Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus
Background: In China, Coptis chinensis Franch. (Chinese name: Huanglian) prescriptions (HLPs) are prominent hypoglycemic agents used in glycemic control. However, the curative effect of HLPs as adjunctive therapies for type 2 diabetes mellitus (T2DM) has not been evaluated. Based on a systematic rev...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.956313/full |
| _version_ | 1797961409547468800 |
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| author | Linlin Pan Xin Zhai Zhanhui Duan Kun Xu Guirong Liu |
| author_facet | Linlin Pan Xin Zhai Zhanhui Duan Kun Xu Guirong Liu |
| author_sort | Linlin Pan |
| collection | DOAJ |
| description | Background: In China, Coptis chinensis Franch. (Chinese name: Huanglian) prescriptions (HLPs) are prominent hypoglycemic agents used in glycemic control. However, the curative effect of HLPs as adjunctive therapies for type 2 diabetes mellitus (T2DM) has not been evaluated. Based on a systematic review and a meta-analysis, this study was conducted to assess the effects of HLPs combined with metformin as a reinforcing agent for T2DM.Materials and methods: A total of 33 randomized controlled trials (RCTs) reporting on 2,846 cases concerning the use of HLPs in the treatment of T2DM were identified from the China National Knowledge Infrastructure (CNKI), Weipu (VIP), Wanfang, PubMed, Cochrane Library, and EMBASE databases. Primary outcomes included fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin, type A1c (HbA1c), fasting serum insulin (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR). Secondary outcomes included total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and gastrointestinal dysfunction (GD). Continuous data were expressed as mean differences (MDs) with 95% confidence intervals (CIs). The methodological quality of the included RCTs was assessed by Cochrane evidence-based medicine systematic evaluation. Statistical analysis was performed using the Review Manager and Stata software. The required information size and treatment benefits were evaluated by trial sequential analysis (TSA). The quality of evidence was rated using the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach.Results: The results revealed that HLPs are beneficial to improve the following: FBG (MD = −1.16%, 95% CI: −1.24 to −1.07), 2hPG (MD = −1.64%, 95% CI: −1.84 to −1.43), HbA1c (MD = −0.78%, 95% CI:−0.96 to −0.60), FINS (MD = −1.94%, 95% CI: −2.68 to −1.20), HOMA-IR (MD = −0.77%, 95% CI: −1.28 to −0.27), TC (MD = −0.70%, 95% CI: −1.00 to −0.39), TG (MD = −0.57%, 95% CI: −0.74 to −0.40), LDL-c (MD = −0.70%, 95% CI: −0.97 to −0.43), and HDL-c (MD = −0.21%, 95% CI: −0.32 to −0.10) for patients with T2DM. The funnel plot, Egger’s test, and trim-and-fill method indicated a moderate publication bias in the results. The TSA showed that the required sample size of HLPs in improving FBG, 2hPG, HbA1c, FINS, HOMA-IR, TC, TG, LDL-c, and HDL-c could sufficiently draw reliable conclusions. GRADE assessment revealed that the quality of the evidence for the effectiveness of HLPs in improving FBG was moderate, but the quality of evidence for 2hPG, HbA1c, FINS, HOMA-IR, TC, TG, LDL-c, and HDL-c was low, and for GD was very low.Conclusion: The systematic review and meta-analysis suggested that HLPs were beneficial for achieving glycemic control. However, HLPs recommended for T2DM patients have yet to be confirmed because of the poor methodological quality of some trials. Therefore, more RCTs with multicenter and double-blind designs are needed to assess the efficacy of HLPs for patients with T2DM. |
| first_indexed | 2024-04-11T00:57:59Z |
| format | Article |
| id | doaj.art-b4180a2f71514fa3b3dd14a9127d2276 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-11T00:57:59Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| spelling | doaj.art-b4180a2f71514fa3b3dd14a9127d22762023-01-04T23:04:58ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-09-011310.3389/fphar.2022.956313956313Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitusLinlin Pan0Xin Zhai1Zhanhui Duan2Kun Xu3Guirong Liu4Department of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, ChinaDepartment of Chinese Medicine Literature and Culture, Shandong University of Traditional Chinese Medicine, Jinan, ChinaDepartment of Chinese Medicine Literature and Culture, Shandong University of Traditional Chinese Medicine, Jinan, ChinaDepartment of Chinese Medicine Literature and Culture, Shandong University of Traditional Chinese Medicine, Jinan, ChinaDepartment of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, ChinaBackground: In China, Coptis chinensis Franch. (Chinese name: Huanglian) prescriptions (HLPs) are prominent hypoglycemic agents used in glycemic control. However, the curative effect of HLPs as adjunctive therapies for type 2 diabetes mellitus (T2DM) has not been evaluated. Based on a systematic review and a meta-analysis, this study was conducted to assess the effects of HLPs combined with metformin as a reinforcing agent for T2DM.Materials and methods: A total of 33 randomized controlled trials (RCTs) reporting on 2,846 cases concerning the use of HLPs in the treatment of T2DM were identified from the China National Knowledge Infrastructure (CNKI), Weipu (VIP), Wanfang, PubMed, Cochrane Library, and EMBASE databases. Primary outcomes included fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin, type A1c (HbA1c), fasting serum insulin (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR). Secondary outcomes included total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and gastrointestinal dysfunction (GD). Continuous data were expressed as mean differences (MDs) with 95% confidence intervals (CIs). The methodological quality of the included RCTs was assessed by Cochrane evidence-based medicine systematic evaluation. Statistical analysis was performed using the Review Manager and Stata software. The required information size and treatment benefits were evaluated by trial sequential analysis (TSA). The quality of evidence was rated using the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach.Results: The results revealed that HLPs are beneficial to improve the following: FBG (MD = −1.16%, 95% CI: −1.24 to −1.07), 2hPG (MD = −1.64%, 95% CI: −1.84 to −1.43), HbA1c (MD = −0.78%, 95% CI:−0.96 to −0.60), FINS (MD = −1.94%, 95% CI: −2.68 to −1.20), HOMA-IR (MD = −0.77%, 95% CI: −1.28 to −0.27), TC (MD = −0.70%, 95% CI: −1.00 to −0.39), TG (MD = −0.57%, 95% CI: −0.74 to −0.40), LDL-c (MD = −0.70%, 95% CI: −0.97 to −0.43), and HDL-c (MD = −0.21%, 95% CI: −0.32 to −0.10) for patients with T2DM. The funnel plot, Egger’s test, and trim-and-fill method indicated a moderate publication bias in the results. The TSA showed that the required sample size of HLPs in improving FBG, 2hPG, HbA1c, FINS, HOMA-IR, TC, TG, LDL-c, and HDL-c could sufficiently draw reliable conclusions. GRADE assessment revealed that the quality of the evidence for the effectiveness of HLPs in improving FBG was moderate, but the quality of evidence for 2hPG, HbA1c, FINS, HOMA-IR, TC, TG, LDL-c, and HDL-c was low, and for GD was very low.Conclusion: The systematic review and meta-analysis suggested that HLPs were beneficial for achieving glycemic control. However, HLPs recommended for T2DM patients have yet to be confirmed because of the poor methodological quality of some trials. Therefore, more RCTs with multicenter and double-blind designs are needed to assess the efficacy of HLPs for patients with T2DM.https://www.frontiersin.org/articles/10.3389/fphar.2022.956313/fullcoptis chinensis franchtype 2 diabetes mellitussystematic reviewmeta-analysiscurative effect |
| spellingShingle | Linlin Pan Xin Zhai Zhanhui Duan Kun Xu Guirong Liu Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus Frontiers in Pharmacology coptis chinensis franch type 2 diabetes mellitus systematic review meta-analysis curative effect |
| title | Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus |
| title_full | Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus |
| title_fullStr | Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus |
| title_full_unstemmed | Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus |
| title_short | Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus |
| title_sort | systematic review and meta analysis of coptis chinensis franch containing traditional chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus |
| topic | coptis chinensis franch type 2 diabetes mellitus systematic review meta-analysis curative effect |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.956313/full |
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