大黄治疗动物糖尿病肾病的效果:一项系统评价与Meta分析
The Effects of Rhubarb for the Treatment of Diabetic Nephropathy in Animals: A Systematic Review and Meta-analysis.
作者信息
Zeng Jing-Yi, Wang Yu, Miao Miao, Bao Xiao-Rong
机构信息
Department of Nephrology, Jinshan Hospital, Fudan University, Shanghai, China.
出版信息
Front Pharmacol. 2021 Jun 11;12:602816. doi: 10.3389/fphar.2021.602816. eCollection 2021.
Rhubarb, also known as Da Huang, is a traditional Chinese medicine, and it was often used as a laxative in the past. Recently, multiple studies have applied rhubarb to treat diabetic nephropathy (DN). Anthraquinones, including emodin and rhein, have been extracted from rhubarb and used to explore the effective components and possible mechanisms of rhubarb for DN. Evaluating the efficacy of rhubarb may provide a scientific reference for the clinical application of rhubarb for the treatment of DN. 1) To evaluate the efficacy of rhubarb in the treatment of DN; 2) To identify the most effective ingredient of rhubarb for DN; 3) To explore the specific mechanism of rhubarb in treating DN. Data sources: related studies were identified by searching Cochrane Library, Ovid-EMBASE, PubMed, SinoMed, WanFang, VIP, CNKI, and other Chinese magazines. Assessment and analysis: SYRCLE's risk of bias tool for animal studies was used to assess the quality of articles. The meta-analysis was performed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. Data analysis adopted RevMan 5.3 and STATA 12.0 software. This study was published in the register with PROSPERO, number CRD42020204701. Aggregated data were collected from 27 eligible studies. The results illustrated an intense improvement in the following outcomes in rhubarb-treated animals with DN ( < 0.05): blood glucose, serum creatinine (Scr), blood urea nitrogen (BUN), albumin creatinine ratio (ACR), urine protein (UP), urinary albumin excretion (UAE), renal index (two kidneys weight/body weight, KW/BW), tubulointerstitial injury index (TII), transforming growth factor-beta1 (TGF-β1) mRNA and protein, alpha-smooth muscle actin (α-SMA) protein, and E-cadherin (E-cad) protein. Of these, DN animals with rhubarb exhibited a significantly higher level of E-cad protein. In addition, the level of the other outcomes mentioned above decreased significantly, while there was no significant association between the intervention and nephrin protein ( > 0.05). This systematic review and meta-analysis demonstrated that rhubarb has a positive therapeutic effect on animals with DN, which may provide confidence and some theoretical reference for clinical application to a certain extent.
大黄,又称“大黄”,是一种传统中药,过去常被用作泻药。最近,多项研究将大黄应用于治疗糖尿病肾病(DN)。已从大黄中提取了包括大黄素和大黄酸在内的蒽醌类物质,用于探索大黄治疗DN的有效成分和可能机制。评估大黄的疗效可为大黄治疗DN的临床应用提供科学参考。1)评估大黄治疗DN的疗效;2)确定大黄治疗DN最有效的成分;3)探索大黄治疗DN的具体机制。数据来源:通过检索Cochrane图书馆、Ovid-EMBASE、PubMed、中国生物医学文献数据库、万方数据库、维普数据库、中国知网以及其他中文杂志来识别相关研究。评估与分析:采用SYRCLE动物研究偏倚风险工具评估文章质量。按照《Cochrane系统评价干预措施手册》进行荟萃分析。数据分析采用RevMan 5.3和STATA 12.0软件。本研究已在PROSPERO注册,注册号为CRD42020204701。从27项符合条件的研究中收集汇总数据。结果表明,用大黄治疗的DN动物在以下指标上有显著改善(<0.05):血糖、血清肌酐(Scr)、血尿素氮(BUN)、白蛋白肌酐比值(ACR)、尿蛋白(UP)、尿白蛋白排泄率(UAE)、肾指数(双肾重量/体重,KW/BW)、肾小管间质损伤指数(TII)、转化生长因子-β1(TGF-β1)mRNA和蛋白、α-平滑肌肌动蛋白(α-SMA)蛋白以及E-钙黏蛋白(E-cad)蛋白。其中,用大黄治疗的DN动物E-cad蛋白水平显著更高。此外,上述其他指标水平显著降低,而干预措施与nephrin蛋白之间无显著关联(>0.05)。这项系统评价和荟萃分析表明,大黄对DN动物具有积极的治疗作用,这在一定程度上可为临床应用提供信心和一些理论参考。
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