Ooi Cheow Peng, Yassin Zaitun, Hamid Tengku-Aizan
Endocrine Unit, Department of Medicine, Universiti Putra Malaysia, Serdang, Malaysia.
Cochrane Database Syst Rev. 2012 Aug 15;2012(8):CD007845. doi: 10.1002/14651858.CD007845.pub3.
Momordica charantia (bitter gourd) is not only a nutritious vegetable but it 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 were The Cochrane Library (Issue 1, 2012), MEDLINE, EMBASE, CINAHL, SIGLE and LILACS (all up to February 2012), combined with handsearches. No language restriction was used.
We included randomised controlled trials (RCTs) that compared momordica charantia with placebo or a control intervention, with or without pharmacological or non-pharmacological interventions.
Two authors independently extracted data. Risk of bias of the trials was evaluated using the parameters of randomisation, 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 the interventions (no similar preparation was tested twice).
Four randomised controlled trials with up to three months duration and investigating 479 participants met the inclusion criteria. Risk of bias of these trials (only two studies were published as a full peer-reviewed publication) was generally high. Two RCTs compared the effects of preparations from different parts of the momordica charantia plant with placebo on glycaemic control in type 2 diabetes mellitus. There was no statistically significant difference in the glycaemic control with momordica charantia preparations compared to placebo. When momordica charantia was compared to metformin or glibenclamide, there was also no significant change in reliable parameters of glycaemic control. No serious adverse effects were reported in any trial. No trial investigated death from any cause, morbidity, health-related quality of life or costs.
AUTHORS' CONCLUSIONS: There is insufficient evidence on the effects of 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，还被用于传统医学治疗2型糖尿病。针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，包括《考克兰图书馆》（2012年第1期）、MEDLINE、EMBASE、CINAHL、SIGLE和LILACS（截至2012年2月），并结合手工检索。未设语言限制。
我们纳入了将苦瓜与安慰剂或对照干预措施进行比较的随机对照试验（RCT），无论是否有药理学或非药理学干预。
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（没有相似制剂进行过两次测试），未进行荟萃分析。
四项持续时间长达三个月、涉及479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（只有两项研究作为完整的同行评审出版物发表）总体较高。两项RCT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影响。与安慰剂相比，苦瓜制剂在血糖控制方面无统计学显著差异。当将苦瓜与二甲双胍或格列本脲进行比较时，血糖控制的可靠参数也没有显著变化。任何试验均未报告严重不良反应。没有试验调查任何原因导致的死亡、发病率、健康相关生活质量或成本。
关于苦瓜对2型糖尿病的影响，证据不足。因此，需要进一步研究来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RCT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。
