目的：糖尿病為臨床常見的慢性病之一，為國人十大死因第五名，國人糖尿病盛行率現已高於全球平均，除了西藥，研究顯示臺灣有77.9% 糖尿病人曾接受中藥治療，而「六味地黃丸」為最常使用之中藥，糖尿病治療目標之重點為血糖控制及降低其他併發症之產生，故本研究目的為探討使用六味地黃丸作為第二型糖尿病人之中藥治療的臨床效益。
方法：本研究搜尋之資料庫為PubMed、Embase、Ebscohost/CINAHL、Cochrane Library 及華藝線上圖書館 (Airiti Library)、搜尋時間軸為西元2011年1月至2022年3月止，中文關鍵字使用「六味地黃丸」及「糖尿病」，英文關鍵字則使用「Liuwei Dihuang Wan」或「Rehmannia Six Formula」或「Six-Ingredient Rehmannia」及「diabetes」。
結果：總計得到191篇文獻，排除55篇重複文章，共136篇文獻進入初步篩選，初步篩選後排除110篇文獻，共26篇文獻進入全文閱覽評估，全文閱覽後排除19篇文獻，最終為7篇文獻進入系統性文獻回顧。六味地黃丸於人體試驗上皆呈現有降低血糖、維持腎功能之效果。
結論：六味地黃丸對第二型糖尿病人的血糖及腎功能指標皆有改善，惟國內尚缺實證證據較佳的人體試驗，未來研究應以多國多中心試驗或雙盲試驗邁進，並記錄有無藥物不良反應，六味地黃丸之加減方也是常用複方，有研究指出某些衍生方對血糖之控制效果優於六味地黃丸，期待做為未來之研究方向。
Objective: Diabetes is a prevalent chronic disease worldwide, ranking fifth among the top ten causes of death in Taiwan. Traditional Chinese medicine (TCM) has been widely used by 77.9% of patients for the treatment of type 2 diabetes, with Liuwei Dihuang Wan being the most commonly prescribed formula. This study aimed to evaluate the clinical efficacy of Liuwei Dihuang Wan in type 2 diabetic patients.
Methods: A comprehensive search was conducted in PubMed, Embase, Ebscohost/CINAHL, Cochrane Library, and Airiti Library for studies published between January 2011 and March 2022. The search terms “Liuwei Dihuang Wan” or “Rehmannia Six
Formula” or “Six-Ingredient Rehmannia” in both English and Chinese, combined with “diabetes” were used.
Results: A total of 191 studies were initially identified and retrieved. After two rounds of screening, seven human trial studies were included in the systematic review. Liuwei Dihuang Wan demonstrated clinical efficacy in reducing blood glucose and urine protein levels, indicating its potential in maintaining renal function.
Conclusion: Liuwei Dihuang Wan shows promise in controlling blood glucose levels and preserving kidney function in patients with type 2 diabetes. Healthcare practitioners may consider incorporating Liuwei Dihuang Wan into the treatment
regimen for type 2 diabetes. Additionally, studies have suggested that derivative formulas based on Liuwei Dihuang Wan exhibit excellent clinical efficacy in blood glucose control, providing new research avenues for further exploration.
Submitted for publication: 2022.9.1; Accepted for publication: 2023.3.1
