Introduction

Type 2 diabetes mellitus (T2DM) is characterized by defects in insulin action and secretion. Bauhinia forficata has been observed to exhibit an effect in diabetes treatment due to its hypoglycemic activity. This systematic review with meta-analysis aimed to assess the effects of using Bauhinia forficata Link as an adjuvant treatment for individuals with T2DM.

Methods

We conducted a comprehensive search strategy using relevant keywords and their synonyms, focusing on "Bauhinia forficata" and "diabetes mellitus." The search encompassed online databases such as Medline, Embase via OVID, and the Cochrane Library, without imposing language restrictions. We included studies that evaluated individuals diagnosed with T2DM, who were administered Bauhinia forficata compared to placebo or active control, and who presented glycemia and glycated hemoglobin as outcome measures. Studies not meeting these criteria, as well as literature reviews, animal or in vitro experiments, were excluded. The methodological quality of the included studies was assessed using the Risk of Bias 2 tool. The results were presented through tables and graphs, and forest plots were generated to illustrate the effects of interventions on various outcomes, using RevMan software 5.4.

Results

Four studies met the inclusion criteria, comprising two randomized controlled trials (RCT) and two non-randomized studies of interventions (NRSI). Compared to placebo, Bauhinia forficata significantly improved glycemia (SMD -0.60, 95% CI -0.15 to -1.05, p=0.009, 1 RCT, n=111, low certainty evidence; SMD -0.64, 95% CI -1.25 to -0.03, p=0.04, I²=42%, 2 NSRIs pre-test/post-test, n=40, very low certainty evidence). However, only the RCT evidence demonstrated significant improvements in HbA1c (SMD -0.48, 95% CI -0.93, p=0.03, 1 RCT, n=111, low certainty evidence; SMD -0.25, 95%CI -0.69 to 0.19, p-0.27, I²=0%, 2 NSRIs pretest/post-test, n=40, very low certainty evidence). No differences were found between Bauhinia forficata and Imperata brasiliensis (glycemia SMD -0.03, 95% CI -1.01 to 0.95, p=0.96, 1 RCT, n=16, very low certainty evidence; HbA1c SMD 0.06, 95% CI -0.92 to 1.04, p=0.96, 1 RCT, n=16, very low certainty evidence).

Conclusions

The findings suggest that Bauhinia forficata may be effective in reducing blood glucose levels; however, this evidence needs to be interpreted with caution.

PROSPERO registration

CRD42022370143.

中文翻译：

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紫荆辅助治疗2型糖尿病的效果评价：系统评价和荟萃分析

介绍

2 型糖尿病 (T2DM) 的特点是胰岛素作用和分泌缺陷。由于其降血糖活性，洋紫荆已被观察到在糖尿病治疗中表现出效果。这项荟萃分析系统综述旨在评估使用Bauhinia forficata Link作为 T2DM 患者辅助治疗的效果。

方法

我们使用相关关键词及其同义词进行了全面的搜索策略，重点关注“Bauhinia forficata”和“diabetes mellitus”。检索涵盖了 Medline、Embase via OVID 和 Cochrane 图书馆等在线数据库，没有语言限制。我们纳入的研究评估了诊断为 T2DM 的个体，将紫荆花与安慰剂或活性对照进行比较，并以血糖和糖化血红蛋白作为结果指标。不符合这些标准的研究以及文献综述、动物或体外实验均被排除在外。使用偏倚风险 2 工具评估纳入研究的方法学质量。结果通过表格和图表呈现，并使用 RevMan 软件 5.4 生成森林图来说明干预措施对各种结果的影响。

结果

四项研究符合纳入标准，其中包括两项随机对照试验（RCT）和两项非随机干预研究（NRSI）。与安慰剂相比，紫荆花显着改善血糖（SMD -0.60，95% CI -0.15 至 -1.05，p=0.009，1 项 RCT，n=111，低确定性证据；SMD -0.64，95% CI -1.25 至 -0.03 ，p=0.04，I²=42%，2 个 NSRI 测试前/测试后，n=40，质量非常低的证据）。然而，只有 RCT 证据显示 HbA1c 显着改善（SMD -0.48，95% CI -0.93，p=0.03，1 个 RCT，n=111，低确定性证据；SMD -0.25，95% CI -0.69 至 0.19，p -0.27，I²=0%，2 个 NSRI 预测试/后测试，n=40，质量非常低的证据）。紫荆花和白茅之间没有发现差异（血糖 SMD -0.03，95% CI -1.01 至 0.95，p=0.96，1 项 RCT，n=16，质量证据极低；HbA1c SMD 0.06，95% CI -0.92 至 0.95） 1.04，p=0.96，1 个 RCT，n=16，质量极低的证据）。

结论

研究结果表明紫荆花可能有效降低血糖水平；然而，需要谨慎解释这一证据。

普洛斯彼罗注册

CRD42022370143。