Hu Zhipeng, Yang Maoyi, Liu Ya, Yang Qiyue, Xie Hongyan, Peng Sihan, Gao Juan, Xie Chunguang
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Pharmacol. 2021 Apr 29;12:648861. doi: 10.3389/fphar.2021.648861. eCollection 2021.
Type 2 diabetes mellitus (T2DM) is a heterogeneous disease characterized by persistent hyperglycemia. Huang-Lian Jie-Du decoction (HLJDD) is a traditional Chinese medicine formula which is widely used in treating T2DM in China. A thorough understanding of current body of evidence is needed. this study aims to summarize the clinical evidence of HLJDD for T2DM to provide an up-to-date and accurate understanding of this issue for research and clinical practice. Six databases were searched from inception to June 27, 2020 without language and publication status restrictions and randomized controlled trials about HLJDD on T2DM were included. Two evaluators searched and screened citations independently. Risk of bias was assessed by 2019 version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB2). Risk ratio (RR) with 95% confidence interval (CI) was used as an effect measure for dichotomous outcomes and mean difference (MD) with 95% CI was used for continuous outcomes. Subgroup analyses and sensitivity analyses were carried out. Nine studies including 811 participants were included in this study. The overall risk of bias was high risk. Compared with metformin alone, combination treatment of HLJDD and metformin may result in a reduction in HbA1c, FBG, 2hPG, HOMA-IR and an improved lipid metabolism. Evidence comparing HLJDD and metformin or no intervention or placebo was insufficient. The quality of evidence was low. Current evidence about HLJDD on T2DM is still uncertain and more high-quality studies are needed to firmly establish the clinical efficacy and safety of HLJJD.
2型糖尿病（T2DM）是一种以持续性高血糖为特征的异质性疾病。黄连解毒汤（HLJDD）是一种中药方剂，在中国广泛用于治疗T2DM。需要全面了解当前的证据。本研究旨在总结HLJDD治疗T2DM的临床证据，以便为研究和临床实践提供关于该问题的最新和准确认识。检索了6个数据库，时间范围从建库至2020年6月27日，无语言和发表状态限制，纳入了关于HLJDD治疗T2DM的随机对照试验。两名评估者独立检索和筛选文献。采用Cochrane随机试验偏倚风险工具（RoB2）2019年第2版评估偏倚风险。二分类结局的效应量采用风险比（RR）及95%置信区间（CI），连续性结局采用均数差（MD）及95%CI。进行了亚组分析和敏感性分析。本研究纳入了9项研究，共811名参与者。总体偏倚风险为高风险。与单用二甲双胍相比，HLJDD与二甲双胍联合治疗可能导致糖化血红蛋白（HbA1c）、空腹血糖（FBG）、餐后2小时血糖（2hPG）、胰岛素抵抗指数（HOMA-IR）降低以及脂质代谢改善。比较HLJDD与二甲双胍或不干预或安慰剂的证据不足。证据质量较低。目前关于HLJDD治疗T2DM的证据仍然不确定，需要更多高质量的研究来确定HLJDD的临床疗效和安全性。
