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1.
ObjectiveTo assess the efficacy of Da Chaihu decoction combined with metformin tablets on patients with type 2 diabetes compared with metformin alone.MethodsThis systematic review and meta‐analysis is written based on 2020 PRISMA Extension for Chinese Herbal Medicines 2020 (PRISMA-CHM 2020) reporting guidelines. We reviewed all the relevant studies from a search of the following databases from inception to February 2022 without any language restriction: Excerpta Medica Database (EMBASE), Google Scholar, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Information, Wanfang Data, and the Chinese Biomedical Literature Database(CBM). Data were extracted and the quality was independently evaluated by two reviewers, based on the inclusion and exclusion criteria. Data were analyzed using the Cochrane software RevMan 5.3.ResultsSix randomized controlled trials comprising 516 participants were included.The meta‐analysis revealed the Da Chaihu decoction combined with metformin tablets group was significantly superior to the metformin tablets group in terms of fasting blood glucose(FPG) (−0.66 mmol/L; 95 % CI (confidence intervals) [− 1.28, − 0.04]), plasma glucose 2 h after meal (2-h PG) (−1.18 mmol/L; 95 % CI [−1.94, −0.42]) in six RCTs, body mass index (BMI) (−3.07 mmol/L; 95 % CI [−6.89, 0.75]) in three RCTs, glycosylated hemoglobin (HbAlc) (−0.36 mmol/L; 95 % CI [−1.04, 0.31]) in three RCTs, and triglycerides (TG) (−0.76 mmol/L; 95 % CI [−1.37, −0.15]) in two RCTs. In two RCTs, there were significant differences in terms of total cholesterol (TC) (−0.97 mmol/L; 95 % CI [−1.18, −0.76]).ConclusionsVery low-quality research shows that Da Chaihu decoction combined with metformin tablets exert a certain level of efficacy on patients with type 2 diabetes compared with metformin alone. However, random sequence generation methodology was reported in five studies leading to the low quality of the included studies. None of the six studies depicted the blinding method, allocation concealment, selective reporting, and assessed the purity and potency of the product. This observation requires verification through high-quality, multi-center, double-blinded randomized controlled trials, and assesses the purity and potency of the product.  相似文献   
2.

Background

There is evidence linking metformin to improved prostate cancer–related outcomes.

Patients and Methods

Twenty-five men with metastatic castration-resistant prostate cancer and prostate-specific antigen (PSA) progression while receiving treatment with abiraterone from 3 Swiss centers were included in this single-arm phase 2 trial between November 2013 and September 2016. Metformin was added to abiraterone continuously at 1000 mg twice daily in uninterrupted 4-week cycles. The primary end point was the absence of disease progression at 12 weeks (PFS12). The Fleming single-stage design was applied. With a 5% significance level and 80% power, 25 patients were required to test PFS12 ≤ 15% (H0) compared to ≥ 35% (H1). Secondary end points included toxicity and safety issues. The study was registered at ClinicalTrials.gov (NCT01677897).

Results

The primary end point PFS12 was 12% (3 of 25 patients) (95% confidence interval, 3-31). Most patients had PSA progression, almost half had radiographic progression, but only 1 patient had symptomatic progression. Eleven (44%) of 25 patients had grade 1 and 2 patients each grade 2 (8%) or grade 3 (8%) gastrointestinal toxicity (nausea, diarrhea, loss of appetite). One patient discontinued treatment at week 5 because of intolerable grade 3 diarrhea.

Conclusion

The addition of metformin to abiraterone for patients with metastatic castration-resistant prostate cancer and PSA progression while receiving abiraterone therapy does not affect further progression and has no meaningful clinical benefit. A higher-than-expected gastrointestinal toxicity attributed to metformin was observed.  相似文献   
3.
目的探讨格列美脲联合二甲双胍对老年糖尿病的治疗作用。方法100例老年糖尿病患者,随机分为二甲双胍组与格列美脲联合二甲双胍组,各50例。二甲双胍组患者采取二甲双胍治疗,格列美脲联合二甲双胍组采取格列美脲联合二甲双胍治疗。比较两组疗效;空腹、餐后血糖达标时间和糖化血红蛋白降低至<6%时间;治疗前后患者血糖、血脂;不良反应发生率。结果格列美脲联合二甲双胍组总有效率为100.00%,高于二甲双胍组的82.00%,差异有统计学意义(P<0.05)。治疗后,格列美脲联合二甲双胍组患者的餐后2 h血糖、空腹血糖、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均低于二甲双胍组,差异有统计学意义(P<0.05)。格列美脲联合二甲双胍组空腹、餐后血糖达标时间和糖化血红蛋白降低至<6%时间均短于二甲双胍组,差异有统计学意义(P<0.05)。格列美脲联合二甲双胍组用药期间出现腹泻症状1例(2.00%);二甲双胍组用药期间出现腹泻症状1例(2.00%),两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论格列美脲联合二甲双胍治疗老年糖尿病效果确切,可有效改善血糖和血脂,且无明显不良反应,安全性高。  相似文献   
4.
目的探讨Nrf2基因在对顺铂耐药的肺腺癌细胞中的表达及二甲双胍对其调控作用的研究。方法应用细胞增殖实验(CCK-8)和流式细胞仪,检测二甲双胍对肺腺癌A549和A549/DDP细胞增殖抑制率、凋亡率,RealtimePCR检测相关耐药基因表达,Western Blot法检测相关蛋白水平表达。结果Nrf2、GSTA1、ABCC1等基因在A549、A549/DDP细胞间表达存在显著差异,在A549/DDP细胞中呈高表达;二甲双胍能够抑制A549、A549/DDP细胞Nrf2及下游GSTA1、ABCC1基因的表达,并进一步抑制细胞增殖和诱导A549/DDP细胞凋亡。结论Nrf2基因及下游基因在肺腺癌细胞不同细胞株表达存在差异,二甲双胍可影响其表达。  相似文献   
5.
目的探讨利拉鲁肽治疗2型糖尿病合并多囊卵巢综合征的临床效果。方法选择2018年1月—2019年6月收治的2型糖尿病合并多囊卵巢综合征患者60例为对象,随机数表法将其分成对照组(n=30)和观察组(n=30)。对照组用二甲双胍治疗,观察组用二甲双胍联合利拉鲁肽治疗,治疗当天和治疗24周时,检测两组患者体内空腹血糖(FPG)、餐后2血糖(2 hPG)和糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)与促卵泡生成素(FSH)及黄体生成素(LH),比较两组患者用药后的不良反应发生率。结果治疗后两组的FPG、2 hPG与HbA1c、HOMA-IR及FSH、LH低于治疗前,观察组的FPG、2 hPG与HbA1c、HOMA-IR与FSH、LH低于对照组,差异有统计学意义(P<0.05)。两组用药后的不良反应发生率比较,差异无统计学意义(P>0.05)。结论2型糖尿病合并多囊卵巢综合征患者在用二甲双胍治疗时,联合利拉鲁肽治疗的效果更显著,可明显降低血糖水平和胰岛素抵抗指数,促使患者体内的性激素水平得到改善,不良反应少,用药安全性高。  相似文献   
6.
BackgroundAn estimated 35 million individuals in the United States have diabetes. The American Diabetes Association recommends metformin as first-line pharmacologic treatment. The primary objective of this study was to evaluate the metformin initiation rate in veterans with recently identified type 2 diabetes.MethodsVeterans with new onset type 2 diabetes were identified using National Veterans Health Administration Data. Retrospective information was obtained from those with a first A1C ≥ 6.5% (48 mmol/mol) between 2013 and 2018. Veterans with at least one additional A1C < 6.5% (48 mmol/mol) documented in the three years prior to the A1C diagnostic for diabetes were included in the analysis.ResultsA total of 144,180 veterans were included. Of those, 45,776 (31.7%) were started on metformin within one year of diabetes diagnosis. The median time to metformin initiation was 12 days and median time to initiation of any anti-hyperglycemic was 11 days. Approximately 16,000 veterans were referred for lifestyle interventions within 90 days.ConclusionMetformin initiation occurred in fewer patients than expected given metformin is a generic, well-tolerated medication recommended as first-line pharmacologic treatment option regardless of A1C. Further studies are needed to assess the barriers of initiating metformin at time of diabetes diagnosis.  相似文献   
7.

Objectives

To determine the incidence of metformin-induced lactic acidosis during the period January 2014 to March 2017 in Aragon Healthcare Area III. To analyse the associated clinical and analytical factors and mortality.

Results

A total of 31 cases (61.3% males). Incidence: 79.76 cases/100,000 patients-year; mean age 75.39±9.34 years; 23 of them with levels of serum metformin (21.91±15.52 mcg/ ml); milligrams/day of metformin ingested: 1790.32 ± 499; 96.8% of cases in the context of acute kidney failure; 11 cases with a history of chronic kidney disease (35.5%); 12 required intensive care (38.7%); 13 required purification treatment (41.9%; 3 haemodiafiltration, 10 haemodialysis). There was a significant correlation between daily milligrams of metformin ingested and drug levels; levels of metformin; and peak creatinine, pH and lactate. Mortality was 25.8%. There were only significant differences between the deceased and survivors regarding the duration of stay and final creatinine. Multivariate logistic regression did not detect any study variables associated with mortality.

Conclusions

The incidence in our healthcare area is higher than in other series, with a 25.8% mortality rate. Virtually all cases were in the context of prerenal acute kidney failure. In 29% of cases, there was an overdose. Patients must be warned about the most common lactic acidosis-inducing situations, especially dehydration, if they continue taking the drug at such times.  相似文献   
8.
目的:探析2型糖尿病患者采取参芪降糖颗粒联合二甲双胍进行治疗的降糖效果。方法:选取2016年1月至2019年10月马鞍山市中心医院收治的2型糖尿病患者66例作为研究对象,按照随机数字表法分为对照组与观察组,每组33例,对照组通过二甲双胍进行治疗,观察组通过二甲双胍联合参芪降糖颗粒进行治疗,比较2组患者治疗总有效率、血糖参数、不良反应发生率等指标。结果:对照组、观察组的治疗总有效分别为75.76%、93.94%,与对照组比较,观察组的治疗总有效率明显较高(P<0.05);观察组的空腹血糖、餐后2 h血糖等血糖参数在治疗后明显低于对照组患者(P<0.05);对照组、观察组的治疗不良反应发生率分别为21.21%、3.03%,观察组治疗不良反应发生率明显低于对照组(P<0.05)。结论:2型糖尿病患者采取参芪降糖颗粒联合二甲双胍进行治疗能够获得较为理想的效果,可明显改善血糖指标,安全性较高,对改善患者的治疗预后有着促进的作用。  相似文献   
9.
目的:建立盐酸二甲双胍肠溶胶囊中二甲胺残留量的柱前衍生HPLC测定方法.方法:用十八烷基硅烷键合硅胶为填充剂,以1.0%甲酸溶液-乙腈为流动相,采用梯度洗脱程序,检测波长为265 nm.结果:在选定的色谱条件下,二甲胺在0.254~4.065μg·mL-1的浓度范围内线性关系良好(r>0.999);精密度试验的RSD为1.6%,稳定性试验的RSD为1.5%;回收率为100.3%(n=9,RSD<1.5%).二甲胺的检测限为0.0508μg·mL-1,在测定的3批样品中,3批均检出二甲胺分别为0.01%,0.04%,0.02%.结论:本方法专属性强,准确度高,重现性好,能控制盐酸二甲双胍肠溶胶囊中二甲胺残留量.  相似文献   
10.
目的 探讨二甲双胍对甲状腺乳头状癌TPC-1细胞凋亡的影响及其机制。方法 用不同浓度(0mmol/L、1mmol/L、5mmol/L、10mmol/L、20mmol/L、40mmol/L)二甲双胍分别处理TPC-1细胞24h。采用四甲基偶氮唑蓝(MTT)法检测细胞增殖能力;采用Annexin Ⅴ-FITC/PI流式细胞术检测不同浓度二甲双胍对TPC-1细胞凋亡的影响,同时在40mmol/L组加入腺苷酸活化蛋白激酶(AMPK)抑制剂Compound C,观察其对TPC-1细胞凋亡的影响;采用Western blot法检测磷酸化AMPK(p-AMPK)及Caspase-9蛋白的表达。结果 与0mmol/L组比较,1mmol/L及5mmol/L组的TPC-1细胞增殖能力无明显改变(P>0.05);而10mmol/L、20mmol/L、40mmol/L二甲双胍均可明显抑制TPC-1细胞的增殖能力,且呈剂量依赖性(P<0.05)。与0mmol/L组比较,不同浓度二甲双胍均可明显增加TPC-1细胞凋亡率(P<0.001);而加入Compound C后,40mmol/L组TPC-1细胞凋亡率较前明显下降(P<0.001)。与0mmol/L组比较,1mmol/L、5mmol/L、10mmol/L、20mmol/L、40mmol/L组p-AMPK、Caspase-9表达量增加。结论 二甲双胍可诱导甲状腺乳头状癌TPC-1细胞凋亡,且二甲双胍诱导TPC-1细胞凋亡的过程可能与激活AMPK通路有关,可能由Caspase-9介导。  相似文献   
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