ABSTRACT
Background: diabetes mellitus (DM) is a chronic disease and its pathogenesis is still inconclusive. Current evidence suggests an association between intestinal flora and type-2 diabetes mellitus (T2DM). In this paper, we summarized the current research, determining whether intestinal flora may become a new method to treat T2DM, and providing a theoretical basis and literature references for the prevention of T2DM based on the regulation of intestinal flora. Method: we carried out a review based on 13 published clinical trials to determine the correlation between T2DM and intestinal flora, and between changes in clinical outcomes and in intestinal flora in the development of T2DM; to assess the pathological mechanisms; and to discuss the treatment of diabetes based on intestinal flora. Results: we found that intestinal flora is involved in the occurrence and development of T2DM. Several pathological mechanisms may be involved in the process, including improving the gut barrier, alleviating inflammation, increasing glucagon-like peptide (GLP) 1 and GLP 2, increasing the production of short-chain fatty acids (SCFAs), and so on. Several measures based on intestinal flora, including exercise, food, specific diets, drugs and probiotics, would be used to treat and even prevent T2DM. Conclusions: high-quality studies are required to better understand the clinical effects of intestinal flora in T2DM(AU)
Antecedentes: la diabetes mellitus (DM) es una enfermedad crónica cuya patogénesis no está clara. La evidencia actual sugiere una asociación entre la flora intestinal y la diabetes mellitus de tipo 2 (DMT2). Este artículo revisa la investigación actual para determinar si la flora intestinal puede ser un nuevo método de tratamiento de la diabetes mellitus de tipo 2 y proporciona la base teórica y las referencias de la literatura para la prevención de la diabetes mellitus de tipo 2 basada en la regulación de la flora intestinal. Métodos: se revisaron 13 ensayos clínicos publicados para determinar la correlación entre la DMT2 y la flora intestinal, los cambios en los resultados clínicos y los cambios en la flora intestinal durante el desarrollo de la DMT2; para resumir su mecanismo patogénico; y, desde el punto de vista de la flora intestinal, para explorar el tratamiento de la diabetes. Resultados: se encontró que la flora intestinal estaba involucrada en el desarrollo de la diabetes mellitus de tipo 2. Este proceso puede implicar una variedad de mecanismos patológicos, incluyendo la mejora de la barrera intestinal, la reducción de la inflamación, el aumento del péptido similar al glucagón (GLP) 1 y GLP 2, y el aumento del rendimiento de los ácidos grasos de cadena corta (SCFA). Algunas medidas basadas en la flora intestinal, como el ejercicio, los alimentos, las dietas especiales, los medicamentos y los probióticos, se utilizarán para tratar e incluso prevenir la DMT2. Conclusión: se necesitan estudios de alta calidad para comprender mejor los efectos clínicos de la flora intestinal en los pacientes con diabetes mellitus de tipo 2 (AU)
Subject(s)
Humans , Diabetes Mellitus, Type 2/drug therapy , Gastrointestinal Microbiome , Glucagon-Like Peptide 1 , Probiotics/therapeutic use , Clinical Trials as Topic , Fatty Acids, VolatileABSTRACT
Objective: This paper analyzed the present clinical researches of traditional Chinese medicine (TCM) in the treatment of heart failure caused by coronary heart disease and discusses the ideas and methods of evidence-based optimization. Methods: PubMed, EMBASE, Cochrane Library, CNKI, WanFang, VIP and CBM were searched to screen the clinical studies of TCM for treating heart failure caused by coronary heart disease. The problems and solutions were discussed by evaluating the risk of bias of the studies and analyzing the outcomes compared with the Cochrane systematic reviews of chronic heart failure. Results: A total of 32 clinical researches were included and the methodological quality of the studies was generally low. In addition, few studies assessed the endpoint events, mortality and readmission, as the primary outcomes in their trials, which is significantly different from the outcomes concerned in the Cochrane systematic reviews. Conclusion: It is really critical to improve the methodological quality of the trials and to choose the endpoint events as the primary outcomes in the evidence-based optimization of the prevention and treatment of TCM for heart failure caused by coronary heart disease Chinese medicine.
ABSTRACT
Objective: To summarize the clinical effects of Shuxuening Injection on diseases and evaluate the quality of evidence to provide reference for the clinical application of Shuxuening Injection. Methods: Journal articles and conference papers were retrieved from the databases CNKI, Wanfang, VIP, CBM, EMbase, Pubmed and Cochrane with thematic word"Shuxuening"in Chinese and English, then all forms of clinical studies were screened and the disease types and frequency were analyzed, the dominant disease types of Shuxuening Injection were identified. Futhermore, RCT was extracted, and the literature quality was graded using the cochrane manual recommendation method, and its effectiveness and safety were evaluated. Results: All clinical research results show that Shuxuening Injection to treat disease with as many as 74 kinds of varieties, mainly circulation system disease and neural system disease, followed by endocrine disease, respiratory disease, scattered remaining research in ten other system diseases. These researches appeared with the highest frequency of the three diseases were cerebral infarction and its aftermath, angina pectoris and coronary heart disease, diabetes mellitus and its complication. A total of 337 RCT articles were included, all of which were of poor quality. In general, the efficiency of Shuxuening Injection treatment group was significantly higher than that of the control group, with a total efficiency of 84.48％. There were 21.96％ references to adverse reactions, but all of them were minor adverse reactions, such as pruritus, which generally got better by itself or after treatment. Conclusion:Shuxuening Injection has a wide range of clinical application and remarkable effect, especially for the ischemic diseases of cardiovascular and cerebrovascular diseases with good efficacy, less adverse reactions and safety. However, the quality of evidence is generally poor, which needs further study.
