益气养阴类中药联合二甲双胍治疗2型糖尿病疗效与安全性的Meta分析OA

Objective To systematically evaluate the efficacy and safety of qi-benefiting and yin-nourishing traditional Chinese medicine combined with metformin in the treatment of type 2 diabetes mellitus(T2DM).Methods A systematic search of seven major databases,Cochrane Library,Web of Science,PubMed,China Biomedical Literature Database,Wanfang,China Knowledge,and Wipro,was conducted to collect literature related to the clinical randomised controlled trials on the combination of qi nourishing and yin nourishing Chinese herbs with metformin for the treatment of T2DM,with a limited time period of the library construction to January 2025.The literature was screened according to preset criteria,the overall quality of the literature was assessed,and the data were analysed using Review Manager 5.4 software.Results Fifteen articles were obtained,with a total of 1 693 patients,848 in the observation group(qi and yin-boosting traditional Chinese medicine+metformin)and 845 in the control group(metformin).Meta-analysis results showed that,the total clinical effectiveness rate of the observation group was significantly higher than the control group[RR=1.26,95%CI(1.20,1.32),P＜0.000 01].Meanwhile,compared with the control group,the observation group had significantly higher clinical efficacy rates in fasting glucose(FPG)[MD=-1.00,95%CI(-1.30,-0.71),P＜0.000 01],2-hour postprandial glucose(2hPBG)[MD=-1.44,95%CI(-1.84,-1.04),P＜0.000 01],and glycosylated haemoglobin(HbA1c)[MD=-0.82,95%CI(-0.99,-0.65),P＜0.000 01],Chinese medicine evidence score[MD=-3.40,95%CI(-4.18,-2.62),P＜0.000 01],fasting insulin(FINS)[MD=-3.75,95%CI(-5.95,-1.56),P＜0.000 1],insulin resistance index(HOMA-IR)[MD=-1.03,95%CI(-1.59,-0.47),P=0.000 3],and triglycerides(TG)[MD=-0.45,95%CI(-0.84,-0.06),P=0.02],and serum total cholesterol(TC)[MD=-0.79,95%CI(-1.20,-0.38),P=0.000 2],and low-density lipoprotein(LDL)[MD=-0.62,95%CI(-0.89,0.35),P＜0.000 01],whereas there was a more pronounced decrease in elevated high-density lipoprotein(HDL)[MD=0.26,95%CI(-0.03,0.55),P=0.08]was more favourable.The incidence of adverse events was not statistically significant in the two groups[RR=0.61,95%CI(0.30,1.21),P=0.16].Conclusion The efficacy of qi-benefiting and yin-nourishing herbs combined with metformin in the treatment of T2DM is superior to that of metformin alone,whereas there is no significant difference in the safety of the two treatment modalities.