Pueraria lobata radix (Ge Gen)-containing traditional Chinese medicine prescriptions for the treatment of nonalcoholic fatty liver disease: A systematic review and meta-analysis

Abstract

Introduction

This study aimed to systematically evaluate the effectiveness and safety of Pueraria lobata radix (Chinese name: Ge Gen)-containing prescriptions (GGPs) for the treatment of nonalcoholic fatty liver disease (NAFLD).

Methods

Seven databases were searched for randomized controlled trials (RCTs) comparing the effectiveness of GGPs plus basic therapies (Western medicines or lifestyle interventions) versus the same basic therapies in patients with NAFLD. The primary outcomes were liver function indicators, and the secondary outcomes included metabolism indicators, severity of symptoms, and incidence of adverse events. The effects were measured as weighted mean differences (WMDs), standard mean differences (SMDs), and 95 % confidence intervals (CIs).

Results

Eighteen RCTs involving 1,991 patients were included. Meta-analysis results showed that compared to the control group, the GGP group had a significant improvement in liver function (aspartate aminotransferase: WMD -9.60 U/L, 95 % CI -14.96 to -4.25; alanine aminotransferase:6.30 U/L, 95 % CI -9.57 to -3.02; gamma-glutamyl transferase:6.35 U/L, 95 % CI -10.44 to -2.25), blood lipid levels (total cholesterol: WMD -0.68 mmol/L, 95 % CI -0.88 to -0.49; triglycerides:0.61 mmol/L, 95 % CI -0.84 to -0.38; low-density lipoprotein cholesterol:0.42 mmol/L, 95 % CI -0.56 to -0.27; high-density lipoprotein cholesterol: 0.34 mmol/L, 95 % CI 0.21 to 0.47), body mass index (WMD -0.79 kg/m², 95 % CI -1.38 to -0.19), blood glucose levels (fasting blood glucose: WMD -1.03 mmol/L, 95 % CI -1.52 to -0.44; 2-hour postprandial blood glucose:1.06 mmol/L, 95 % CI -1.68 to -0.28; glycosylated hemoglobin:0.56 %, 95 % CI -0.85 to -0.28; homeostatic model assessment of insulin resistance:0.85 mmol/L, 95 % CI -1.15 to -0.56; fasting insulin:2.34 mmol/L, 95 % CI -3.14 to -1.55), and symptom severity scores (SMD -1.91, 95 % CI -2.48 to -1.34). The GGP group reported six mild adverse events, including diarrhea, nausea, and stomach discomfort.

Conclusion

GGPs, as an adjunct therapy for NAFLD, may improve liver function, metabolic parameters, and clinical symptoms, with good safety. However, the quality of evidence was moderate-to-very low owing to the presence of a moderate-to-high risk of bias and significant heterogeneity.