ABSTRACT
Objective: To systematically evaluate the clinical effect of Xiaoke Decoction in the treatment of type 2 diabetes. Methods: Chinese databases such as CNKI, Wanfang, Weipu Chinese Biomedical Journal Database, and Chinese Medical Biological Literature Database, PubMed, Cochrane Library, Embase, and Web of Science were searched for English language literature from their inception until November 2019. A Meta-analysis was performed using RevMan 5.3 and Stata 12.0. Results: Thirty-eight studies were included in this study, with a total of 3757 patients. It was found that adding Xiaoke Decoction could improve total efficiency. The Xiaoke Decoction groups surpassed the western medicine groups regarding improvement in total efficiency (OR = 3.49; 95% CI: 2.78–4.39, P < 0.00001). Adding Xiaoke Decoction could lower the fasting plasma glucose (FPG) level. The Xiaoke Decoction groups surpassed the western medicine groups regarding reduction in FPG levels (MD = −1.14; 95% CI: −1.36 to 0.92, P < 0.00001). Adding Xiaoke Decoction could lower the 2 h postprandial blood glucose (2hPG) level. The Xiaoke Decoction groups surpassed the western medicine groups regarding reduction in 2hPG (MD = −1.40; 95% CI: −1.61 to 1.19, P < 0.00001). Adding Xiaoke Decoction could lower glycated hemoglobin (HbA1c). The Xiaoke Decoction groups surpassed the western medicine groups regarding reduction in HbA1c (MD = −0.77; 95% CI: −0.95 to 0.58, P < 0.00001). It was found that adding Xiaoke Decoction could lower the traditional Chinese medicine (TCM) syndrome score. The TCM syndrome scores among patients in the Xiaoke Decoction group were lower than those among patients in the control group after treatment (MD = −4.90; 95% CI: −7.22 to 2.57, P < 0.0001). At the same time, we conducted a subgroup and sensitivity analysis of age and intervention duration on the heterogeneity of total efficiency, FPG, 2hPG, HbAlc, and TCM syndrome score outcome indicators. For detecting publication bias, an egger test was conducted. Conclusion: Compared with western medicine alone, Xiaoke Decoction has more advantages for the treatment of type 2 diabetes with respect to total efficiency, FPG, 2hPG, HbAlc, and TCM syndrome score.
ABSTRACT
Objective To establish type 2 diabetes mellitus(T2DM)KM mouse models via the combined use of high-calorie diet and multiple administration of low-dose streptozotocin(STZ). Methods Based on the randomized number table,30 KM mice were equally and randomly divided into 2 groups:modeling group and control group. Mice in the modeling group were given foods with high calories for one month and injected with 30 mg/kg STZ via the left lower abdominal cavity for 2-4 consecutive days,while mice in the control group were fed with standard maintenance foods and the same dose of citrate buffer solution. The general conditions including food and water intake and mice weight were recorded. Blood glucose level was measured 1,2,4,5,12,and 21 weeks after STZ injection. When the glucose level became stabilized,the serum insulin and blood lipids [including total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein(HDL) and low-density lipoprotein(LDL)],and hemoglobin a1c (HbA1c)were measured,and oral glucose tolerance test were performed. Results The modeling group had a 100% survival rate. After STZ injection,the body weight of mice in the modeling group reached the peak in the forth week,and later the growth rate decreased,still significantly lower than that of control group mice till the 21week(t=3.160,P=0.006). Their blood glucose level was significantly higher than that of mice before STZ injection and in the control group(all P<0.05);as time went on,it was also rising,and it remained high till the 21week [(26.38±1.34)mmol/L]. In the 4week,the fasting blood glucose of mice in the modeling group was(11.86±3.33)mmol/L,which was significantly higher than that of mice in the control group [(6.37±1.27)mmol/L](t=-3.830,P=0.002). Fasting serum insulin of mice in the modeling group showed no significant difference compared with control group [(5.73±0.24)mU/L vs.(5.48±0.32)mU/L;t=-0.863,P=0.416]. Insulin sensitivity index was 0.0145±0.0039,which was significantly lower than that(0.0267±0.0039)in control group(t=4.414,P=0.003). In the 6week,the blood glucose levels of mice in the modeling group were(15.35±1.82),(26.45±1.07),(25.58±1.46),and(26.15±1.00)mmol/L 0,30,60,and 120 min after oral gavage of D-glucose,which were all significantly higher than those in the control group [(6.88±1.75)(t=-8.203,P=0.000),(17.65±2.94)(t=-6.884,P=0.000),(13.18±2.04)(t=-12.110,P=0.000),and(7.37±3.40)mmol/L(t=-12.969,P=0.000)]. In the 8week,serum TC and TG levels of mice in the modeling group were(3.83±0.06)and(2.20±0.20)mmol/L,which were significantly higher than those in the control group [(3.10±0.10)(t=11.000,P=0.000)and(0.90±0.10)mmol/L(t=10.070,P=0.000)]. HDL level of mice in the modeling group was(2.03±0.06)mmol/L,which was significantly lower than that in the control group [(2.48±0.02)mmol/L;t=11.662,P=0.000]. LDL level was increased but showed no significant difference [(0.34±0.08)mmol/L vs.(0.26±0.02)mmol/L](t=1.680,P=0.168). HbA1c content of mice in the modeling group was(7.30±0.31)%,which was significantly higher than that(4.40±0.32)% in the control group(t=-11.587,P=0.000). Conclusion KM mice models of T2DM were successfully established after high-calorie diet and multiple administration of low-dose STZ.