中医药治疗糖尿病及对肠道菌群影响的Meta分析

A Meta-analysis of the effects of TCM medicine on diabetes and intestinal flora

目的:系统评价中医药对糖尿病患者肠道菌群的影响情况。方法:检索2007年1月-2022年7月维普数据库、中国期刊全文数据库、万方数据库、中国生物医学数据库,搜索国内公开发表的中医药对糖尿病肠道菌群影响的随机对照试验,运用RevMan 5.3软件对单纯西医疗法与中医药疗法治疗糖尿病的临床效果及其对糖尿病肠道菌群的影响进行Meta分析。结果:经过逐步筛选,最终纳入随机对照试验11个,共涉及糖尿病患者1062例。Meta分析结果显示,治疗组糖尿病临床总疗效优于对照组(P<0.05)。两组糖尿病患者治疗后空腹血糖指标变化情况比较结果显示,χ^(2)=297.64,P<0.00001,I2=98%;治疗后治疗组患者空腹血糖较治疗前降低(P<0.05)。治疗组患者的肠道菌群改善情况优于对照组。其中,两组糖尿病患者拟杆菌指标变化情况比较结果显示:χ^(2)=18.99,P=0.0008,I2=79%;两组糖尿病患者双歧杆菌指标变化情况比较结果显示,χ^(2)=14.31,P=0.05,I2=51%;两组糖尿病患者肠杆菌指标变化情况比较结果显示,χ^(2)=47.24,P<0.00001,I2=85%;两组糖尿病患者肠球菌指标变化情况比较结果显示,χ^(2)=26.58,P<0.0001,I2=85%。结论:中医药治疗糖尿病的临床疗效佳,在降低血糖、调节肠道菌群失调方面疗效显著。

Objective:To systematically evaluate the effect of TCM medicine on intestinal flora in patients with diabetes mellitus.Methods:Randomized controlled trials in VIP database,CNKI,Wanfang database and CBM from January 2007 to July 2022 of the effect of TCM medicine on diabetic intestinal flora published in China were searched.Through RevMan 5.3 software,the clinical effects of western medicine alone and TCM medicine therapy on diabetes and their effects on intestinal flora were Meta-analyzed.Results:After screening,eleven randomized controlled trials involving a total of 1062 patients with diabetes were included.Meta-analysis showed that the total effective in the treatment group was better than that in the control group(P<0.05).The fasting blood glucose indexes in the two groups were compared after treatment,and the results showed thatχ^(2)=297.64,P<0.00001,I2=98%.After treatment,fasting blood glucose in the treatment group was lower than before treatment(P<0.05).The improvement of intestinal flora in the treatment group was better than the control group.Among them,the bacteroides indexes in the two groups were compared,and the results showed thatχ^(2)=18.99,P=0.0008,I2=79%.The bifidobacteria indexes in the two groups were compared,and the results showed thatχ^(2)=14.31,P=0.05,I2=51%.The enterobacteria index in the two groups were compared,and the results showed thatχ^(2)=47.24,P<0.00001,I2=85%.The enterococcal indexes in the two groups were compared,and the results showed thatχ^(2)=26.58,P<0.0001,I2=85%.Conclusion:Traditional Chinese medicine has good clinical efficacy on diabetes,and has significant efficacy in reducing blood glucose and regulating intestinal flora imbalance.