Yang Long, Yao Min, Lan Yun, Mo Wei, Sun Yue-Li, Wang Jing, Wang Yong-Jun, Cui Xue-Jun
1 Longhua Hospital, Shanghai University of Traditional Chinese Medicine , Shanghai, China .
2 Institute of Spine Disease, Shanghai University of Traditional Chinese Medicine , Shanghai, China .
J Neurotrauma. 2016 Feb 1;33(3):290-300. doi: 10.1089/neu.2015.4038. Epub 2016 Jan 7.
Spinal cord injury (SCI) leads to loss of function below the lesion and affects individuals worldwide. An increasing number of experimental studies support the effectiveness of melatonin (MT) for SCI. Our objectives were to investigate neurological recovery and anti-oxidant effects of MT in animal models of SCI, and to explore the appropriate dose. Published MT studies in SCI animal models described in six databases were searched. Two practiced investigators selected the studies, extracted the data, and independently evaluated the quality of the included studies. A meta-analysis evaluated the effect of MT in SCI and a network meta-analysis was performed to explore the appropriate MT dose for SCI models. Thirteen studies were analyzed, of which three were high quality. The results of the meta-analysis manifested that the behavioral evaluation (Basso, Beattie, and Bresnahan scales, n = 90, p = 0.003; motor function scores, n = 92, p = 0.004; Tarlov's criteria, n = 150, p = 0.002; inclined plane test, n = 150, p = 0.001) and biochemical outcomes (malondialdehyde, n = 121, p = 0.0010; glutathione levels, n = 64, p < 0.0001; and myeloperoxidase activity, n = 32, p < 0.00001) were improved, compared with the control group, after MT administration. A dose of 12.5 mg/kg was most effective in SCI rat models. Studies indicated that MT administration significantly improved neurological recuperation and anti-oxidant effects in rat models of SCI. The appropriate dose of MT was 12.5 mg/kg for SCI rat models. The majority of included studies were low quality; however, optimal MT treatment in SCI still requires high quality studies.
脊髓损伤（SCI）会导致损伤平面以下功能丧失，影响着全球各地的患者。越来越多的实验研究证实褪黑素（MT）对脊髓损伤具有疗效。我们的目标是研究褪黑素在脊髓损伤动物模型中的神经功能恢复情况和抗氧化作用，并探索合适的剂量。我们检索了六个数据库中已发表的关于褪黑素在脊髓损伤动物模型中的研究。两名经验丰富的研究人员筛选了研究、提取了数据，并独立评估了纳入研究的质量。进行了荟萃分析以评估褪黑素对脊髓损伤的影响，并进行了网状荟萃分析以探索脊髓损伤模型的合适褪黑素剂量。共分析了13项研究，其中3项为高质量研究。荟萃分析结果表明，与对照组相比，给予褪黑素后行为评估（Basso、Beattie和Bresnahan量表，n = 90，p = 0.003；运动功能评分，n = 92，p = 0.004；Tarlov标准，n = 150，p = 0.002；斜面试验，n = 150，p = 0.001）和生化指标（丙二醛，n = 121，p = 0.0010；谷胱甘肽水平，n = 64，p < 0.0001；髓过氧化物酶活性，n = 32，p < 0.00001）均有所改善。12.5mg/kg的剂量在脊髓损伤大鼠模型中效果最为显著。研究表明，给予褪黑素能显著改善脊髓损伤大鼠模型的神经功能恢复和抗氧化作用。脊髓损伤大鼠模型的合适褪黑素剂量为12.5mg/kg。纳入的研究大多质量较低；然而，脊髓损伤的最佳褪黑素治疗仍需要高质量的研究。
