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中医治疗老年糖尿病的机制及其临床应用的系统评价

Mechanism of traditional Chinese medicine in elderly diabetes mellitus and a systematic review of its clinical application.

作者信息

Zhang Qiqi, Hu Shiwan, Jin Zishan, Wang Sicheng, Zhang Boxun, Zhao Linhua

机构信息

Institute of Metabolic Diseases, Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.

Graduate School, Beijing University of Chinese Medicine, Beijing, China.

出版信息

Front Pharmacol. 2024 Mar 6;15:1339148. doi: 10.3389/fphar.2024.1339148. eCollection 2024.

Abstract

Affected by aging, the elderly diabetes patients have many pathological characteristics different from the young people, including more complications, vascular aging, cognitive impairment, osteoporosis, and sarcopenia. This article will explore their pathogenesis and the mechanism of Traditional Chinese medicine (TCM) intervention, and use the method of systematic review to evaluate the clinical application of TCM in elderly diabetes. Searching for randomized controlled trials (RCTs) published from January 2000 to November 2023 in the following databases: Web of Science, Pubmed, Embase, Cochrane Library, Sinomed, China National Knowledge Internet, Wanfang and VIP. They were evaluated by three subgroups of Traditional Chinese Prescription, Traditional Chinese patent medicines and Traditional Chinese medicine extracts for their common prescriptions, drugs, adverse reactions and the quality of them. TCM has the advantages of multi-target and synergistic treatment in the treatment of elderly diabetes. However, current clinical researches have shortcomings including the inclusion of age criteria and diagnosis of subjects are unclear, imprecise research design, non-standard intervention measures, and its safety needs further exploration. In the future, the diagnosis of elderly people with diabetes needs to be further clarified. Traditional Chinese patent medicines included in the pharmacopoeia can be used to conduct more rigorous RCTs, and then gradually standardize the traditional Chinese medicine prescriptions and traditional Chinese medicine extracts, providing higher level evidence for the treatment of elderly diabetes with traditional Chinese medicine.

摘要

受衰老影响,老年糖尿病患者具有许多与年轻人不同的病理特征,包括更多并发症、血管老化、认知障碍、骨质疏松和肌肉减少症。本文将探讨其发病机制及中医干预机制,并采用系统评价方法评估中医在老年糖尿病中的临床应用。检索2000年1月至2023年11月在以下数据库发表的随机对照试验(RCT):Web of Science、Pubmed、Embase、Cochrane Library、中国生物医学文献数据库、中国知网、万方和维普。从中药方剂、中成药和中药提取物三个亚组对其常用方剂、药物、不良反应及质量进行评价。中医在老年糖尿病治疗中具有多靶点、协同治疗的优势。然而,目前临床研究存在纳入年龄标准及受试者诊断不明确、研究设计不精确、干预措施不规范等不足,其安全性也有待进一步探索。未来,老年糖尿病患者的诊断需要进一步明确。可对药典收录的中成药开展更严格的随机对照试验,进而逐步规范中药方剂和中药提取物,为中医治疗老年糖尿病提供更高质量的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c65/10953506/be37aec40f62/fphar-15-1339148-g001.jpg

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