首页|近5年常用中成药治疗2型糖尿病的随机对照试验证据图分析

近5年常用中成药治疗2型糖尿病的随机对照试验证据图分析

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利用证据图系统梳理近5年中成药治疗2型糖尿病(T2DM)的随机对照试验(RCT),了解该领域证据分布及质量,发现现有治疗T2DM中成药及其研究存在的问题。收集3种药物目录中关于治疗T2DM的常用中成药;检索中、英文数据库,获取相关中成药近5年的RCT;提取文献样本量、研究药物、联合用药、疗程、结局指标等;依据Cochrane协作网偏倚风险评估工具进行质量评价;采用图、表展示结果。共收集19种中成药,其中13种发表了RCT,共131篇;文献占比较大的是参芪降糖胶囊/颗粒、津力达颗粒、消渴丸;结局指标包括血糖、血脂、胰岛细胞功能、临床症状等;文献质量方面,75篇随机方法正确,1篇执行了分配隐藏及盲法。结果表明,治疗T2DM的中成药临床定位宽泛,无法体现各自特色,且安全性信息不足;体现中医特色的中医证候积分、生活质量,以及血脂结局指标关注度不足;治疗T2DM中成药各品种间研究数量差异较大,且研究质量偏低。建议治疗T2DM的中成药上市许可持有人按照国家药品监督管理局相关要求,开展中成药品种上市后评价,规范临床定位,修订完善说明书中的安全性信息;建议研究人员构建中成药治疗T2DM的核心指标数据集,完善疗效评价体系,在开展RCT前,参照CONSORT制定试验方案。
Evidence map analysis of randomized controlled trial of commonly used Chinese patent medicines in treatment of type 2 diabetes mellitus in recent five years
This study systematically combed the randomized controlled trial(RCT)of Chinese patent medicines in treatment of type 2 diabetes mellitus(T2DM)in recent five years by using the method of evidence map.It understood the distribution and quality of evidence in this field and found the existing Chinese patent medicines in treatment of T2DM and the problems in its research.The study collected the commonly used Chinese patent medicines for the treatment of T2DM from three drug catalogs,retrieved Chinese and English databases to obtain RCT literature related to Chinese patent medicines in recent five years,and extracted information such as sample size,study drug,combination medication,course of treatment,and outcome indicators from the literature.It also conducted quality evaluation based on the Cochrane collaborative network bias risk assessment tool and used charts to display the analysis results.A total of 19 kinds of Chinese patent medicines are collected,of which 13 kinds of Chinese patent medicines are mentioned in 131 articles related to RCT.The literature concerning Shenqi Jiangtang Capsules/Granules,Jinlida Granules,and Xiaoke Pills accounts for a large proportion.Outcome indicators include blood glucose,blood lipids,pancreatic islet cell function,and clinical symptoms.In terms of literature quality,75 articles have correct random methods,and 1 article performs allocation hiding and blind methods.Therefore,the clinical orientation of Chinese patent medicines for the treatment of T2DM is broad,failing to reflect their own characteristics and lacking safety information.Insufficient attention has been paid to TCM syndrome scores,quality of life,and blood lipid outcome indicators that reflect the characteristics of traditional Chinese medicine(TCM).The number of studies on the treatment of T2DM by Chinese patent medicines varies greatly among varieties,and the quality of the studies is low.It is suggested that the holders of the marketing license of T2DM Chinese patent medicines should carry out a post-marketing re-evaluation of the varieties of traditional Chinese patent medicines for treating T2DM according to the relevant requirements of the State Food and Drug Administration,standardize the clinical positioning,and revise and improve the safety information in the instructions.It is recommended that researchers construct a core indicator dataset for Chinese patent medicine treatment of T2DM,improve the efficacy evaluation system,and develop an experimental plan based on CONSORT before conducting RCT.

type 2 diabetes mellitusChinese patent medicinerandomized controlled trialevidence map

姜俊杰、井媛媛、黎元元、杨亚男、廖星、谢雁鸣

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中国中医科学院 中医临床基础医学研究所,北京 100700

中国中医科学院广安门医院,北京 100053

2型糖尿病 中成药 随机对照试验 证据图

中国中医科学院科技创新工程项目中国中医科学院科技创新工程中医临床基础学科创新团队项目

C12021A05305C12021B003

2024

中国中药杂志
中国药学会

中国中药杂志

CSTPCD北大核心
影响因子:1.718
ISSN:1001-5302
年,卷(期):2024.49(4)
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