Liu Hongyan, Peng Sihan, Yuan Haipo, He Yuchi, Tang Jiao, Zhang Xiyu
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Pharmacol. 2023 Jan 24;14:1102513. doi: 10.3389/fphar.2023.1102513. eCollection 2023.
Chinese herbal medicine (CHM) has the advantage of being safe and effective and has been widely used in clinical practice for the treatment of type 2 diabetes mellitus (T2DM) with hyperuricemia (HUA), but its overall efficacy and safety remain unclear. This study aimed to evaluate the efficacy and safety of CHM for the treatment of T2DM with HUA based on randomized controlled trials (RCTs) to provide clinical evidence. The protocol evaluated in this study is registered with PROSPERO (CRD42022351519). As of November 2022, eight databases were searched, and RCTs of CHM for the treatment of T2DM with HUA were included. Outcome indicators observed included fasting blood glucose (FBG), 2-h postprandial glucose (2hPG), glycated hemoglobin (HbA1c), uric acid (UA), triglycerides (TG), total cholesterol (TC), overall effectiveness, and adverse events. Utilizing Review Manager 5.4, Stata V14.0, and GRADEpro, the included studies were evaluated, and the quality of the evidence was determined. 18 RCTs covering 1,311 patients were included in this study. The results of the study demonstrated that the combination of CHM and western medicine (WM) was more effective in treating patients with T2DM with HUA than WM alone, with significant improvements in FBG (weighted mean differences (WMD) = -0.60.95% confidence interval (CI) [-0.81, -0.40], < 0.00001), 2hPG (WMD = -1.12.95% CI [-1.64, -0.60], < 0.0001), HbA1c (WMD = -0.80.95% CI [-1.04, -0.56], < 0.00001), UA (WMD = -53.47.95% CI [-67.45, -39.48], < 0.00001), TG (WMD = -0.56.95% CI [-0.74, -0.38], < 0.00001), TC (WMD = -0.49.95% CI [-0.65, -0.33], < 0.00001), and overall effective rate (risk ratio (RR) = 1.29.95%CI [1.13, 1.48], = 0.0002). The quality of evidence for all outcomes was low. Compared with WM alone, the combination of CHM and WM was more effective in treating patients with T2DM with HUA, with significant improvements in glucose metabolism, uric acid, and lipids. However, further evaluation by high-quality RCT results is needed due to the low quality and high heterogeneity of the evidence. : [https://systematicreview.gov/], identifier [CRD42022351519].
中药具有安全有效的优势，已在临床实践中广泛用于治疗伴有高尿酸血症（HUA）的2型糖尿病（T2DM），但其总体疗效和安全性仍不明确。本研究旨在基于随机对照试验（RCT）评估中药治疗伴有HUA的T2DM的疗效和安全性，以提供临床证据。本研究评估的方案已在国际前瞻性系统评价注册平台（PROSPERO）注册（注册号：CRD42022351519）。截至2022年11月，检索了8个数据库，并纳入了中药治疗伴有HUA的T2DM的RCT。观察的结局指标包括空腹血糖（FBG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbA1c）、尿酸（UA）、甘油三酯（TG）、总胆固醇（TC）、总体疗效和不良事件。利用RevMan 5.4、Stata V14.0和GRADEpro对纳入的研究进行评估，并确定证据质量。本研究纳入了18项RCT，涉及1311例患者。研究结果表明，与单纯西药相比，中药联合西药治疗伴有HUA的T2DM患者更有效，FBG（加权均数差（WMD）=-0.60，95%置信区间（CI）[-0.81，-0.40]）、2hPG（WMD=-1.12，95%CI[-1.64，-0.60]）、HbA1c（WMD=-0.80，95%CI[-1.04，-0.56]）、UA（WMD=-53.47，95%CI[-67.45，-39.48]）、TG（WMD=-0.56，95%CI[-0.74，-0.38]）、TC（WMD=-0.49，95%CI[-0.65，-0.33]）和总体有效率（风险比（RR）=1.29，95%CI[1.13，1.48]）均有显著改善（均P<0.00001或P<0.0001或P<0.0002）。所有结局的证据质量均较低。与单纯西药相比，中药联合西药治疗伴有HUA的T2DM患者更有效，在糖代谢、尿酸和血脂方面有显著改善。然而，由于证据质量低且异质性高，需要高质量RCT结果进行进一步评估。来源：[https://systematicreview.gov/]，标识符[CRD42022351519]
