Gegen Qinlian decoction ameliorates insulin resistance in type 2 diabetes: A systematic review and meta-analysis of RCTs with mechanistic insights into SIRT1/AMPK pathway activation
Abstract
Ethnopharmacological relevance: Gegen Qinlian Decoction (GQD,also known as Gegen Qinlian Tang), a classical Traditional Chinese Medicine formula documented in Zhang Zhongjing's "Treatise on Cold Damage" (circa 200 CE), has been used for nearly two millennia to treat conditions characterized by "damp-heat" patterns, which correspond to modern metabolic disorders including type 2 diabetes mellitus (T2DM). Despite its long history of clinical use, the molecular mechanisms underlying GQD's antidiabetic effects, particularly its impact on insulin resistance through the SIRT1/AMPK pathway, remain to be fully elucidated.
Aim of the study: The novelty of this study lies in its pioneering approach of combining a large-scale meta-analysis with molecular docking validation for the first time. This research aims to provide high-quality evidence for GQD's clinical efficacy in improving insulin resistance and to uncover its direct interaction mechanism with the SIRT1/AMPK signaling pathway.
Materials and methods: We conducted a systematic search of six databases (PubMed, EMBASE, Cochrane Library, CNKI, WanFang, VIP) from inception to October 2024. Randomized controlled trials (RCTs) evaluating GQD for T2DM with insulin resistance were included following PICO principles. Study quality was assessed using Cochrane ROB 2.0 tool. Meta-analysis was performed using RevMan 5.4 and Stata 16.0, calculating standardized mean differences (SMD) with 95 % confidence intervals (CI). Molecular docking…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,247 participants or records.
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