Li Jie, Zheng Ruqun, Lin Zixin, Hu Fangyuan, Lin Ying, Zeng Guomei, Fang Jieni, Shen Yingyan, Tan Huiyan, Han Mei, Li Juan
Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Guangzhou Medical University, Guangzhou, China.
Evid Based Complement Alternat Med. 2022 Sep 30;2022:3245663. doi: 10.1155/2022/3245663. eCollection 2022.
This investigation was conducted to analyze and evaluate the impact of Chinese herbal medicine on glucolipid metabolism in women with polycystic ovary syndrome (PCOS).
We used manual and computer-aided search methods, and the search scopes included Chinese databases (China National Knowledge Infrastructure, Wanfang, the China Science and Technology Journal Database, and the Chinese Biomedical Literature Database) and English databases (PubMed, Embase, Web of Science, and the Cochrane Library). We searched these eight databases for randomized controlled trials investigating the effects of Chinese herbal medicine on glucolipid metabolism in women with PCOS, with the retrieval deadline being June 2021. Two reviewers screened, selected, and extracted data and verified the results independently. The NoteExpress software was used to manage and screen the literature, the risk of bias assessment tool was used to evaluate the methodological quality of the included studies, and the RevMan 5.4 software was used for meta-analysis.
A total of 13 trials were included, including 825 patients with PCOS. Because the drugs used in the control group were different, we divided the results into two parts, with four trials using placebo and nine trials using metformin as the control. The results of the meta-analysis showed that fasting insulin (MD = -2.45, 95% CI = [-4.74, -0.17], = 0.04), 2 h fasting plasma glucose (MD = -0.33, 95% CI = [-0.64, -0.02], = 0.04), serum total cholesterol (MD = -0.38, 95% CI = [-0.58, -0.18], = 0.0002), triglycerides (MD = -0.36, 95% CI = [-0.58, -0.14], = 0.001), and low-density lipoprotein cholesterol (MD = -0.58, 95% CI = [-0.75, -0.41], < 0.00001) were significantly improved in the Chinese herbal medicine group compared with the placebo group. In addition, compared with metformin, body mass index (MD = -1.04, 95% CI = [-1.55, -0.53], < 0.0001), serum total cholesterol (MD = -0.27, 95% CI = [-0.46, -0.07] = 0.007), and low-density lipoprotein cholesterol were significantly reduced (MD = -0.12, 95% CI = [-0.22, -0.02], = 0.02) and high-density lipoprotein cholesterol (MD = 0.09, 95% CI = [0.02, 0.17], = 0.01) was significantly improved after treatment with Chinese herbal medicine.
Compared with the placebo group, Chinese herbal medicine had positive effects on glucolipid metabolism in women with PCOS. Chinese herbal medicine had a positive effect on lipid metabolism when the control group was metformin, but no effect on glucose metabolism. These findings need to be verified in high-quality, large-sample, randomized controlled trials in the future.
本研究旨在分析和评估中药对多囊卵巢综合征（PCOS）女性糖脂代谢的影响。
采用手工检索和计算机辅助检索方法，检索范围包括中文数据库（中国知网、万方、维普、中国生物医学文献数据库）和英文数据库（PubMed、Embase、Web of Science、Cochrane图书馆）。检索这八个数据库中关于中药对PCOS女性糖脂代谢影响的随机对照试验，检索截止日期为2021年6月。两名研究者独立进行文献筛选、数据提取和结果验证。使用NoteExpress软件管理和筛选文献，采用偏倚风险评估工具评估纳入研究的方法学质量，使用RevMan 5.4软件进行Meta分析。
共纳入13项试验，包括825例PCOS患者。由于对照组使用的药物不同，我们将结果分为两部分，4项试验使用安慰剂作为对照，9项试验使用二甲双胍作为对照。Meta分析结果显示，与安慰剂组相比，中药组空腹胰岛素（MD=-2.45，95%CI=[-4.74，-0.17]，P=0.04）、空腹2小时血糖（MD=-0.33，95%CI=[-0.64，-0.02]，P=0.04）、血清总胆固醇（MD=-0.38，95%CI=[-0.58，-0.18]，P=0.0002）、甘油三酯（MD=-0.36，95%CI=[-0.58，-0.14]，P=0.001）和低密度脂蛋白胆固醇（MD=-0.58，95%CI=[-0.75，-0.41]，P<0.00001）均有显著改善。此外，与二甲双胍相比，中药治疗后体重指数（MD=-1.04，95%CI=[-1.55，-0.53]，P<0.0001）、血清总胆固醇（MD=-0.27，95%CI=[-0.46，-0.07]，P=0.007）和低密度脂蛋白胆固醇显著降低（MD=-0.12，95%CI=[-0.22，-0.02]，P=0.02），高密度脂蛋白胆固醇显著升高（MD=0.09，95%CI=[0.02，0.17]，P=0.01）。
与安慰剂组相比，中药对PCOS女性糖脂代谢有积极作用。当对照组为二甲双胍时，中药对脂质代谢有积极作用，但对糖代谢无作用。这些结果有待未来高质量、大样本的随机对照试验进一步验证。
