基于网状Meta分析研究天然产物改善胆汁淤积的效应特征  

Characterization of the effect of natural products on ameliorating cholestasis based on reticulated Meta-analysis

作　　者：胡芳丽 罗诗曼 杨家越 陈沅 胡启超 马骁[1] HU Fangli;LUO Shiman;YANG Jiayue;CHEN Yuan;HU Qichao;MA Xiao(School of Pharmacy,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China;School of Clinical Medicine,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China)

机构地区：[1]成都中医药大学药学院,四川成都611137 [2]成都中医药大学临床医学院,四川成都610075 [3]成都中医药大学附属医院,四川成都610072

出　　处：《药学研究》2025年第1期8-12,19,共6页Journal of Pharmaceutical Research

基　　金：国家自然科学基金面上项目(No.82274187)。

摘　　要：目的本研究通过网状Meta分析对天然产物治疗胆汁淤积的疗效进行比较,在所研究的天然产物内,找到治疗胆汁淤积效果最好的天然产物。方法检索PubMed、Web of Science、Embase、中国知网(CNKI)、万方、维普数据库,根据纳入标准纳入符合要求的文章。用Stata 17.0软件对其进行网状Meta分析。结果初步纳入244篇文献,最终纳入57篇文献,涉及891只实验动物模型(小鼠102只,大鼠789只),所有文章均有一定的偏倚风险。网状Meta分析结果表示,与模型组相比,各天然产物干预后,对胆汁淤积均表现出显著的治疗效果,谷丙转氨酶(ALT)(I^(2)=87.0%,95%CI=-1.94~-1.56,P<0.001),谷草转氨酶(AST)(I^(2)=82.5%,95%CI=-2.00~-1.61,P<0.001),总胆红素(TBIL)(I^(2)=84.3%,95%CI=-2.11~-1.70,P<0.001),总胆汁酸(TBA)(I^(2)=84.1%,95%CI=-2.56~-2.03,P<0.001),从胆汁淤积指标ALT和TBIL两个因素综合观察不同天然产物进行干预时对胆汁淤积疗效的优劣差异,治疗效果按优到劣排列,排列在前的为大黄素和芍药苷。结论研究的各天然产物对胆汁淤积均有一定的治疗效果,并且在从ALT和TBIL两个指标角度进行的综合分析中,发现大黄素和芍药苷治疗效果最为突出。Objective In this study,the efficacy of natural products in the treatment of cholestasis was compared by reticulated Meta-analysis to find the most effective natural product for the treatment of cholestasis within the natural products studied.Methods PubMed,Web of Science,Embase,CNKI,Wanfang,and VIP databases were searched,and articles that met the requirements were included according to the inclusion criteria.Network Meta-analysis was performed with Stata 17.0 software.Results Initially,244 articles were included,and finally,57 articles were included,involving 891 experimental animal models(102 mice and 789 rats),and all the articles were at a certain risk of bias.The results of Meta-analysis indicated that,compared with the model group,each natural product showed a significant therapeutic effect on biliary stasis after treatment,ALT(I^(2)=87.0%,95%CI=-1.94~-1.56,P<0.001),AST(I^(2)=82.5%,95%CI=-2.00~-1.61,P<0.001),TBIL(I^(2)=84.3%,95%CI=-2.11~-1.70,P<0.001),TBA(I^(2)=84.1%,95%CI=-2.56~-2.03,P<0.001),to observe the differences in the efficacy of different natural products on cholestasis when intervening from two factors,ALT and TBIL,the therapeutic effects were ranked from the best to the worst,with rhododendron and paeoniflorin in the first place.Conclusion Each of the natural products studied showed some therapeutic effect on cholestasis,and in a comprehensive analysis from the point of view of both ALT and TBIL indicators,emodin and paeoniflorin were found to have the most prominent therapeutic effect.

关 键 词：天然产物 胆汁淤积 网状Meta分析 大黄素 芍药苷 

分 类 号：R285[医药卫生—中药学]