目的 基于Meta分析和网络药理学研究方法，评价黄连阿胶汤治疗2型糖尿病（T2DM）的临床疗效，初探其作用机制。方法 首先全面检索CNKI、VIP、Wanfang、PubMed、The Cochrane Library和Web of science数据库，查找截至2020年5月的黄连阿胶汤治疗T2DM的随机对照试验，根据Cochrane风险偏倚评估工具对纳入的文献进行评价，采用Review Manager软件进行定量合成；而后基于网络药理学，筛选黄连阿胶汤中的化学成分及其作用靶点，与T2DM靶点映射对比后利用生物信息学技术进行关键通路的相关注释，探讨黄连阿胶汤治疗T2DM的潜在机制。结果 Meta分析纳入15篇随机对照试验（RCTs），共计1 254例受试者，结果显示，西药常规治疗的基础上联合使用黄连阿胶汤可显著提高有效率，且降血糖和调血脂效果更优；网络药理学通过在线数据库共得到258种化学成分和985个作用靶点，其中60种成分、121个靶点和181条途径与T2DM的治疗密切相关，主要涉及晚期糖基化终末产物及其受体（AGE-RAGE）信号通路、缺氧诱导因子-1（HIF-1）信号通路、丝裂原活化蛋白激酶（MAPK）信号通路、胰岛素抵抗（IR）等。结论 根据已有研究数据，黄连阿胶汤联合西药常规治疗可增加T2DM的临床疗效，降低血糖和调节血脂，主要通过改善IR、减轻炎症反应、降低氧化应激等治疗T2DM。

Objective To evaluate the clinical efficacy of Huanglian Ejiao Decoction and explore its mechanism in the treatment of type 2 diabetes (T2DM) based on Meta-analysis and network pharmacology technology. Methods Firstly, CNKI, VIP, Wanfang, PubMed, the Cochrane Library, and Web of Science were used to find randomized controlled trials of Huanglian Ejiao Decoction for T2DM until May 2020. The included literatures were evaluated according to the Cochrane risk bias assessment tool, and the Review Manager software was used for quantitative synthesis. The chemical components and its targets of Huanglian Ejiao Decoction were screened based on network pharmacology. Common targets were obtained after taking the intersection with T2DM targets. The bioinformatics technology was used to annotate key pathways, and the potential mechanism of Huanglian Ejiao Decoction was explored in the treatment of T2DM. Results A total of 15 RCTs were selected which included 1 254 patients. Compared with the conventional treatment of western medicine, Huanglian Ejiao Decoction combined with western medicine had a more satisfactory clinical effect, stronger hypoglycemic and hypolipidemic effect. Through network pharmacology methods, 258 chemical components and 985 targets were obtained from online databases. There were 60 components, 121 targets, and 181 pathways closely related to the treatment of T2DM, mainly involving AGE-RAGE signaling pathway in diabetic complications, HIF-1 signaling pathway, MAPK signaling pathway, insulin resistance, etc. Conclusion According to the existing research, the conventional treatment of western medicine combined with Huanglian Ejiao Decoction can increase the clinical efficacy of T2DM and have better hypoglycemic and hypolipidemic action. T2DM can be cured by improving insulin resistance, reducing inflammation, mitigating oxidative stress and other treatments.

R28;R587.1

国家自然科学基金资助项目（81774014）