Meta-analysis Of Clinical Efficacy And Safety Of Huanglian Wendan Decoction In Improving Blood Glucose,Blood Lipid And Blood Pressure

Objective:To evaluate the clinical efficacy and safety of Huanglian Wendan Decoction in improving blood glucose,blood lipid and blood pressure based on Meta-analysis,so as to provide evidence-based medicine evidence for clinical practice.To preliminarily discuss the clinically commonly used doses of various drugs in the original prescription of Huanglian Wendan Decoction,and provide a reference for clinical application.Methods:Manual and electronic search of the clinical research literature published before January 1,2021 on the treatment of diabetes,pre-diabetes,hyperlipidemia and hypertension by Huanglian Wendan Decoction and its addition and subtraction.Imported the retrieved literature into the Note Express document management software to eliminate the duplicate literature.After screening,the information of the literature that met the inclusion but not the exclusion criteria was extracted,and the Cochrane risk bias assessment tool was used to evaluate the quality of the literature.Nine clinical reported outcomes,including Fasting plasma glucose（FPG）,2h postprandial plasma glucose（2h PG）,glycated hemoglobin(Hb A_1c),total cholesterol（TC）,triglyceride（TG）,low density lipoprotein（LDL-C）,high density lipoprotein（HDL-C）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,were analyzed by Rev Man5.4.1 software.Finally,the results of the Meta-analysis were explained and discussed,the safety of adverse reactions was evaluated,and the dosage of each medicine in Huanglian Wendan Decoction was counted.Results:1.A total of 556 articles were retrieved,and 26 articles were eventually collected,all of which were obtained from electronic search.They were used for the treatment of type 2 diabetes mellitus,pre-diabetes,hyperlipidemia and hypertension.The total number of subjects was 2307,including 1157 in the experimental group and 1150 in the control group.There were seven subgroups in the meta-analysis:Huanglian Wendan Decoction combined with lifestyle intervention versus lifestyle intervention alone:The efficacy of Huanglian Wendan Decoction combined with lifestyle intervention in reducing FPG（MD=-0.54,95%CI=[-0.62,-0.46],P<0.00001）,2h PG（MD=-1.09,95%CI=[-1.27,-0.90],P<0.00001）,Hb A_1c（MD=-0.81,95%CI=[-1.53,-0.10],P=0.03）,TC（MD=-0.74,95%CI=[-0.91,-0.57],P<0.00001）,TG（MD=-0.56,95%CI=[-0.74,-0.38],P<0.00001）,DBP（MD=-3.70,95%CI=[-6.88,-0.51],P=0.02）was better than that of pure lifestyle intervention.Huanglian Wendan Decoction with lifestyle intervention had the same efficacy with pure lifestyle intervention in improving LDL-C（MD=-0.42,95%CI=[-0.90,0.06],P=0.09）,HDL-C（P=0.43）and SBP（MD=-8.81,95%CI=[-18.12,0.50],P=0.06）;Huanglian Wendan Decoction combined with hypoglycaemics versus the same kind of hypoglycaemic drugs:The efficacy of Huanglian Wendan Decoction combined with hypoglycaemics in reducing FPG（MD=-1.13,95%CI=[-1.67,-0.59],P<0.0001）,2h PG（MD=-1.67,95%CI=[-2.55,-0.78],P=0.0002）,Hb A_1c（MD=-0.75,95%CI=[-0.96,-0.54],P<0.00001）,TC（MD=-0.40,95%CI=[-0.79,-0.01],P=0.04）was better than that of the same kind of hypoglycaemic drugs.Huanglian Wendan Decoction combined with hypoglycaemics had the same efficacy in improving TG（MD=-0.23,95%CI=[-0.51,0.05],P=0.11）,LDL-C（MD=-0.12,95%CI=[-0.43,0.18],P=0.43）,and HDL-C（MD=0.00,95%CI=[-0.14,0.14],P=1.00）with the same kind of hypoglycemic drugs;Huanglian Wendan Decoction versus hypoglycaemic drugs:The efficacy of Huanglian Wendan Decoction in reducing FPG（MD=-0.13,95%CI=[-0.30,0.05],P=0.15）,2h PG（MD=-0.13,95%CI=[-0.43,0.18],P=0.42）,Hb A_1c（P=0.60）,TC（P=0.25）,TG（MD=-0.16,95%CI=[-0.67,0.35],P=0.53）,LDL-C（MD=-0.27,95%CI=[-0.63,0.08],P=0.13）and increasing HDL-C（MD=-0.02,95%CI=[-0.16,0.11],P=0.73）was same as that of hypoglycaemic drugs;Huanglian Wendan Decoction combined with lipid lowering drugs versus the same kind of lipid lowering drugs:The efficacy of Huanglian Wendan Decoction combined with lipid lowering drugs was better than that of the same kind of lipid lowering drugs in reducing TC（4 weeks,P=0.02;8 weeks,P=0.04）and TG（4 weeks,P<0.00001;8 weeks,P=0.005）.When the course of treatment was 4 weeks,the efficacy of lipid lowering drugs in reducing LDL-C was better than that of the same kind of lipid lowering drugs combined with Huanglian Wendan Decoction（P<0.00001）.When the course of treatment was 8 weeks,the efficacy of Huanglian Wendan Decoction combined with lipid lowering drugs was better than that of the same kind of lipid lowering drugs（P<0.00001）.Both of them had the same efficacy in increasing HDL-C（4 weeks,P=1.00;8 weeks,P=0.55）;Huanglian Wendan Decoction versus lipid lowering drugs:The efficacy of Huanglian Wendan Decoction was better than that of lipid lowering drugs in reducing TC,TG,LDL-C and increasing HDL-C（P<0.00001）;Huanglian Wendan Decoction combined with hypotensors versus the same kind of hypotensors:The efficacy of Huanglian Wendan Decoction combined with hypotensors in reducing SBP（MD=-10.99,95%CI=[-14.50,-7.49],P<0.00001）,DBP（MD=-7.41,95%CI=[-9.87,-4.95],P<0.00001）,TC（MD=-0.61,95%CI=[-0.73,-0.49],P<0.00001）,TG（MD=-0.43,95%CI=[-0.65,-0.20],P=0.0002）,LDL-C（MD=-0.39,95%CI=[-0.51,-0.26],P<0.00001）and increasing HDL-C（MD=0.28,95%CI=[0.13,0.43],P=0.0003）was better than that of the same kind of hypotensors;Huanglian Wendan Decoction versus hypotensors:The efficacy of Huanglian Wendan Decoction was better than that of hypotensors in reducing SBP（MD=-13.64,95%CI=[-23.12,-4.15],P=0.005）and DBP（MD=-11.85,95%CI=[-20.61,-3.09],P=0.008）;2.Due to the fact that this study included less literature and complicated types of adverse reactions,the safety of Huanglian Wendan Decoction was not evaluated.3.The common dosage of Huanglian Wendan Decoction was 10g of Coptis,10g of Pinellia,10g of Zhuru,15g of Citrus aurantium,10g of Tangerine Peel,15g of Poria,5g of Licorice,and 5g of Ginger.Conclusion:1.In the treatment of type 2 diabetes mellitus and pre-diabetes,the hypoglycemic efficacy of Huanglian Wendan Decoction combined with hypoglycaemic drugs was better than that of hypoglycaemic drugs,and the hypoglycemic efficacy of Huanglian Wendan Decoction combined with lifestyle intervention was better than that of pure lifestyle intervention.2.In the treatment of hypertension,the antihypertensive efficacy of Huanglian Wendan Decoction combined with hypotensors was better than that of using hypotensors alone.3.The common dosage of Huanglian Wendan Decoction was 10g of Coptis,10g of Pinellia,10g of Zhuru,15g of Citrus aurantium,10g of Tangerine Peel,15g of Poria,5g of Licorice,and 5g of Ginger.