目的:系统评价玉液汤对2型糖尿病患者血糖及相关指标的治疗效果,为玉液汤在2型糖尿病患者中广泛应用及作用机制研究提供依据.方法:检索PubMed、Embase、Web of Science、Cochrane Library、Sinomed、中国知网(CNKI)、中国学术期刊数据库(CSPD)及维普中国科技期刊数据库(CSTJ)8个常用数据库中玉液汤治疗2型糖尿病患者的随机对照试验(RCTs)文献,并制定纳入和排除标准进行文献筛选、资料提取、质量评价和风险评估,以上步骤均由2名研究人员独立完成.运用Review Manager 5.4统计学软件对纳入文献进行Meta分析.结果:检索到相关文献313篇,最终纳入30项RCTs,共计2758例患者.Meta分析结果显示,与对照组比较,玉液汤能降低患者空腹血糖(FBG)[MD=-1.23,95%CI(-1.69,-0.78),P<0.000 01]、餐后2 h血糖(2 h PG)[MD=-1.74,95%CI(-2.22,-1.26),P<0.000 01]、糖化血红蛋白(HbA1c)[MD=-1.24,95%CI(-1.61,-0.87),P<0.000 01]水平和胰岛素抵抗指数(HOMA-IR)[MD=-0.41,95%CI(-0.61,-0.21),P<0.000 01],差异均具有统计学意义;抗氧化应激,提高超氧化物歧化酶(SOD)[MD=12.14,95%CI(9.46,14.82),P<0.000 01]、谷胱甘肽过氧化物酶(GSH-Px)[MD=28.23,95%CI(15.06,41.40),P<0.000 01]水平,降低丙二醛(MDA)[MD=-1.40,95%CI(-1.85,-0.96)),P<0.000 01]水平,差异均具有统计学意义;改善脂代谢,降低血清胆固醇(TC)[MD=-0.90,95%CI(-1.56,-0.24),P=0.008]、低密度脂蛋白胆固醇(LDL-C)[MD=-0.46,95%CI(-0.63,-0.29),P<0.000 01]水平及颈动脉内中膜厚度[MD=-0.15,95%CI(-0.19,-0.10),P<0.000 01],提高高密度脂蛋白胆固醇(HDL-C)[MD=0.19,95%CI(0.14,0.25),P<0.000 01]水平,差异均具有统计学意义.结论:玉液汤具有明确的降糖作用,此作用可能与改善胰岛细胞功能、调节脂代谢、抗氧化应激等因素有关.
Systematic evaluation of the clinical effect of Yuye Decoction in treating type 2 diabetes mellitus and discussion on the mechanism of action
Objective:To systematically evaluate the therapeutic effect of Yuye Decoction on blood glucose and re-lated indexes in type 2 diabetes mellitus patients,and to provide a basis for the widespread application of Yuye Decoction in type 2 diabetes mellitus patients and the study of its mechanism of action.Methods:Eight commonly used databases in-cluding PubMed,Embase,Web of Science,Cochrane Library,Sinomed,China National Knowledge Infrastructure(CNKI),China Science Periodical Database(CSPD)and China Science and Technology Journal Database(CSTJ)searched.Randomized controlled trials(Rcts)of Yuye Decoction in treating type 2 diabetes mellitus were searched,and inclusion and exclusion criteria were established for literature screening,data extraction,quality evaluation and risk assessment,all of which were completed by two researchers independently.Review Manager 5.4 software was used for Meta-analysis of the included literature.Results:A total of 313 relevant articles were searched,and 30 Rcts were included,with a total of 2758 patients.Meta-analysis results showed that compared with the control group,Yuye Decoction could reduce fasting blood glucose(FBG)[MD =-1.23,95%CI(-1.69,-0.78),P<0.000 01],2 h postprandial blood glucose(2 h PG)[MD =-1.74,95%CI(-2.22,-1.26),P<0.000 01],glycosylated hemoglobin(HbA1c)[MD =-1.24,95%CI(-1.61,-0.87),P<0.000 01]and insulin resistance index(HOMA-IR)[MD =-0.41,95%CI(-0.61,-0.21),P<0.000 01]and the differences were all statistically significant;Yuye Decoction could inhibit oxidative stress,increase superoxide dismutase(SOD)[MD =12.14,95%CI(9.46,14.82),P<0.000 01]and glutathione peroxidase(GSH-Px)level[MD =28.23,95%CI(15.06,41.40),P<0.000 01],reduce the level of malondialdehyde(MDA)[MD=-1.40,95%CI(-1.85,-0.96),P<0.000 01]and the differences were all statistically significant;Yuye Decoction could improve lipid metabolism,reduce total cholesterol(TC)[MD=-0.90,95%CI(-1.56,-0.24),P =0.008],low density lipoprotein cholesterol(LDL-C)[MD=-0.46,95%CI(-0.63,-0.29),P<0.000 01],and carotid intima-media thickness[MD=-0.15,95%CI(-0.19,-0.10),P<0.000 01],increase high density lipoprotein cholesterol(HDL-C)[MD=0.19,95%CI(0.14,0.25),P<0.000 01]and the differences were all statistically significant.Conclusion:Yuye Decoction has a definite hypoglycemic effect,which may be related to improving islet cell function,regulating lipid metabolism,and anti-oxidative stress.
type 2 diabetes mellitusYuye DecoctionMeta-analysisclinical effectdiscussion on mechanism
NETL
NSTL
万方数据
维普
