人参提取物对脓毒症大鼠心肌损伤影响的系统评价和Meta分析  

Systematic Review and Meta-analysis of the Effect of Ginseng Extract on Myocardial Injury in Septic Rats

作　　者：宋爽 胡雅慧 赵国桢[2] 李博[3,4] 徐霄龙[3] 郭玉红[3] 刘清泉[3,4] SONG Shuang;HU Yahui;ZHAO Guozhen;LI Bo;XU Xiaolong;GUO Yuhong;LIU Qingquan(Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学,天津301617 [2]北京中医药大学 [3]北京市中医药研究所 [4]首都医科大学附属中医医院,北京100010

出　　处：《中西医结合心脑血管病杂志》2023年第22期4077-4084,共8页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家中医药多学科创新团队(No.ZYYCXTD-D-202201);国家自然科学基金项目(No.82174348)。

摘　　要：目的:系统评价人参提取物[人参多糖、人参二醇组皂苷(PDS)、人参皂苷(RG1)、人参总皂苷(TG)]对脓毒症大鼠心肌损伤的影响。方法:采用计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普(VIP)及万方数据库(WanFang Database)、Web of Science、PubMed、EMbase数据库,同时手工检索补充文献,检索时限为建库至2022年1月1日,检索日期为2022年1月17日。根据纳入与排除标准筛选文献,选择天门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、血清肿瘤坏死因子-α(TNF-α)作为效应指标,提取数据,采用SYRCLE动物实验偏倚风险评估工具进行质量评价,运用RevMan 5.3软件进行Meta分析。结果:最终纳入9篇研究文献,Meta分析结果显示,各研究间异质性可接受(I~2=0%,P=1.00),采用固定效应模型进行Meta分析。镇静4 h后,与其他治疗相比,人参提取物(人参多糖、PDS、RG1、TG)可降低脓毒症心肌损伤大鼠的AST[SMD=-1.38,95%CI(-1.92,-0.85),P<0.001],CK[SMD=-1.73,95%CI(-2.30,-1.16),P<0.001],LDH[SMD=-1.43,95%CI(-1.90,-0.96),P<0.001],TNF-α[SMD=-18.23,95%CI(-20.84,-15.63),P<0.001],差异有统计学意义。结论:现有证据表明,人参提取物治疗脓毒症疗效较好,能降低脓毒症大鼠AST、CK、LDH水平,并通过TNF-α炎性因子改善炎症反应,对脓毒症心肌损伤大鼠的治疗作用更显著。提示人参提取物中PDS、RG1、TG是人参的有效成分,为临床替代地塞米松等其他副作用大的药物治疗脓毒症心肌损伤提供了可能,人参提取物在脓毒症心肌损伤治疗中具有潜在的临床应用前景。Objective:To evaluate the effects of ginseng extracts ginseng polysaccharides,panaxadiol group saponins(PDS),ginsenosides(RG1),total ginsenosides(TG)on myocardial injury in septic rats.Methods:The databases of China National Knowledge Infrastructure(CNKI),China Biomedical Literature Database(CBM),VIP,WanFang Database,Web of Science,PubMed,and EMbase were searched from the year of construction to January 1,2022,and supplementary literature was searched manually.The search date was January 17,2022.The literature was screened according to inclusion and exclusion criteria.Aspartate aminotransferase(AST),creatine kinase(CK),lactate dehydrogenase(LDH),and serum tumor necrosis factor-α(TNF-α)were selected as effect indicators.The quality of the data was evaluated using the SYRCLE animal experiment risk of bias assessment tool,and Meta-analysis was performed using RevMan 5.3 software.Results:Nine research papers were included,and the results of Meta-analysis showed that the heterogeneity among the studies was small(I 2=0%,P=1.00),so the fixed effect model was used for Meta-analysis.After sedation for 4 hours,compared with other treatments,ginseng extract can significantly reduce the levels of AST,CK,LDH,TNF-αin septic myocardial injury rats.The difference in AST detection was statistically significant(SMD=-1.38,95%CI-1.92--0.85,P<0.001).The difference in CK detection was statistically significant(SMD=-1.73,95%CI-2.30--1.16,P<0.001).The difference in LDH detection was statistically significant(SMD=-1.43,95%CI-1.90--0.96,P<0.001).The difference in the detection of TNF-αin cells was statistically significant(SMD=-18.23,95%CI-20.84--15.63,P<0.001).Conclusion:Existing evidence shows that ginseng extract shows better curative effect on sepsis,which can reduce the levels of AST,CK,and LDH,and improve the inflammatory response through TNF-αinflammatory factor,and reduce the apoptosis of myocardial cells in septic myocardial injury rats.The results suggest that PDS,RG1,and TG in ginseng extract are the active ingredients of

关 键 词：脓毒症 人参 人参提取物 心肌损伤 大鼠 META分析 

分 类 号：R285.5[医药卫生—中药学]