RESUMEN
BACKGROUND: Currently, most studies on the health benefits of traditional Chinese exercises on type 2 diabetes mellitus have explored the effects of a single type of traditional Chinese exercise on type 2 diabetes. Although a previous study evaluated the combined clinical effects of traditional Chinese exercises on type 2 diabetes, the studies included in that review were deficient in their study design. In addition, previous studies have not explored the ideal exercise dose that should be taken by patients with type 2 diabetes when performing traditional Chinese exercises. OBJECTIVE: To understand whether the findings of previous systematic reviews and meta-analyses are still applicable and to try to address the deficiencies in the previous review, this review conducted a meta-analysis of existing randomized controlled trials to investigate the impact of traditional Chinese exercises on glycemic control with type 2 diabetes. METHODS: The literature was searched in seven Chinese and English databases. Randomized controlled trials published in English and Chinese, from database inception to March 2023, were included in this review. Two reviewers independently reviewed the search results, extracted the data, and assessed the risk of bias. A meta-analysis of the included studies was conducted using Rev Man 5.4 and Stata 15.1 software. Heterogeneity was investigated using a sensitivity analysis, a subgroup analysis, and a meta-regression analysis. Pre-determined subgroups included the duration of the intervention, frequency of exercise, and duration of the single exercise session. RESULTS: A total of 31 randomized controlled trials (2077 subjects) were selected in this review. The meta-analysis revealed that traditional Chinese exercises were more effective than control groups in lowering glycated hemoglobin (Z = 6.06; mean difference [MD] = - 0.64, 95% confidence interval [CI] - 0.85, - 0.44; P < 0.00001), fasting blood glucose (Z = 7.81; MD = - 0.82, 95% CI - 1.03, - 0.62; P < 0.00001), 2-h plasma glucose (Z = 5.61; MD = - 1.03, 95% CI - 1.39, - 0.67; P < 0.00001), total cholesterol (Z = 4.23; MD = - 0.37, 95% CI - 0.54, - 0.20; P < 0.0001), high-density lipoprotein cholesterol (Z = 5.94; MD = 0.12, 95% CI 0.08, 0.16; P < 0.00001), low-density lipoprotein cholesterol (Z = 6.20; MD = - 0.34, 95% CI - 0.44, - 0.23; P < 0.00001), and triglyceride levels (Z = 3.74; MD = - 0.44, 95% CI - 0.67, - 0.21; P = 0.0002) among patients with type 2 diabetes. CONCLUSIONS: Traditional Chinese exercises can significantly improve blood glucose and lipid levels in patients with type 2 diabetes. When performing traditional Chinese exercise interventions for type 2 diabetes, it is recommended that exercise programs are designed for 30-50 min/session, 4-5 sessions/week for at least 3 months.
RESUMEN
BACKGROUND: Most studies about exercise interventions for patients with type 2 diabetes mellitus (T2DM) have been conducted in hospitals or labs, but it is unclear whether study findings from this specific condition can be generalised to real-life T2DM communities. If patients with T2DM can exercise on their own or with family members, it may also reduce the need for patient supervision by medical staff, thereby reducing the burden of medical treatment and improving condition management's cost-effectiveness and practicability. Much of the current research on exercise interventions for T2DM was focused on the type of exercise and less on the mode of management, so we aimed to examine the effect of exercise interventions based on family management or self-management on glycaemic control in patients with T2DM. METHODS: Articles were searched from eight Chinese and English databases. Randomized control trials (RCTs) published in English and Chinese, from inception to October 17, 2022, were included in this review. The methodological quality of the included studies was assessed using the RCT risk of bias assessment tool provided by the Cochrane Collaboration's tool. Meta-analysis was performed using Rev Man 5.4 and Stata 15.0 software. Heterogeneity was investigated using sensitivity analysis and subgroup analyses. Publication bias was tested by funnel plot and Egger's asymmetry tests. RESULTS: A total of 10 studies with a total of 913 subjects were finally included in this review. The Meta-analysis showed that exercise interventions based on family management or self-management were more effective than control groups in reducing HbA1c (Z = 3.90; 95% CI MD = - 0.81; - 1.21 to - 0.40; P < 0.0001), fasting glucose (Z = 4.63; 95% CI MD = - 1.17; - 1.67 to - 0.68; P < 0.00001), 2-h plasma glucose (Z = 5.53; 95% CI MD = - 1.84; - 2.50 to - 1.19; P < 0.00001), and Low-density lipoproteins levels (Z = 3.73; 95% CI MD = - 0.38; - 0.58 to - 0.18; P = 0.0002). CONCLUSIONS: Exercise interventions based on family management or self-management can significantly reduce glycosylated haemoglobin, fasting glucose, 2-h plasma glucose, and Low-density lipoproteins levels in patients with T2DM, which can effectively delay disease progression and reduce the risk of developing complications. In the future, for exercise interventions based on family or self-management, this review recommended that exercise intervention programmes should be formulated according to 30-60 min per session, more than three times per week, for more than six months of aerobic exercise or aerobic combined with resistance exercise.
RESUMEN
Objective: Most of the studies on the herb Chuanxiong Rhizoma (CR) have focused on the l-arginine-nitric oxide (NO) pathway, but the nitrate-nitrite-NO (NO3 --NO2 --NO) pathway was rarely investigated. Therefore, the aim of this study was to evaluate the effects and mechanisms of action of CR in coronary artery disease (CAD). Methods: The NO3 -, NO2 - and NO levels were examined in the NO3 --NO2 --NO pathway. High-performance ion chromatography was used to quantify NO3 - and NO2 - levels. Then, NO was quantified using a multifunctional enzyme marker with a fluorescent probe. The tension of aortic rings was measured using a multi myograph system. Results: High content of NO3 - and low content of NO2 - was found in CR, and which could potently convert NO3 - to NO2 - in the presence of endogenous reductase enzyme. Incubating human coronary artery endothelial cells (HCAECs) with CR-containing serum showed that CR significantly decreased the NO3 - content and increased the levels of NO2 - and NO in the cells under hypoxic conditions. In addition, CR significantly relaxed isolated aortic rings when the l-arginine -NO pathway was blocked. The optimal concentration of CR for relaxation was 200 mg/mL. Conclusion: CR supplements large amounts of NO in cells and vessels to achieve relaxation via the NO3 --NO2 --NO pathway, thereby making up for the deficiency caused by the lack of NO after the l-arginine-NO pathway is suppressed. This study also supports the potential use of a traditional Chinese herb for future drug development.