葛根芩连汤联合西医常规治疗2型糖尿病的有效性研究OACSTPCD

[Objective]To systematically evaluate the efficacy and safety of Gegen Qinlian Decoction in the treatment of type 2 diabetes.[Methods]Systematically search seven major databases:EMbase,PubMed,Cochrane Library,China National Knowledge Infrastructure(CNKI),VIP,WANFANG DATA and Chinese Biomedical Literature Database(CBM).The retrieval time was from the establishment of each database to June 2023.According to the pre-set screening criteria,randomized controlled trials of Gegen Qinlian Decoction in the treatment of type 2 diabetes were included.The Cochrane risk of bias assessment tool was used to evaluate the quality of the literature,and RevMan 5.4 software was used for data analysis.[Results]A total of 439 literatures were retrieved,and 33 studies were finally included,with a total sample size of 2 764 cases.The results of Meta analysis showed that the total effective rate of Gegen Qinlian Decoction combined with conventional Western medicine in the treatment of type 2 diabetes was better than conventional Western medicine alone[OR=0.24,95%CI(0.17,0.33),P<0.00001].Compared with the control group,the fasting blood glucose of the experimental group[MD=-1.27,95%CI(-1.57,-0.88),P<0.000 01],2-hour postprandial blood glucose[MD=-1.43,95%CI(-1.78,-1.08),P<0.000 01],glycation hemoglobin[MD=-0.97,95%CI(-1.30,-0.63),P<0.000 01],total cholesterol[MD=-0.56,95%CI(-0.77,-0.35),P<0.000 01],triglycerides[MD=-0.29,95%CI(-0.43,-0.14),P=0.000 02],low density lipoprotein[MD=-0.43,95%CI(-0.53,-0.34),P<0.000 01],body mass index[MD=-1.39,95%CI(-2.42,-0.35),P=0.009]and other aspects of the reduction effect and the increasing effect of high-density lipoprotein[MD=0.17,95%CI(0.03,0.30),P=0.01]are better,and Gegen Qinlian decoction combined with conventional Western medicine treatment can reduce the incidence of adverse reactions[OR=0.40,95%CI(0.24,0.67),P=0.00004],but in the fasting insulin index,there was no significant difference between the experimental group and the control group[MD=-1.50,95%CI(-4.12,1.11),P=0.26].The subgroup analysis showed that Gegen Qinlian Decoction combined with routine western medicine had a better effect in reducing fasting blood sugar,2-hour postprandial blood sugar and glycosylated hemoglobin when the course of treatment was 8 weeks or more.The results of sensitivity analysis and publication bias suggested that there was publication bias in the total effective rate,but the results were still reliable.The GRADE assessment of the quality of evidence suggested that the overall quality of outcome indicators was low.[Conclusion]Gegen Qinlian Decoction combined with conventional treatment of Western medicine has significant efficacy in the treatment of type 2 diabetes mellitus,with less adverse reactions.However,due to the limited sample size and methodological quality of the included studies,more high-quality randomized controlled trials are needed to validate this conclusion.