Verification of the Efficacy and Safety of Qi‐Replenishing Chinese Medicine in Treating Prediabetes: A Meta‐Analysis and Literature Review

Abstract

Background. Qi-replenishing Chinese medicines (QCMs) are used for treating prediabetes in the traditional Chinese medicine (TCM) clinical practice. The aims of this meta-analysis were to (i) verify the efficacy and safety of QCMs in treating prediabetes and (ii) investigate the clinical outcomes between the trials complying with and not complying with the principle of “syndrome differentiation.” Methods. We included only randomized controlled clinical trials (RCTs) whose Jadad scores were not less than 4. The overall clinical outcomes, including the incidence rate of diabetes, normalization of blood glucose, changes in fasting blood glucose (FBG), 2 h postprandial blood glucose, HbA1c, and occurrence of adverse events, were evaluated. Subgroup analyses were performed. Results. A total of 11 RCTs that enrolled 2210 patients with prediabetes were included. We observed that overall treatment with QCMs significantly ameliorated the clinical outcomes of prediabetes without increasing incidence of adverse events. The results of subgroup analyses revealed that prescribing QCMs complying with syndrome differentiation ameliorated all the clinical indices, whereas prescribing not complying with syndrome differentiation could not achieve significant amelioration in FBG and HbA1c levels. Furthermore, the subgroup with syndrome differentiation reported more adverse events. Conclusions. The overall results suggested that QCMs are effective and safe in treating prediabetes. Results of subgroup analyses indicated that the groups with syndrome differentiation presented better efficacy but had a higher occurrence of adverse events. This study indicated the important role of the principle of syndrome differentiation in TCM and that the adverse events of QCMs cannot be ignored in TCM clinical practice.

Comparative clinical-related outcomes of Chinese patent medicines for cardiac hypertrophy: A systematic review and network meta-analysis of randomized clinical trials

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Treatment options of traditional Chinese patent medicines for dyslipidemia in patients with prediabetes: A systematic review and network meta-analysis

“…Qi deficiency would cause clinical manifestations like thirst and fatigue in these patients ( Pang and Ni, 2019 ). The included TCPM all followed the basic understanding of traditional context and contained mainly herbs that have the effect of clearing Fire and benefiting Qi, thus showing some positive significance in clinical research studies and getting recommended in experts’ advice and official guidelines ( Xia et al, 2020 ). Until now, although there were some meta-analyses focusing on the clinical effectiveness and safety of TCPM for treating prediabetes ( Pang et al, 2017 ; Pang et al, 2018 ; Jiang et al, 2022 ), the general shortcomings still existed: 1) the main outcome was blood glucose indicators, such as glycosylated hemoglobin, FBG, and PBG, with insufficient emphasis on lipids.…”