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2型糖尿病患者代谢功能障碍相关脂肪性肝病:常用中药制剂的系统评价和荟萃分析能否阐明其疗效?

Metabolic dysfunction-associated fatty liver in type 2 diabetes mellitus patient: can a systematic review of and meta-analysis of commonly used TCM-preparation shed light on their efficacy?

作者信息

Cao Jingsi, Bao Tingting, Cao Jingxian, Fan Xuechun, Wang Yanyan, Yu Jing, Wang Ying, Deng RuiXue, Shi Jingjing, Shen Changlong, Li Qingwei, Mi Jia

机构信息

College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China.

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

出版信息

Front Pharmacol. 2025 Aug 14;16:1578371. doi: 10.3389/fphar.2025.1578371. eCollection 2025.

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) and Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) are mutually causal, which can jointly promote the development of the disease. As an important means to evaluate the steatosis of MAFLD, Controlled Attenuation Parameter (CAP) can also evaluate the metabolism related fat parameters. Whether Traditional Chinese Medicine preparation (TCM-preparation) can improve CAP has not been reported yet, so the purpose of this meta-analysis is to evaluate the effect of TCM-preparation on CAP in T2DM patients with MAFLD.

METHODS

In this meta-analysis, eight databases were searched from the establishment of the database to 23 April 2025, to obtain clinical randomized controlled trials of TCM-preparation or TCM-preparation combined with Standard Biomedical Treatment in the treatment of T2DM complicated with MAFLD. After screening the literature and extracting the data, Meta-analysis was conducted using RevMan5.4 software, with results presented in the form of a forest plot. This study was registered with PROSPERO (CRD42024569613).

RESULTS

A total of 599 papers were retrieved, and the papers were screened according to the nadir and ranking criteria, and finally 8 trials (648 participants) were included in this study. Meta-analysis showed that TCM-preparation significantly reduced CAP values in patients with T2DM combined with MAFLD compared with TCM-preparation (MD = -15.19, CI [-22.53, -7.85], P < 0.0001).

CONCLUSION

TCM-preparation can reduce the CAP value of T2DM combined with MAFLD and can have a good therapeutic effect on glucose-lipid metabolism level and liver function, indicating that TCM-preparation can reduce the deposition of hepatic fat, restore the function of hepatocytes, and have a positive effect on T2DM combined with MAFLD; however, due to the heterogeneity of the included literature, it needs to be further validation by high-quality trials.

摘要

背景

2型糖尿病(T2DM)与代谢功能障碍相关脂肪性肝病(MAFLD)互为因果,可共同促进疾病发展。受控衰减参数(CAP)作为评估MAFLD脂肪变性的重要手段,也能评估代谢相关脂肪参数。中药制剂能否改善CAP尚未见报道,因此本荟萃分析的目的是评估中药制剂对T2DM合并MAFLD患者CAP的影响。

方法

在本荟萃分析中,检索了从数据库建立至2025年4月23日的8个数据库,以获取中药制剂或中药制剂联合标准生物医学治疗用于治疗T2DM合并MAFLD的临床随机对照试验。在筛选文献和提取数据后,使用RevMan5.4软件进行荟萃分析,结果以森林图的形式呈现。本研究已在国际前瞻性注册系统(PROSPERO)注册(注册号:CRD42024569613)。

结果

共检索到599篇文献,按照纳入和排除标准进行筛选,最终纳入8项试验(648例参与者)。荟萃分析表明,与未使用中药制剂相比,中药制剂显著降低了T2DM合并MAFLD患者的CAP值(MD=-15.19,CI[-22.53,-7.85],P<0.0001)。

结论

中药制剂可降低T2DM合并MAFLD患者的CAP值,对糖脂代谢水平及肝功能有良好的治疗作用,表明中药制剂可减少肝脏脂肪沉积,恢复肝细胞功能,对T2DM合并MAFLD有积极作用;然而,由于纳入文献的异质性较大,需要通过高质量试验进一步验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3ad/12390981/df04d334b62a/fphar-16-1578371-g001.jpg

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