Liao Yu-Ning, Chen Hsing-Yu, Yang Ching-Wei, Lee Pai-Wei, Hsu Chiu-Yi, Huang Yu-Tung, Yang Tsung-Hsien
Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Front Pharmacol. 2022 Sep 9;13:978814. doi: 10.3389/fphar.2022.978814. eCollection 2022.
In Taiwan, many people receive Chinese herbal medicine (CHM) as an alternative choice to help control body weight. However, the clinical effectiveness of CHM on weight control has not been well studied, while potential risks and adverse effects are still unknown. The aim of our study is to find out a safe and efficient treatment model of CHM for weight control compared to liraglutide in a real-world setting. we retrospectively analyzed obese subjects [body mass index (BMI)≧25 kg/m] from Chang Gung Research Database (2013-2018). We evaluated the effect on body weight and BMI changes in obese groups receiving CHM or western medicine (WM, represented liraglutide) within 180 days. The proportion of subjects who achieved 5 and 10% weight reduction was calculated as well. Furthermore, the potential adverse events were analyzed during the study period. Overlap weighting was used to balance the baseline differences between CHM and WM groups. The full cohort comprised 1,360 participants: 701 in the CHM group and 659 in the WM group. At baseline, the CHM group was younger (42.75 ± 12.12 years old in CHM vs. 52.31 ± 11.7 years old in WM, -value <0.001) and has more female subjects (77.6% in CHM vs. 53.0% in WM, -value <0.001). On the other hand, CHM users had lower body weight (79.83 ± 15.66 kg vs. 84.68 ± 17.14 kg, -value <0.001) and BMI (30.58 ± 5.20 vs. 32.84 ± 6.95, -value <0.001). At day 180, CHM users lost more body weight (-4.5 ± 4.07 kg vs. -2.15 ± 4.05 kg, -value <0.001) and higher reduction in BMI (-1.77 ± 1.73 vs. -0.9 ± 2.14, -value <0.001). A total of 53.21% (n = 373) CHM users lost at least 5% of body weight (22.46% for WM users, -value <0.001), and 18.97% (n = 132) lost at least 10% of body weight (4.55% for WM users, -value <0.001). The benefit remained consistent with and without overlap weighting. For adverse events, 18 cases of hypertension occurred in 659 subjects in the WM group (2.7%) in comparison to 1 of 701 subjects in the CHM group (0.1%). CHM led to clinically meaningful weight loss without serious adverse events in a real-world setting. Further clinical trials are warranted to validate this result.
在台湾，许多人选择服用中药作为控制体重的替代方法。然而，中药控制体重的临床疗效尚未得到充分研究，其潜在风险和副作用也尚不明确。我们研究的目的是在现实环境中，找出一种相较于利拉鲁肽而言，安全有效的中药控制体重治疗模式。我们回顾性分析了长庚研究数据库（2013 - 2018年）中的肥胖受试者[体重指数（BMI）≧25 kg/m²]。我们评估了在180天内接受中药或西药（西药，以利拉鲁肽为代表）治疗的肥胖组受试者体重和BMI的变化情况。同时计算了体重减轻5%和10%的受试者比例。此外，还分析了研究期间的潜在不良事件。采用重叠加权法来平衡中药组和西药组之间的基线差异。整个队列共有1360名参与者：中药组701人，西药组659人。在基线时，中药组受试者更年轻（中药组平均年龄42.75 ± 12.12岁，西药组平均年龄52.31 ± 11.7岁，P值<0.001）且女性受试者更多（中药组77.6%，西药组53.0%，P值<0.001）。另一方面，服用中药的受试者体重较低（79.83 ± 15.66 kg vs. 84.68 ± 17.14 kg，P值<0.001），BMI也较低（30.58 ± 5.20 vs. 32.84 ± 6.95，P值<0.001）。在第180天时，服用中药的受试者体重减轻更多（-4.5 ± 4.07 kg vs. -2.15 ± 4.05 kg，P值<0.001），BMI下降幅度更大（-1.77 ± 1.73 vs. -0.9 ± 2.14，P值<0.001）。共有53.21%（n = 373）的中药使用者体重至少减轻了5%（西药使用者为22.46%，P值<0.001），18.97%（n = 132）的使用者体重至少减轻了10%（西药使用者为4.55%，P值<0.001）。无论是否采用重叠加权法，结果均保持一致。关于不良事件，西药组659名受试者中有18例发生高血压（2.7%），而中药组701名受试者中仅有1例（0.1%）。在现实环境中，中药能带来具有临床意义的体重减轻，且无严重不良事件。有必要进行进一步的临床试验来验证这一结果。
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