA1c）。治疗效果通过治疗组和安慰剂组在 HbA1c 和 FBG 最终值之间的平均差异来估计。
确定了 9 项随机、安慰剂对照试验（n = 487 名患者）。Ipomoea batatas、Silybum marianum 和 Trigonella foenum-graecum 显著改善了血糖控制，而 Cinnamomum cassia 则没有。Ipomoea batatas、Silybum marianum 和 Trigonella foenum-graecum 的 HbA1c 平均差值分别为-0.30%（95%CI -0.04%至-0.57%；P = 0.02）、-1.92%（95%CI -0.51%至-3.32%；P = 0.008）和-1.13%（95%CI -0.11%至-2.14%；P = 0.03），相应的 FBG 值分别为-10.20mg/dL（95%CI -5.32mg/dL 至-15.08mg/dL；P<0.0001）和-38.05mg/dL（95%CI -9.54mg/dL 至-66.57mg/dL；P = 0.009）。
目前的证据表明，Ipomoea batatas、Silybum marianum 和 Trigonella foenum-graecum 的补充可能改善 2 型糖尿病患者的血糖控制。Cinnamomum cassia 则没有这种效果。鉴于现有研究的局限性以及乳蓟和胡芦巴的研究结果存在高度异质性，需要进一步进行高质量、大样本的对照试验，使用标准化制剂，以更好地阐明这些草药对 2 型糖尿病患者血糖控制的影响。
