含葛根的中药处方治疗非酒精性脂肪肝：系统回顾和荟萃分析

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine Pub Date : 2024-10-01 DOI:10.1016/j.eujim.2024.102405

Haoyu Wang , Huilin Liu , Xiangmin Deng , Ping Luo , Yaqi Tian , Rui Zhang , Gaochuan Zhang , Xunxun Yuan , Xu Zhou

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引用次数: 0

摘要

方法检索了七个数据库，比较了葛根汤加基本疗法（西药或生活方式干预）与相同基本疗法对非酒精性脂肪肝患者的疗效。主要结果是肝功能指标，次要结果包括代谢指标、症状严重程度和不良事件发生率。疗效以加权平均差（WMDs）、标准平均差（SMDs）和95%置信区间（CIs）来衡量。元分析结果显示，与对照组相比，GGP 组的肝功能有显著改善（天门冬氨酸氨基转移酶：WMD -9.60 U/L）：WMD -9.60 U/L，95 % CI -14.96 to -4.25；丙氨酸氨基转移酶：6.30 U/L，95 % CI -9.57 to -3.02；γ-谷氨酰转移酶：6.35 U/L，95 % CI -10.44 to -2.25）、血脂水平（总胆固醇：WMD -0.68 mmol/L，95 % CI -0.88 to -0.49；甘油三酯：0.61 mmol/L，95 % CI -0.84 至 -0.38；低密度脂蛋白胆固醇：0.42 mmol/L，95 % CI -0.56 至 -0.27；高密度脂蛋白胆固醇：0.34 mmol/L，95 % CI 0.21 至 0.47）、体重指数（WMD -0.79 kg/m2，95 % CI -1.38 至 -0.19）、血糖水平（空腹血糖：WMD -1.03 mmol/L，95 % CI -1.52 to -0.44；餐后 2 小时血糖：1.06 mmol/L，95 % CI -1.68 to -0.28；糖化血红蛋白：0.56 %，95 % CI -0.85 to -0.28；胰岛素抵抗稳态模型评估：0.85 mmol/L，95 % CI -1.15 至 -0.56；空腹胰岛素：2.34 mmol/L，95 % CI -3.14 至 -1.55）和症状严重程度评分（SMD -1.91，95 % CI -2.48 至 -1.34）。结论GGP作为非酒精性脂肪肝的辅助疗法，可改善肝功能、代谢指标和临床症状，安全性良好。然而，由于存在中度到高度的偏倚风险和显著的异质性，证据质量为中度到极低。

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Pueraria lobata radix (Ge Gen)-containing traditional Chinese medicine prescriptions for the treatment of nonalcoholic fatty liver disease: A systematic review and meta-analysis

Introduction

This study aimed to systematically evaluate the effectiveness and safety of Pueraria lobata radix (Chinese name: Ge Gen)-containing prescriptions (GGPs) for the treatment of nonalcoholic fatty liver disease (NAFLD).

Methods

Seven databases were searched for randomized controlled trials (RCTs) comparing the effectiveness of GGPs plus basic therapies (Western medicines or lifestyle interventions) versus the same basic therapies in patients with NAFLD. The primary outcomes were liver function indicators, and the secondary outcomes included metabolism indicators, severity of symptoms, and incidence of adverse events. The effects were measured as weighted mean differences (WMDs), standard mean differences (SMDs), and 95 % confidence intervals (CIs).

Results

Eighteen RCTs involving 1,991 patients were included. Meta-analysis results showed that compared to the control group, the GGP group had a significant improvement in liver function (aspartate aminotransferase: WMD -9.60 U/L, 95 % CI -14.96 to -4.25; alanine aminotransferase:6.30 U/L, 95 % CI -9.57 to -3.02; gamma-glutamyl transferase:6.35 U/L, 95 % CI -10.44 to -2.25), blood lipid levels (total cholesterol: WMD -0.68 mmol/L, 95 % CI -0.88 to -0.49; triglycerides:0.61 mmol/L, 95 % CI -0.84 to -0.38; low-density lipoprotein cholesterol:0.42 mmol/L, 95 % CI -0.56 to -0.27; high-density lipoprotein cholesterol: 0.34 mmol/L, 95 % CI 0.21 to 0.47), body mass index (WMD -0.79 kg/m², 95 % CI -1.38 to -0.19), blood glucose levels (fasting blood glucose: WMD -1.03 mmol/L, 95 % CI -1.52 to -0.44; 2-hour postprandial blood glucose:1.06 mmol/L, 95 % CI -1.68 to -0.28; glycosylated hemoglobin:0.56 %, 95 % CI -0.85 to -0.28; homeostatic model assessment of insulin resistance:0.85 mmol/L, 95 % CI -1.15 to -0.56; fasting insulin:2.34 mmol/L, 95 % CI -3.14 to -1.55), and symptom severity scores (SMD -1.91, 95 % CI -2.48 to -1.34). The GGP group reported six mild adverse events, including diarrhea, nausea, and stomach discomfort.

Conclusion

GGPs, as an adjunct therapy for NAFLD, may improve liver function, metabolic parameters, and clinical symptoms, with good safety. However, the quality of evidence was moderate-to-very low owing to the presence of a moderate-to-high risk of bias and significant heterogeneity.

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来源期刊

European Journal of Integrative Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

4.70

自引率

4.00%

发文量

102

审稿时长

33 days

期刊介绍： The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education. EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians. The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.