{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:22:07Z","timestamp":1791591727895,"version":"4.3.4"},"reference-count":91,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by chronic hyperglycemia. While biomedicine (e.g., metformin) serves as the first-line treatment, combination therapies involving botanical drugs are increasingly utilized. However, the comparative efficacy of different botanical formulations remains to be systematically evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aims to analyze randomized controlled trials (RCTs) to evaluate the clinical efficacy and safety of eight specific classical botanical drug formulas combined with metformin (Met) for T2DM, providing evidence to support integrated clinical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Bayesian network meta-analysis (NMA) was performed on RCTs sourced from PubMed, Cochrane Library, Embase, Web of Science, and Chinese databases. The taxonomic validation of all botanical drugs was conducted using MPNS. Outcomes including HbA1c, FPG, and lipid profiles were assessed using the SUCRA and GRADE methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty RCTs involving 3,088 patients were included. In terms of glycemic control, the combination of\n                      <jats:italic>Huanglian Jiedu<\/jats:italic>\n                      Decoction (HLJDD) and Met ranked highest for reducing FPG [MD = \u22121.46, 95% CrIs=(\u22122.24, \u22120.68)], while HLJDD,\n                      <jats:italic>Zhibai Dihuang<\/jats:italic>\n                      Decoction (ZBDHD), and Dachaihu Decoction (DCHD) combined with Met emerged as the most effective for reducing HbA1c. Notably, sensitivity analysis restricted to trials \u22658 weeks identified HLJDD [MD = \u22121.02, 95% CrIs=(\u22121.39, \u22120.66)] and ZBDHD [MD = \u22121.02, 95% CrIs=(\u22121.28, \u22120.76)] as the most robust interventions for long-term glycemic control. Safety reporting was limited, with only 8 out of 40 trials (20.0%) providing data on adverse events. While no severe adverse events were reported in these specific trials, the overall safety evidence remains uncertain due to substantial missingness and potential under-reporting.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The current NMA results suggest that HLJDD combined with Met is a consistently effective option for reducing both FPG and HbA1c. For HbA1c improvement, while DCHD combined with Met showed initial potential, sensitivity analysis restricted to trials \u22658 weeks identified HLJDD and ZBDHD as the most physiologically robust interventions. However, given the \u201cVery Low\u201d certainty of evidence for many comparisons, these rankings remain exploratory.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1693378","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T06:52:27Z","timestamp":1770792747000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of traditional Chinese classic prescriptions combined with metformin in the treatment of type 2 diabetes mellitus: a Bayesian network meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Linlin","family":"Che","sequence":"first","affiliation":[{"name":"Heilongjiang University of Traditional Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Dong","sequence":"additional","affiliation":[{"name":"Heilongjiang University of Traditional Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Liu","sequence":"additional","affiliation":[{"name":"Heilongjiang University of Traditional Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Guo","sequence":"additional","affiliation":[{"name":"Heilongjiang University of Traditional Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S27","DOI":"10.2337\/dc25-S002","article-title":"2. Diagnosis and classification of diabetes: standards of care in Diabetes-2025","volume":"48","year":"2025","journal-title":"Diabetes Care"},{"key":"B2","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1136\/emermed-2020-209567","article-title":"Population, intervention, comparison, outcomes and study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews","volume":"37","author":"Amir-Behghadami","year":"2020","journal-title":"Emerg. Med. J."},{"key":"B3","unstructured":"Observation on the therapeutic effect of Zhibai dihuang decoction on type 2 diabetes mellitus and its impact on HOMA-IR\n          \n          \n            \n              Chen\n              C.\n            \n          \n          Guangzhou University of Chinese Medicine\n          \n          2015"},{"key":"B4","unstructured":"Clinical observation on the treatment of T2DM combined with non- alcoholic fatty liver disease with phlegm-heat interlocking syndrome by modified Huanglian Wenchan decoction\n          \n          \n            \n              Chen\n              X.\n            \n          \n          Shandong University of Chinese Medicine\n          \n          2018"},{"key":"B5","doi-asserted-by":"publisher","first-page":"136","DOI":"10.19335\/j.cnki.2096-1219.2022.13.042","article-title":"The clinical application of Huanglian Wenchan decoction combined with metformin Sustained-release Tablets in patients with early type 2 diabetes of the damp-heat accumulation type","volume":"8","author":"Chen","year":"2022","journal-title":"Smart Health Mag."},{"key":"B6","doi-asserted-by":"publisher","first-page":"711","DOI":"10.13633\/j.cnki.zjtcm.2021.10.005","article-title":"Modified huanglian Detoxification Decoction combined with metformin in the treatment of 50 cases of diabetes complicated with obesity","volume":"56","author":"Chen","year":"2021","journal-title":"Zhejiang J. Traditional Chin. Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"120401","DOI":"10.1016\/j.jep.2025.120401","article-title":"Efficacy of Chinese patent medicines combined with conventional western medicine in treatment of preeclampsia: a systematic review and Bayesian network meta-analysis","volume":"353","author":"Chen","year":"2025","journal-title":"J. Ethnopharmacol."},{"key":"B8","article-title":"Observation on the therapeutic effect of modified Gegen Qinlian Decoction combined with metformin in the treatment of type 2 diabetes with internal accumulation of damp heat","author":"Cheng","year":"2018"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.3969\/j.issn.1002-2619.2015.08.026","article-title":"Clinical observation on the treatment of type 2 diabetes with modified da-chai-hu decoction","volume":"37","author":"Cui","year":"2015","journal-title":"Hebei J. Traditional Chin. Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.16658\/j.cnki.1672-4062.2022.11.001","article-title":"Exploring the clinical efficacy of using the traditional Chinese medicine formula Guqiong Qinlian Decoction in treating patients with diabetes","volume":"25","author":"Dai","year":"2022","journal-title":"Diabetes New World J."},{"key":"B11","doi-asserted-by":"publisher","first-page":"8636","DOI":"10.1038\/s41598-025-87624-1","article-title":"Efficacy of continuous venovenous hemodiafiltration in patients with metformin associated lactic acidosis and acute kidney injury","volume":"15","author":"De Simone","year":"2025","journal-title":"Sci. Rep."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e0278536","DOI":"10.1371\/journal.pone.0278536","article-title":"Benefits of herbal formulae containing Poria cocos (Fuling) for type 2 diabetes mellitus: a systematic review and meta-analysis","volume":"17","author":"Di","year":"2022","journal-title":"PLoS One"},{"key":"B13","doi-asserted-by":"publisher","first-page":"111422","DOI":"10.1016\/j.jclinepi.2024.111422","article-title":"Guideline for reporting systematic reviews of outcome measurement instruments (OMIs): PRISMA-COSMIN for OMIs 2024","volume":"173","author":"Elsman","year":"2024","journal-title":"J. Clin. Epidemiol."},{"key":"B14","first-page":"94","article-title":"The clinical efficacy of traditional Chinese medicine Huanglian Jiedu Decoction in treating patients with type 2 diabetes","volume":"17","author":"Feng","year":"2019","journal-title":"Chin. J. Prescr. Drugs"},{"key":"B15","doi-asserted-by":"publisher","first-page":"51","DOI":"10.16808\/j.cnki.issn1003-7705.2020.08.020","article-title":"Clinical observation of 30 cases of type 2 diabetes mellitus with Qi-Yin deficiency treated with Baihu Jia Ren Shen Decoction","volume":"36","author":"Feng","year":"2020","journal-title":"Hunan J. Traditional Chin. Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"112075","DOI":"10.1016\/j.diabres.2025.112075","article-title":"Reduced glomerular filtration rate in individuals with intermediate hyperglycemia and type 2 diabetes as defined by 1-hour post-load glucose levels according to the newly released IDF criteria","volume":"222","author":"Fiorentino","year":"2025","journal-title":"Diabetes Res. Clin. Pract."},{"key":"B17","article-title":"Clinical observation on the treatment of obesity-type Type 2 diabetes mellitus (Damp-Heat Accumulation Type) with Gegen Kinfenlian Decoction","author":"Fu","year":"2017"},{"key":"B18","doi-asserted-by":"publisher","first-page":"117136","DOI":"10.1016\/j.jep.2023.117136","article-title":"Shen-Ling-Bai-Zhu-San alleviates the imbalance of intestinal homeostasis in dextran sodium sulfate-induced colitis mice by regulating gut microbiota and inhibiting the NLRP3 inflammasome activation","volume":"319","author":"Gao","year":"2024","journal-title":"J. Ethnopharmacol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"19","DOI":"10.3969\/j.issn.1009-3931.2012.06.007","article-title":"Clinical observation on the treatment of type 2 diabetes mellitus of the spleen deficiency and phlegm-stasis type with modified shenling baizhu powder combined with metformin","volume":"30","author":"Gong","year":"2012","journal-title":"Xinjiang J. Traditional Chin. Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"10286","DOI":"10.1038\/s41598-024-61011-8","article-title":"Exploring the mechanism of Jinlida granules against type 2 diabetes mellitus by an integrative pharmacology strategy","volume":"14","author":"Gu","year":"2024","journal-title":"Sci. Rep."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e0221199","DOI":"10.1371\/journal.pone.0221199","article-title":"The efficacy and safety of concentrated herbal extract granules, YH1, as an add-on medication in poorly controlled type 2 diabetes: a randomized, double-blind, placebo-controlled pilot trial","volume":"14","author":"Huang","year":"2019","journal-title":"PLoS One"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1857","DOI":"10.3390\/pharmaceutics14091857","article-title":"Gut Microbiota and bile acids mediate the clinical benefits of YH1 in Male patients with type 2 diabetes mellitus: a pilot observational Study","volume":"14","author":"Huang","year":"2022","journal-title":"Pharmaceutics"},{"key":"B23","article-title":"Clinical observation on the treatment of abdominal type type 2 diabetes mellitus with insulin resistance by Huanglian Wenchan decoction","author":"Ji","year":"2017"},{"key":"B24","doi-asserted-by":"publisher","first-page":"18","DOI":"10.3969\/j.issn.1001-6910.2020.09.06","article-title":"Modified Da Chenghu Decoction combined with metformin tablets for the treatment of 20 cases of type 2 diabetes","volume":"33","author":"Ji","year":"2020","journal-title":"J. Traditional Chin. Med. Res."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.3109\/13880209.2014.952838","article-title":"Antidiabetic mechanism of Coptis chinensis polysaccharide through its antioxidant property involving the JNK pathway","volume":"53","author":"Jiang","year":"2015","journal-title":"Pharm. Biol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"4890","DOI":"10.3748\/wjg.v28.i33.4890","article-title":"Chinese herbal formula shen-ling-bai-zhu-san to treat chronic gastritis: clinical evidence and potential mechanisms","volume":"28","author":"Jin","year":"2022","journal-title":"World J. Gastroenterol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s00125-024-06254-w","article-title":"Glycaemic control is still central in the hierarchy of priorities in type 2 diabetes management","volume":"68","author":"Khunti","year":"2025","journal-title":"Diabetologia"},{"key":"B28","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/S2213-8587(25)00022-1","article-title":"Long-term effects and effect heterogeneity of lifestyle and metformin interventions on type 2 diabetes incidence over 21 years in the US Diabetes Prevention program randomised clinical trial","volume":"13","author":"Knowler","year":"2025","journal-title":"Lancet Diabetes Endocrinol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"65","DOI":"10.16808\/j.cnki.issn1003-7705.2018.08.029","article-title":"Clinical observation of 48 cases of type 2 diabetes treated with compound Kudzu root, coptis and ligusticum decoction","volume":"34","author":"Li","year":"2018","journal-title":"Hunan J. Traditional Chin. Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"48","DOI":"10.3969\/j.issn.1674-4721.2023.21.012","article-title":"The effect of Zhibai Dihuang Decoction combined with Western medicine on blood glucose levels and insulin resistance in patients with type 2 diabetes","volume":"30","author":"Li","year":"2023","journal-title":"Chin. Contemp. Med. J."},{"key":"B31","doi-asserted-by":"publisher","first-page":"784","DOI":"10.13463\/j.cnki.jlzyy.2023.07.010","article-title":"Modified linggui Zhuanshan Gancao decoction for treating obesity-type type 2 diabetes","volume":"43","author":"Li","year":"2023","journal-title":"Jilin J. Traditional Chin. Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"81","DOI":"10.3969\/j.issn.1674-7860.2024.09.014","article-title":"Clinical observation on the treatment of prediabetes with modified Linggui Zhugan Decoction","volume":"16","author":"Li","year":"2024","journal-title":"Chin. J. Clin. Res. Traditional Chin. Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s13020-025-01117-x","article-title":"Effect of traditional Chinese medicine combined with conventional Western medicine for patients with severe\/very severe chronic obstructive pulmonary disease: a multi-center, randomized, double-blind, controlled study","volume":"20","author":"Li","year":"","journal-title":"Chin. Med."},{"key":"B34","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1080\/10408347.2023.2290056","article-title":"Spectrum-Effect relationship in Chinese herbal medicine: current status and future perspectives","volume":"55","author":"Li","year":"","journal-title":"Crit. Rev. Anal. Chem."},{"key":"B35","doi-asserted-by":"publisher","first-page":"40","DOI":"10.13729\/j.issn.1671-7813.2016.11.17","article-title":"Linggui shugan decoction + intervention of lifestyle combined with metformin for the treatment of diabetes and obesity caused by excessive phlegm: a randomized parallel controlled study","volume":"30","author":"Liang","year":"2016","journal-title":"Pract. J. Traditional Chin. Intern. Med."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1501305","DOI":"10.3389\/fendo.2025.1501305","article-title":"Clinical metabolomics in type 2 diabetes mellitus: from pathogenesis to biomarkers","volume":"16","author":"Liu","year":"","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"B37","doi-asserted-by":"publisher","first-page":"118902","DOI":"10.1016\/j.jep.2024.118902","article-title":"Ethnobotanical usages, phytochemistry, pharmacology, and quality control of chuanxiong rhizoma: a review","volume":"337","author":"Liu","year":"","journal-title":"J. Ethnopharmacol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"2486551","DOI":"10.1080\/0886022X.2025.2486551","article-title":"Metformin and risk factors for chronic kidney disease in a European population based on Mendelian randomization","volume":"47","author":"Liu","year":"","journal-title":"Ren. Fail"},{"key":"B39","doi-asserted-by":"publisher","first-page":"118841","DOI":"10.1016\/j.jep.2024.118841","article-title":"Systematic pharmacology and experimental validation to elucidate the inflammation-associated mechanism of Huanglian Wendan (HLWD) decoction in the treatment of MAFLD associated with atherosclerosis","volume":"337","author":"Liu","year":"","journal-title":"J. Ethnopharmacol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"668418","DOI":"10.3389\/fphar.2021.668418","article-title":"Constituents, pharmacokinetics, and pharmacology of Gegen-Qinlian decoction","volume":"12","author":"Lu","year":"2021","journal-title":"Front. Pharmacol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"15","DOI":"10.13862\/j.cnki.cn43-1446\/r.2005.06.008","article-title":"Clinical observation of 52 cases of type 2 diabetes treated with Zhibai Dihuang decoction combined with metformin","author":"Luo","year":"2005","journal-title":"Chin. Med. Her."},{"key":"B42","doi-asserted-by":"publisher","first-page":"2092","DOI":"10.13935\/j.cnki.sjzx.221037","article-title":"Observation on the therapeutic effect of gegen kinfenlian decoction combined with metformin in the treatment of patients with type 2 diabetes","volume":"17","author":"Ma","year":"2022","journal-title":"World J. Integr. Traditional West. Med."},{"key":"B43","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.3390\/ijms26031094","article-title":"Type 2 diabetes mellitus: new pathogenetic mechanisms, treatment and the Most important complications","volume":"26","author":"M\u0142ynarska","year":"2025","journal-title":"Int. J. Mol. Sci."},{"key":"B44","doi-asserted-by":"publisher","first-page":"e40221","DOI":"10.1097\/MD.0000000000040221","article-title":"Metformin: diverse molecular mechanisms, gastrointestinal effects and overcoming intolerance in type 2 diabetes mellitus: a review","volume":"103","author":"Mohamed","year":"2024","journal-title":"Med. Baltim."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1397900","DOI":"10.3389\/fmed.2024.1397900","article-title":"The efficacy and safety of Dachaihu decoction in the treatment of nonalcoholic fatty liver disease: a systematic review and meta-analysis","volume":"11","author":"Mou","year":"2024","journal-title":"Front. Med. (Lausanne)"},{"key":"B46","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1080\/13880209.2024.2374794","article-title":"Evidence of traditional Chinese medicine for treating type 2 diabetes mellitus: from molecular mechanisms to clinical efficacy","volume":"62","author":"Ni","year":"2024","journal-title":"Pharm. Biol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"557","DOI":"10.3969\/j.issn.1001-1528.2021.02.055","article-title":"The clinical efficacy of Huanglian Wendan Decoction combined with metformin hydrochloride in patients with early type 2 diabetes of the damp-heat accumulation type","volume":"43","author":"Pan","year":"2021","journal-title":"Zhongchengyao Mag."},{"key":"B48","doi-asserted-by":"publisher","first-page":"956313","DOI":"10.3389\/fphar.2022.956313","article-title":"Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus","volume":"13","author":"Pan","year":"2022","journal-title":"Front. Pharmacol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"84","DOI":"10.13457\/j.cnki.jncm.2015.01.039","article-title":"Observation on the therapeutic effect of Baihu Jia Ren Shen Decoction in treating type 2 diabetes mellitus with initial symptoms of Qi-Yin deficiency and excessive heat","volume":"47","author":"Peng","year":"2015","journal-title":"J. New Traditional Chin. Med."},{"key":"B50","doi-asserted-by":"publisher","first-page":"32","DOI":"10.13729\/j.issn.1671-7813.z20190196","article-title":"A randomized parallel controlled Study on the treatment of diabetes (with excessive heat in the lung and stomach) by Baihu Jia Ren Shen Decoction","volume":"33","author":"Rong","year":"2019","journal-title":"Pract. J. Traditional Chin. Intern. Med."},{"key":"B51","doi-asserted-by":"publisher","first-page":"e32057","DOI":"10.1097\/MD.0000000000032057","article-title":"A network pharmacology study of mechanism and efficacy of Jiawei Huanglian-Wendan decoction in polycystic ovary syndrome with insulin resistance","volume":"101","author":"Shi","year":"2022","journal-title":"Med. Baltim."},{"key":"B52","doi-asserted-by":"publisher","first-page":"873","DOI":"10.2147\/DMSO.S479889","article-title":"Metformin for the treatment of type 2 diabetes in Asian adults: a systematic review","volume":"18","author":"Somasundaram","year":"2025","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"B53","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/S1875-5364(19)30003-2","article-title":"An insoluble polysaccharide from the sclerotium of Poria cocos improves hyperglycemia, hyperlipidemia and hepatic steatosis in ob\/ob mice via modulation of gut microbiota","volume":"17","author":"Sun","year":"2019","journal-title":"Chin. J. Nat. Med."},{"key":"B54","doi-asserted-by":"publisher","first-page":"50","DOI":"10.3390\/medsci11030050","article-title":"Review of the case reports on metformin, sulfonylurea, and thiazolidinedione therapies in type 2 diabetes mellitus patients","volume":"11","author":"Susilawati","year":"2023","journal-title":"Med. Sci. (Basel)"},{"key":"B55","article-title":"Clinical observation study on the treatment of diarrhea in type 2 diabetes patients caused by metformin with shenling baizhu powder","author":"Tan","year":"2017"},{"key":"B56","first-page":"913","article-title":"Clinical Study on the treatment of type 2 diabetes with gastrointestinal reactions caused by metformin by adjusting the formula of shenling baizhu powder","volume":"37","author":"Tan","year":"2021","journal-title":"Pract. Chin. Med. J."},{"key":"B57","doi-asserted-by":"publisher","first-page":"10988","DOI":"10.3390\/ijms231910988","article-title":"Glycyrrhizic acid and its derivatives: promising candidates for the management of type 2 diabetes mellitus and its complications","volume":"23","author":"Tan","year":"2022","journal-title":"Int. J. Mol. Sci."},{"key":"B58","doi-asserted-by":"publisher","first-page":"1316269","DOI":"10.3389\/fendo.2023.1316269","article-title":"Efficacy and safety of Gegen Qinlian decoction in the treatment of type II diabetes mellitus: a systematic review and meta-analysis of randomized clinical trials","volume":"14","author":"Tan","year":"2023","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"B59","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1080\/17425255.2025.2474128","article-title":"Safety of concomitant use of oral anticoagulants and antidiabetic drugs: a systematic review of observational studies","volume":"21","author":"Tassopoulou","year":"2025","journal-title":"Expert Opin. Drug Metab. Toxicol."},{"key":"B60","doi-asserted-by":"publisher","first-page":"e20210","DOI":"10.1097\/MD.0000000000020210","article-title":"Baihu Jia Renshen Decoction for type 2 diabetic mellitus: a protocol for systematic review and meta-analysis","volume":"99","author":"Tian","year":"2020","journal-title":"Med. Baltim."},{"key":"B61","doi-asserted-by":"publisher","first-page":"e35299","DOI":"10.1097\/MD.0000000000035299","article-title":"Clinical efficacy of Huanglian Wendan decoction in treating type 2 diabetes mellitus: a systematic review and meta-analysis","volume":"102","author":"Tian","year":"2023","journal-title":"Med. Baltim."},{"key":"B62","doi-asserted-by":"publisher","first-page":"16","DOI":"10.13457\/j.cnki.jncm.2021.12.004","article-title":"Clinical study on the treatment of newly diagnosed type 2 diabetes with phlegm (dampness) heat interlocking syndrome by modified Gegen Qinlian decoction","volume":"53","author":"Wang","year":"2021","journal-title":"J. New Traditional Chin. Med."},{"key":"B63","doi-asserted-by":"publisher","first-page":"26","DOI":"10.3969\/j.issn.1008-0104.2022.04.010","article-title":"The clinical efficacy of modified Da-Chai-Hu Decoction combined with metformin tablets in the treatment of type 2 diabetes","volume":"45","author":"Wang","year":"","journal-title":"Heilongjiang J. Med. Sci."},{"key":"B64","doi-asserted-by":"publisher","first-page":"124","DOI":"10.19335\/j.cnki.2096-1219.2022.07.039","article-title":"Clinical application of Huanglian Wendan decoction in early type 2 diabetes patients with internal accumulation of dampness and heat","volume":"8","author":"Wang","year":"","journal-title":"Smart Health Mag."},{"key":"B65","first-page":"369","article-title":"Clinical Study on the treatment of type 2 diabetes mellitus of the hydropic heat accumulation type with Huanglian Wenchan decoction","volume":"13","author":"Wang","year":"2021","journal-title":"J. Integr. Traditional West. Med. Res."},{"key":"B66","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.2147\/DMSO.S517874","article-title":"The therapeutic effect and mechanism of traditional Chinese medicine in type 2 diabetes mellitus and its complications","volume":"18","author":"Wen","year":"2025","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"B67","article-title":"Clinical study on the treatment of type 2 diabetes with damp-heat obstruction pattern by modified Gegen Keminlian Decoction","author":"Wu","year":"2021"},{"key":"B68","doi-asserted-by":"publisher","first-page":"918","DOI":"10.3389\/fphys.2019.00918","article-title":"Linggui Zhugan formula improves glucose and lipid levels and alters gut Microbiota in high-fat diet-induced diabetic mice","volume":"10","author":"Wu","year":"2019","journal-title":"Front. Physiol."},{"key":"B69","doi-asserted-by":"publisher","first-page":"9294605","DOI":"10.1155\/2020\/9294605","article-title":"Zhibaidihuang decoction ameliorates cell oxidative stress by regulating the Keap1-Nrf2-ARE signalling pathway","volume":"2020","author":"Wu","year":"2020","journal-title":"Evid. Based Complement. Altern. Med."},{"key":"B70","first-page":"112","article-title":"Observation on the effect of modified Gegen Kinfenlian Decoction in regulating blood glucose levels in patients with type 2 diabetes","volume":"29","author":"Xie","year":"2023","journal-title":"J. Marriage, Reproduction Health"},{"key":"B71","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1016\/j.gpb.2019.09.007","article-title":"Antidiabetic effects of Gegen Qinlian Decoction via the gut microbiota are attributable to its key ingredient berberine","volume":"18","author":"Xu","year":"2020","journal-title":"Genomics Proteomics Bioinforma."},{"key":"B72","doi-asserted-by":"publisher","first-page":"1560271","DOI":"10.3389\/fphar.2025.1560271","article-title":"Therapeutic effects of medicinal and food-based traditional herbal couples on type 2 diabetes mellitus based on pharmacodynamics and pharmacokinetics","volume":"16","author":"Xu","year":"2025","journal-title":"Front. Pharmacol."},{"key":"B73","article-title":"Clinical research on modified Ge Gen Qin Lian decoction combined with metformin in the treatment of damp-heat obstructing the spleen syndrome of type 2 diabetes mellitus","author":"Yang","year":"2021"},{"key":"B74","doi-asserted-by":"publisher","first-page":"535","DOI":"10.16295\/j.cnki.0257-358x.2013.08.006","article-title":"Huanglian jiedu decoction intervention in obese type 2 diabetics: efficacy for glycemic control and weight management","volume":"32","author":"Yang","year":"2013","journal-title":"Shandong J. Traditional Chin. Med."},{"key":"B75","doi-asserted-by":"publisher","first-page":"153950","DOI":"10.1016\/j.phymed.2022.153950","article-title":"Isoliquiritigenin alleviates diabetic symptoms via activating AMPK and inhibiting mTORC1 signaling in diet-induced diabetic mice","volume":"98","author":"Yang","year":"2022","journal-title":"Phytomedicine"},{"key":"B76","doi-asserted-by":"publisher","first-page":"1051962","DOI":"10.3389\/fcimb.2022.1051962","article-title":"Baihu renshen decoction ameliorates type 2 diabetes mellitus in rats through affecting gut microbiota enhancing gut permeability and inhibiting TLR4\/NF-\u03baB-mediated inflammatory response","volume":"12","author":"Yao","year":"2022","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B77","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/j.tem.2024.07.017","article-title":"The direct targets of metformin in diabetes and beyond","volume":"36","author":"Yao","year":"2025","journal-title":"Trends Endocrinol. Metab."},{"key":"B78","doi-asserted-by":"publisher","first-page":"142","DOI":"10.19335\/j.cnki.2096-1219.2023.12.034","article-title":"A study on the clinical effectiveness and safety of gegen qinlian decoction in treating diabetic patients","volume":"9","author":"Yu","year":"2023","journal-title":"Smart Health Mag."},{"key":"B79","first-page":"978","article-title":"Clinical observation of shenling baizhu powder combined with metformin in the treatment of type 2 diabetes with obesity: a randomized controlled trial","volume":"39","author":"Yuan","year":"2023","journal-title":"Pract. Chin. Med. J."},{"key":"B80","article-title":"Clinical efficacy observation of Shenling Baizhu Powder combined with metformin in the treatment of patients with overweight\/obese type 2 diabetes with spleen deficiency and dampness obstruction syndrome","author":"Zeng","year":"2022"},{"key":"B81","doi-asserted-by":"publisher","first-page":"34","DOI":"10.13729\/j.issn.1671-7813.2017.11.12","article-title":"A randomized parallel controlled Study on the treatment of type 2 diabetes with severe heat-induced dehydration using Huanglian Jiedu decoction combined with Western medicine","volume":"31","author":"Zhang","year":"2017","journal-title":"Pract. J. Traditional Chin. Intern. Med."},{"key":"B82","doi-asserted-by":"publisher","first-page":"371","DOI":"10.3969\/j.issn.1004-2814.2025.02.064","article-title":"Clinical observation on the treatment of type 2 diabetes with modified Gegen Kinfenlian Decoction combined with metformin for the syndrome of dampness and heat accumulating in the spleen","volume":"41","author":"Zhang","year":"2025","journal-title":"Pract. Chin. Med. J."},{"key":"B83","doi-asserted-by":"publisher","first-page":"918681","DOI":"10.3389\/fphar.2022.918681","article-title":"The efficacy and safety of dachaihu decoction in the treatment of type 2 diabetes mellitus: a systematic review and meta-analysis","volume":"13","author":"Zhang","year":"2022","journal-title":"Front. Pharmacol."},{"key":"B84","doi-asserted-by":"publisher","first-page":"1501990","DOI":"10.3389\/fphar.2024.1501990","article-title":"The efficacy and safety of qiwei baizhu san in the treatment of type 2 diabetes mellitus: a systematic review and meta-analysis","volume":"15","author":"Zhang","year":"","journal-title":"Front. Pharmacol."},{"key":"B85","doi-asserted-by":"publisher","first-page":"117484","DOI":"10.1016\/j.jep.2023.117484","article-title":"A new direction in Chinese herbal medicine ameliorates for type 2 diabetes mellitus: focus on the potential of mitochondrial respiratory chain complexes","volume":"321","author":"Zhang","year":"","journal-title":"J. Ethnopharmacol."},{"key":"B86","doi-asserted-by":"publisher","first-page":"108754","DOI":"10.1016\/j.pharmthera.2024.108754","article-title":"The pharmacodynamic and pharmacological mechanisms underlying nanovesicles of natural products: developments and challenges","volume":"265","author":"Zhang","year":"","journal-title":"Pharmacol. Ther."},{"key":"B87","doi-asserted-by":"publisher","first-page":"905","DOI":"10.2147\/DMSO.S512089","article-title":"Metabolomics analysis of the mechanism of Yuquan capsules in the treatment of T2DM rats using UPLC\/MS","volume":"18","author":"Zhang","year":"","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"B88","doi-asserted-by":"publisher","first-page":"156248","DOI":"10.1016\/j.phymed.2024.156248","article-title":"Huang-Lian-Jie-Du decoction alleviates cognitive impairment in high-fat diet-induced obese mice via Trem2\/Dap12\/Syk pathway","volume":"135","author":"Zheng","year":"2024","journal-title":"Phytomedicine"},{"key":"B89","doi-asserted-by":"publisher","first-page":"108827","DOI":"10.1016\/j.pharmthera.2025.108827","article-title":"The anti-inflammatory effects of saponins from natural herbs","volume":"269","author":"Zheng","year":"2025","journal-title":"Pharmacol. Ther."},{"key":"B90","article-title":"Observation on the clinical efficacy of modified da-chai-hu decoction in treating type 2 diabetes mellitus with metabolic syndrome caused by liver-gallbladder stagnation and blood stasis","author":"Zhou","year":"2023"},{"key":"B91","doi-asserted-by":"publisher","first-page":"118787","DOI":"10.1016\/j.jep.2024.118787","article-title":"Huang-Lian-Jie-Du Decoction alleviates diabetic encephalopathy by regulating inflammation and pyroptosis via suppression of AGEs\/RAGE\/NF-\u03baB pathways","volume":"337","author":"Zhuang","year":"2025","journal-title":"J. Ethnopharmacol."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1693378\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T07:56:54Z","timestamp":1770796614000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1693378\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":91,"alternative-id":["10.3389\/fphar.2026.1693378"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2026.1693378","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,11]]},"article-number":"1693378"}}