玉女煎治疗2型糖尿病Meta分析
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摘要
目的:对公开发表的玉女煎加减方治疗2型糖尿病的临床研究进行Meta分析,以评价玉女煎治疗2型糖尿病的疗效及安全性。方法:通过计算机对万方、CNKI、维普、Pubmed等中英文数据库进行检索,选择以玉女煎加减方作为干预措施治疗2型糖尿病随机对照试验的临床研究,认真通读全文,提取文献基本信息并对其进行质量评价,使用Cochrane协作网提供的Review Manager 5.3软件进行Meta分析。结果:最终共筛选出9篇符合纳入标准的临床文献,包含730例受试患者。其中9篇文献均以总有效率作为结局指标,6篇文献记录了空腹血糖情况,5篇文献记录了糖化血红蛋白情况。结果:玉女煎在治疗2型糖尿病的总有效率[OR=5.00,95%CI(3.25,7.71),Z=7.30(P<0.00001)]、空腹血糖[MD=-0.86,95%CI(-1.39,-0.34),Z=3.20(P=0.001)]、糖化血红蛋白[MD=-0.92,95%CI(-1.41,-0.44),Z=3.71(P=0.0002)]等方面均优于对照组。在9篇文献中,都没有提及玉女煎治疗2型糖尿病的不良反应。结论:应用玉女煎治疗2型糖尿病患者有效并且安全,但仍然需要高质量的临床研究来进一步验证。
Objective :To evaluate the efficacy and safety of Yunu Decoction in the treatment of type II diabetes mellitus(T2 DM)by conducting a Meta-analysis on the clinical research of publicly published modified Yunu Decoction in treating T2 DM. Methods :Randomized controlled trial about modified Yunu Decoction as intervention measure in treating T2 DM were selected from Chinese and English database of WanFang,CNKI,Vip and Pubmed through the computer. The essential information of literatures were extracted after reading the whole text through and the quality was assessed. Metaanalysis was performed by using Review Manager 5.3 software provided by Cochrane collaboration network. Results :Totally 9 clinical literatures met the inclusion criteria,including 730 cases of patients,were screened finally. Total effective rate served as outcome indicator was recorded in all of the 9 literatures. The situations of fasting blood glucose and glycosylated hemoglobin was recorded in 6 and 5 literatures,respectively. Results :Statistical analysis indicated that the total effective rate [OR=5.00,95%CI(3.25,7.71),Z=7.30(P<0.00001)],fasting blood glucose [MD=-0.86,95%CI(-1.39,-0.34),Z=3.20(P=0.001)] and glycosylated hemoglobin [MD=-0.92,95%CI(-1.41,-0.44),Z=3.71(P=0.0002)] of Yunu Decoction in treating T2 DM was better than that of control group. The adverse reaction of Yunu Decoction in treating T2 DM was not mentioned in the 9 literatures. Conclusion :Yunu Decoction is effective and safe for the treatment of T2 DM,but high quality clinical researches are still needed for further verification.
Objective :To evaluate the efficacy and safety of Yunu Decoction in the treatment of type II diabetes mellitus(T2 DM)by conducting a Meta-analysis on the clinical research of publicly published modified Yunu Decoction in treating T2 DM. Methods :Randomized controlled trial about modified Yunu Decoction as intervention measure in treating T2 DM were selected from Chinese and English database of WanFang,CNKI,Vip and Pubmed through the computer. The essential information of literatures were extracted after reading the whole text through and the quality was assessed. Metaanalysis was performed by using Review Manager 5.3 software provided by Cochrane collaboration network. Results :Totally 9 clinical literatures met the inclusion criteria,including 730 cases of patients,were screened finally. Total effective rate served as outcome indicator was recorded in all of the 9 literatures. The situations of fasting blood glucose and glycosylated hemoglobin was recorded in 6 and 5 literatures,respectively. Results :Statistical analysis indicated that the total effective rate [OR=5.00,95%CI(3.25,7.71),Z=7.30(P<0.00001)],fasting blood glucose [MD=-0.86,95%CI(-1.39,-0.34),Z=3.20(P=0.001)] and glycosylated hemoglobin [MD=-0.92,95%CI(-1.41,-0.44),Z=3.71(P=0.0002)] of Yunu Decoction in treating T2 DM was better than that of control group. The adverse reaction of Yunu Decoction in treating T2 DM was not mentioned in the 9 literatures. Conclusion :Yunu Decoction is effective and safe for the treatment of T2 DM,but high quality clinical researches are still needed for further verification.
引文
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[14]张先华.玉女煎加味治疗2型糖尿病36例[J].陕西中医,2012,33(9):1183-1184.
[15]张爱霞,岳仁宋,杨彩虹.助脾散精法治疗2型糖尿病胃强脾弱证46例疗效观察[J].四川中医,2012,30(10):96-97.
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[17]梁敬坤.玉女煎在治疗糖尿病的临床应用[J].中国中医药咨讯,2011,3(15):112.
[18]周旭毓,方积乾.Meta分析的常见偏倚[J].循证医学,2002(4):216-220.
[19]张景岳.景岳全书[M].北京:人民卫生出版社,2006:55-58.
[20]林珮琴.类证治裁[M].北京:中国中医药出版社,2008:30-31.
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[22]李钰祥,陶宇,张晋如,等.玉女煎治疗消渴胃热炽盛证的研究进展[J].中西医结合心血管病电子杂志,2016,4(6):84-85.
[23]曹舜,李雅清,丁洪伟.玉女煎治疗2型糖尿病的研究进展[J].中国中医药现代远程教育,2017,15(12):156-158.
[24] Chinese Diabetes Society.中国2型糖尿病防治指南(2017年版)[J].中国实用内科杂志,2018,38(4):292-344.
[25]汪会琴,胡如英,武海滨,等. 2型糖尿病报告发病率研究进展[J].浙江预防医学,2016,28(1):37-39,57.
[26]孙丰卉,王秋虹,邱宗林,等.中医药治疗2型糖尿病胰岛素抵抗的机制研究进展[J].医学综述,2018,24(20):4068-4072,4077.
[27]曲超,杨宇峰,宁顺宇,等.血府逐瘀汤治疗糖尿病视网膜病变Meta分析[J].辽宁中医药大学学报,2018,20(9):184-188.
[28]贾丽燕,赵楠琦,石劢,等. 1286例2型糖尿病患者中医药治疗意愿的横断面调查[J].中医杂志,2018,59(4):307-311.
[2]王卫庆,陆洁莉.中国人群2型糖尿病的分子机制[J].中国科学:生命科学,2018,48(8):840-846.
[3]陈新卫,任路平.能量代谢与2型糖尿病[J].药品评价,2018,15(3):14-18.
[4]周仲瑛.中医内科学[M].北京:中国中医药出版社,2003:120-122.
[5]李冀.方剂学[M].北京:中国中医药出版社,2012:150-152.
[6]中华人民共和国卫生部.中药新药临床研究指导原则[S].北京:中国医药科技出版社,1993:475-486.
[7]刘鸣.系统评价、Meta分析设计与实施方法[M].北京:人民卫生出版社,2011:68-73.
[8]郑明华.Meta分析软件应用与实例解析[M].北京:人民卫生出版社,2013:71-73.
[9]袁群.加味玉女煎治疗Ⅱ型糖尿病临床观察[J].黑龙江中医药,2001(3):17-18.
[10]陈焱.加味玉女煎治疗2型糖尿病胃热阴虚型42例[J].河南中医,2006(12):35-36.
[11]张鸣.玉女煎加减方治疗2型糖尿病临床研究[J].浙江中医药大学学报,2010,34(1):67,69.
[12]陈红梅,扈腾腾,陈凯.玉女煎加味方治疗胃热炽盛型2型糖尿病60例临床疗效观察[J].中医临床研究,2014,6(15):50-51,54.
[13]徐彦阁.玉女煎加减治疗2型糖尿病[J].医药论坛杂志,2009,30(9):81-82.
[14]张先华.玉女煎加味治疗2型糖尿病36例[J].陕西中医,2012,33(9):1183-1184.
[15]张爱霞,岳仁宋,杨彩虹.助脾散精法治疗2型糖尿病胃强脾弱证46例疗效观察[J].四川中医,2012,30(10):96-97.
[16]徐乃佳.加味玉女煎治疗2型糖尿病的临床观察[D].武汉:湖北中医学院,2008.
[17]梁敬坤.玉女煎在治疗糖尿病的临床应用[J].中国中医药咨讯,2011,3(15):112.
[18]周旭毓,方积乾.Meta分析的常见偏倚[J].循证医学,2002(4):216-220.
[19]张景岳.景岳全书[M].北京:人民卫生出版社,2006:55-58.
[20]林珮琴.类证治裁[M].北京:中国中医药出版社,2008:30-31.
[21]吴勉华,王新月.中医内科学[M].北京:中国中医药出版社,2012:383-390.
[22]李钰祥,陶宇,张晋如,等.玉女煎治疗消渴胃热炽盛证的研究进展[J].中西医结合心血管病电子杂志,2016,4(6):84-85.
[23]曹舜,李雅清,丁洪伟.玉女煎治疗2型糖尿病的研究进展[J].中国中医药现代远程教育,2017,15(12):156-158.
[24] Chinese Diabetes Society.中国2型糖尿病防治指南(2017年版)[J].中国实用内科杂志,2018,38(4):292-344.
[25]汪会琴,胡如英,武海滨,等. 2型糖尿病报告发病率研究进展[J].浙江预防医学,2016,28(1):37-39,57.
[26]孙丰卉,王秋虹,邱宗林,等.中医药治疗2型糖尿病胰岛素抵抗的机制研究进展[J].医学综述,2018,24(20):4068-4072,4077.
[27]曲超,杨宇峰,宁顺宇,等.血府逐瘀汤治疗糖尿病视网膜病变Meta分析[J].辽宁中医药大学学报,2018,20(9):184-188.
[28]贾丽燕,赵楠琦,石劢,等. 1286例2型糖尿病患者中医药治疗意愿的横断面调查[J].中医杂志,2018,59(4):307-311.