Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; PhytoPharmacology Interest Group (PPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Clin Nutr. 2020 Feb;39(2):331-342. doi: 10.1016/j.clnu.2019.02.006. Epub 2019 Feb 10.
BACKGROUND & AIMS: Type 2 diabetes mellitus (T2DM) is a metabolic disorder affecting a growing number of patients all over the world. T2DM complications are positively associated with HbA1c which is a long-term glycemic marker. Medicinal plants and their isolated phytochemicals have been extensively used as dietary supplements for the management of chronic disorders including T2DM. Current paper aims to review clinical trials evaluated the effect of phytochemicals for long-term management of T2DM considering the HbA1c level.
Electronic databases including PubMed, Scopus and Cochrane were searched using the keywords "phytochemical", "extract", "herb", or "plant" and "HbA1c" or "glycosylated hemoglobin" in the title/abstract from the date of inception until May 2017. English and Persian language papers were included. References of the retrieved papers were also screened for relevant studies.
Of 2435 studies, 39 relevant clinical trials were finally included in which phytochemicals including berberine, curcumin, catechin, silymarin, resveratrol, pycnogenol, isoflavones, lignans, isohumulone, saponins, corn bran hemicellulose and pinitol were examined. Berberine and silymarin had the strongest evidence regarding their effectiveness in long-term management of HbA1c; however, lack of enough toxicological studies suggests to stay on the safe side for the administration of these agents in diabetic patients.
Current data regarding the efficacy of other phytochemicals are still controversial due to small follow-up period, methodological problems and small sample size. Future well-designed clinical trials are necessary to confirm the safety and efficacy of phytochemicals for long-term glycemic control of diabetic patients.
2 型糖尿病（T2DM）是一种代谢紊乱疾病，影响着全世界越来越多的患者。T2DM 并发症与 HbA1c 呈正相关，后者是一种长期血糖标志物。药用植物及其分离的植物化学物质已被广泛用作包括 T2DM 在内的慢性疾病管理的膳食补充剂。本研究旨在综述评估植物化学物质对 T2DM 长期管理作用的临床试验，同时考虑 HbA1c 水平。
通过关键词“phytochemical”、“extract”、“herb”或“plant”和“HbA1c”或“glycosylated hemoglobin”，检索从建库到 2017 年 5 月期间在 PubMed、Scopus 和 Cochrane 电子数据库中发表的英文和波斯文文献，纳入评估植物化学物质长期管理 T2DM 作用的临床试验。
共检索到 2435 篇文献，最终纳入 39 项相关临床试验，其中研究的植物化学物质包括小檗碱、姜黄素、儿茶素、水飞蓟素、白藜芦醇、碧萝芷、异黄酮、木脂素、异葎草酮、皂苷、玉米麸皮半纤维素和肌醇。关于长期管理 HbA1c 的有效性，小檗碱和水飞蓟素的证据最充分；然而，由于缺乏足够的毒理学研究，建议在糖尿病患者中使用这些药物时仍需谨慎。
由于随访时间短、方法学问题和样本量小，目前关于其他植物化学物质疗效的数据仍存在争议。需要进行未来设计良好的临床试验来确认植物化学物质在长期控制糖尿病患者血糖方面的安全性和有效性。
