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中药方剂JTTZ治疗2型糖尿病伴肥胖和高脂血症的疗效与安全性:一项多中心随机、阳性对照、开放标签临床试验

The Efficacy and Safety of the Chinese Herbal Formula, JTTZ, for the Treatment of Type 2 Diabetes with Obesity and Hyperlipidemia: A Multicenter Randomized, Positive-Controlled, Open-Label Clinical Trial.

作者信息

Yu Xiaotong, Xu Lipeng, Zhou Qiang, Wu Shengping, Tian Jiaxing, Piao Chunli, Guo Hailong, Zhang Jun, Li Liping, Wu Shentao, Guo Meizhen, Hong Yuzhi, Pu Weirong, Zhao Xiyan, Liu Yang, Pang Bing, Peng Zhiping, Wang Song, Lian Fengmei, Tong Xiaolin

机构信息

Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China.

Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.

出版信息

Int J Endocrinol. 2018 Apr 1;2018:9519231. doi: 10.1155/2018/9519231. eCollection 2018.

Abstract

BACKGROUND AND AIM

Studies have shown an increasing number of type 2 diabetes (T2D) patients with concomitant obesity and hyperlipidemia syndromes, resulting from relevant metabolic disorders. However, there are few medications and therapies, which can thoroughly address these issues. Therefore, the current study evaluated the efficacy and safety of using JTTZ, a Chinese herbal formula, to treat T2D with obesity and hyperlipidemia.

METHODS

A total of 450 participants with T2D (HbA1c ≥ 7.0%; waist circumference ≥ 90 cm and 80 cm in males and females, resp.; and triglycerides (TG) ≥ 1.7 mmol/L) were randomly assigned, in equal proportions, to two groups in this multicenter randomized, positive-controlled, open-label trial. One group received JTTZ formula, and the other received metformin (MET) for 12 consecutive weeks. The primary efficacy outcomes were changes in HbA1c, TG, weight, and waist circumference. Adverse reactions and hypoglycemia were monitored.

RESULTS

HbA1c decreased by 0.75 ± 1.32% and 0.71 ± 1.2% in the JTTZ and MET groups, respectively, after 12 weeks of treatment. TG levels in the JTTZ and MET groups were reduced by 0.64 ± 2.37 mmol/L and 0.37 ± 2.18 mmol/L, respectively. Weight was decreased by 2.47 ± 2.71 kg in the JTTZ group and by 2.03 ± 2.36 kg in the MET group. JTTZ also appeared to alleviate insulin resistance and increase HOMA-. In addition, symptoms were significantly relieved in participants in the JTTZ group compared to those in the MET group. One case of hypoglycemia was reported in the MET group. No severe adverse events were reported in either group.

CONCLUSIONS

The JTTZ formula led to safe and significant improvements in the blood glucose, blood lipids, and weight levels; relieved symptoms; and enhanced cell function for T2D patients with obesity and hyperlipidemia. The JTTZ formula has shown that it could potentially be developed as an alternative medicine for patients with T2D, particularly those who cannot tolerate metformin or other hypoglycemic drugs. This trial was registered with Clinicaltrials.gov NCT01471275.

摘要

背景与目的

研究表明,2型糖尿病(T2D)患者合并肥胖和高脂血症综合征的人数不断增加,这是由相关代谢紊乱引起的。然而,能够彻底解决这些问题的药物和疗法却很少。因此,本研究评估了中药方剂JTTZ治疗伴有肥胖和高脂血症的T2D的疗效和安全性。

方法

在这项多中心随机、阳性对照、开放标签试验中,共有450名T2D患者(糖化血红蛋白[HbA1c]≥7.0%;男性腰围≥90 cm,女性腰围≥80 cm;甘油三酯[TG]≥1.7 mmol/L)被等比例随机分为两组。一组接受JTTZ方剂治疗,另一组连续12周接受二甲双胍(MET)治疗。主要疗效指标为HbA1c、TG、体重和腰围的变化。监测不良反应和低血糖情况。

结果

治疗12周后,JTTZ组和MET组的HbA1c分别下降了0.75±1.32%和0.71±1.2%。JTTZ组和MET组的TG水平分别降低了0.64±2.37 mmol/L和0.37±2.18 mmol/L。JTTZ组体重下降了2.47±2.71 kg,MET组体重下降了2.03±2.36 kg。JTTZ似乎还能减轻胰岛素抵抗并增加胰岛素抵抗指数(HOMA-)。此外与MET组相比,JTTZ组患者的症状得到了显著缓解。MET组报告了1例低血糖病例。两组均未报告严重不良事件。

结论

JTTZ方剂使伴有肥胖和高脂血症的T2D患者的血糖、血脂和体重水平得到了安全且显著的改善;缓解了症状;并增强了细胞功能。JTTZ方剂已表明它有可能被开发成为T2D患者,特别是那些不能耐受二甲双胍或其他降糖药物患者的替代药物。本试验已在Clinicaltrials.gov上注册,注册号为NCT01471275。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c9b/5902070/ee1803a4e0e5/IJE2018-9519231.001.jpg

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