Meta-analysis Of Huanglian Wendan Decoction And Its Addition And Reduction Formula Combined With Western Medicine In The Treatment Of Type 2 Diabetes Mellitus

OBJECTIVE:To systematically review the efficacy and safety of Huanglian Wendan Decoction and its addition and reduction formula combined with Western medicine in the treatment of Type 2 diabetes mellitus.METHODS:Comprehensive search database of CNKI,VIP,Wanfang,CBM,PubMed,Cochrane Library,etc.The Chinese search terms were"Huanglian Wendan Decoction","Diabetes Mellitus,Type2 ",The main English search words include "Diabetes Mellitus,Ty pe2","Huanglian Wendan Tang",etc.The relevant Randomized controlled trial were screened out,and the relevant data were recorded and analyzed with Revman 5.4 software.RESULTS:A total of 21 eligible literatures were included,all in Chinese,published from 2010 to 2022,with a total of 1602 patients,including 806 cases in the observation group and 796 cases in the control group,with the largest number of cases being 78.The following results were obtained through meta-analysis:(1)The data of fasting blood glucose levelswere mentioned in the 21 articles included,and the results were MD=-1.27,95%CI[-1.47,-1.08],Z=13.01,P<0.00001;(2)A total of 20 articles mentioned the data of blood glucose 2 hours after meal,and the results were MD=-1.59,95%CI[-1.99,-1.18],Z=7.76,P<0.0001;(3)A total of 17 articles mentioned the data of glycosylated hemoglobin,and the results were MD=-1.29,95%CI[-1.68,-0.90],Z=6.47,P<0.00 001;(4)A total of 15 articles mentioned clinical efficacy data,and the results were OR=4.45,95%CI[3.13,6.33],Z=8.32,P<0.00001;(5)A total of 10 articles mentioned the data of body mass index,and the result was MD=-1.26,95%CI[-1.69,-0.82],Z=5.70,P<0.00001;(6)A total of 11 articles mentioned total cholesterol data,and the results were MD=-0.67,95%CI[-0.95,-0.38],Z=4.56,P<0.00001;(7)A total of 11 articles mentioned the data of triglyceride,and the results were MD=-0.3 2,95%CI[-0.44,-0.20],Z=5.24,P<0.00001;(8)A total of 7 papers mentioned high-density lipoprotein,and the results were MD=0.06,95%CI[-0.04,0.15],Z=1.11,P=0.27;(9)A total of 8 articles mentioned low density lipoprotein,and the results wereMD=0.06,95%CI[-0.04,0.15],Z=1.11,P=0.27;(10)A total of 12 articles mentioned the data of fasting insulin level,and the results were SMD=-0.29,95%CI[-0.96,0.38],Z=0.85,P=0.40;(11)A total of 8 articles mentioned the level of insulin resistance,and the results were SMD=-1.11,95%CI[-1.6 5,-0.5 8],Z=4.1 0,P<0.000 1;(1 2)A total of 9 articles mentioned the data of the total score of TCM syndromes,and the result was SMD=-1.55,95%CI[-2.24,-0.86],Z=4.4 0,P<0.0 00 1;(1 3)A total of 4 articles mentioned the symptoms of chest tightness and abdominal distension,and the results were MD=-0.92,95%CI[-1.05,-0.80],Z=14.62,P<0.000 1;(1 4)A total of 3 articles mentioned the symptoms of thirst and drinking less,and the results were MD=-0.98,95%CI[-1.04,-0.92],Z=3 0.14,P<0.000 1;(1 5)A total of 4 articles mentioned the symptoms of turbid urine,and the results were MD=-0.80,95%CI[-1.10,-0.50],Z=5.16,P<0.0001.One article mentioned that two patient in the observation group had discomfort during medication.CONCLUSION:This study showed that Huanglian Wendan Decoction and its addition and reduction formula combined with Western medicine in the treatment of T2DM can improve clinical efficacy,improve patients’ TCM symptoms such as chest tightness,abdominal distension,less thirst and less urination,and reduce the total score of TCM syndrome.The efficacy of improving laboratory indexes such as FPG,2hPG,HbAIc,TC,TG,HOMA-IR,LDL-C was better than that of the western medicine group alone.However,the differences in FINS and HDL-C were not statistically significant.Whether Huanglian Wendan Decoction can improve the levels of FINS and HDL-C in patients remains to be determined.