文献检索，用中文搜 PubMed

OBJECTIVE

is an herb that has been frequently used in many traditional formulas for the treatment of diabetic mellitus (DM) over thousands of years. Berberine, the main active component of , has been demonstrated to have the potential effect of hypoglycemia. To determine the potential advantages of berberine for diabetic care, we conducted this systematic review and meta-analysis to examine the efficacy and safety of berberine in the treatment of patients with type 2 DM.

METHODS

Eight databases including PubMed, Embase, Web of Science, the Cochrane library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (SinoMed), Wanfang Database, and Chinese VIP Information was searched for randomized controlled trials (RCTs) reporting clinical data regarding the use of berberine for the treatment of DM. Publication qualities were also considered to augment the credibility of the evidence. Glycemic metabolisms were the main factors studied, including glycosylated hemoglobin (HbA1c), fasting plasm glucose (FPG), and 2-hour postprandial blood glucose (2hPG). Insulin resistance was estimated by fasting blood insulin (FINS), homeostasis model assessment-insulin resistance (HOMA-IR), and body mass index (BMI). Lipid profiles were also assessed, including triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), along with inflammation factors such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor- (TNF-). Serum creatinine (Scr), blood urea nitrogen (BUN), and adverse events were applied to evaluate the safety of berberine.

RESULTS

Forty-six trials were assessed. Analysis of berberine applied alone or with standard diabetic therapies versus the control group revealed significant reductions in HbA1c (MD = -0.73; 95% CI (-0.97, -0.51)), FPG (MD = -0.86, 95% CI (-1.10, -0.62)), and 2hPG (MD = -1.26, 95% CI (-1.64, -0.89)). Improved insulin resistance was assessed by lowering FINS (MD = -2.05, 95% CI (-2.62, -1.48)), HOMA-IR (MD = -0.71, 95% CI (-1.03, -0.39)), and BMI (MD = -1.07, 95% CI (-1.76, -0.37)). Lipid metabolisms were also ameliorated via the reduction of TG (MD = -0.5, 95% CI (-0.61, -0.39)), TC (MD = 0.64, 95% CI (-0.78, -0.49)), and LDL (MD = 0.86, 95% CI (-1.06, -0.65)) and the upregulation of HDL (MD = 0.17, 95% CI (0.09, 0.25)). Additionally, berberine improved the inflammation factor.

CONCLUSION

There is strong evidence supporting the clinical efficacy and safety of berberine in the treatment of DM, especially as an adjunctive therapy. In the future, this may be used to guide targeted clinical use of berberine and the development of medications seeking to treat patients with T2DM and dyslipidemia.

OBJECTIVE

METHODS

RESULTS

CONCLUSION

目的

黄连是一种草药，几千年来，它一直被广泛应用于许多传统方剂中，用于治疗糖尿病（DM）。黄连的主要活性成分小檗碱已被证明具有降血糖的潜力。为了确定小檗碱在糖尿病治疗方面的潜在优势，我们进行了这项系统评价和荟萃分析，以检查小檗碱治疗 2 型糖尿病患者的疗效和安全性。

方法

我们检索了包括 PubMed、Embase、Web of Science、Cochrane 图书馆、中国知网（CNKI）、中国生物医学数据库（SinoMed）、万方数据库和中国维普信息在内的 8 个数据库，以获取有关小檗碱治疗 DM 的临床数据的随机对照试验（RCT）。我们还考虑了出版物质量，以提高证据的可信度。血糖代谢是主要研究因素，包括糖化血红蛋白（HbA1c）、空腹血浆葡萄糖（FPG）和餐后 2 小时血糖（2hPG）。空腹胰岛素（FINS）、稳态模型评估-胰岛素抵抗（HOMA-IR）和体重指数（BMI）用于评估胰岛素抵抗。血脂谱也进行了评估，包括甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）和高密度脂蛋白（HDL），以及 C 反应蛋白（CRP）、白细胞介素-6（IL-6）和肿瘤坏死因子-（TNF-）等炎症因子。血清肌酐（Scr）、血尿素氮（BUN）和不良事件用于评估小檗碱的安全性。

结果

评估了 46 项试验。分析小檗碱单独或与标准糖尿病治疗联合应用与对照组相比，HbA1c（MD=-0.73；95%CI[-0.97，-0.51]）、FPG（MD=-0.86，95%CI[-1.10，-0.62]）和 2hPG（MD=-1.26，95%CI[-1.64，-0.89]）显著降低。通过降低 FINS（MD=-2.05，95%CI[-2.62，-1.48]）、HOMA-IR（MD=-0.71，95%CI[-1.03，-0.39]）和 BMI（MD=-1.07，95%CI[-1.76，-0.37]）来改善胰岛素抵抗。血脂代谢也通过降低 TG（MD=-0.5，95%CI[-0.61，-0.39]）、TC（MD=0.64，95%CI[-0.78，-0.49]）和 LDL（MD=0.86，95%CI[-1.06，-0.65]）和升高 HDL（MD=0.17，95%CI[0.09，0.25]）得到改善。此外，小檗碱还改善了炎症因子。