School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Phytomedicine. 2023 Apr;112:154716. doi: 10.1016/j.phymed.2023.154716. Epub 2023 Feb 12.
Berberine has been widely used for the adjuvant therapy of several cardiovascular diseases (CVDs). However, evidence for its efficacy remains controversial.
This study aimed to evaluate the efficacy and safety of berberine in CVDs.
A systematic review and meta-analysis of randomized controlled trials (RCTs).
We searched ten electronic databases for articles from inception to December 23, 2022. RCTs comparing berberine alone or combined with statins versus statins or routine for CVDs were included. Meta-analysis was performed according to the Cochrane Handbook.
Forty-four RCTs were included with 4606 patients. There were no differences between berberine alone and routine or statins in improving total cholesterol (TC) (SMD, 0.43; 95% CI, -0.39 to 1.24; p = 0.30; I = 95%), triglyceride (TG) (SMD, -0.14; 95% CI, -0.49 to 0.21; p = 0.44; I = 76%), low-density lipoprotein cholesterol (LDL-C) (SMD, 0.69; 95% CI, -0.23 to 1.60; p = 0.14; I = 96%), high-density lipoprotein cholesterol (HDL-C) (SMD, 0.55; 95% CI, -0.48 to 1.57; p = 0.30; I = 96%), and Crouse score levels. Berberine alone significantly reduced National Institute of Health Stroke Scale (NIHSS) score, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and intima-media thickness (IMT) levels than routine therapy. Berberine plus statins significantly reduced TC, TG, LDL-C, NIHSS score, hs-CRP, TNF-α, IMT, Crouse score, and number of unstable plaques levels than routine or statins. However, no differences were found between groups in improving HDL-C and IL-6 levels. There were no significant differences between groups in the incidence of adverse reactions.
This study suggests that berberine may be a promising alternative for CVDs with no serious adverse reactions. However, our results may be limited by the quality of existing research. High-quality RCTs are needed to provide more convinced evidence.
小檗碱已被广泛用于几种心血管疾病（CVDs）的辅助治疗。然而，其疗效的证据仍然存在争议。
本研究旨在评估小檗碱在 CVDs 中的疗效和安全性。
一项系统评价和荟萃分析，纳入了随机对照试验（RCTs）。
我们从成立到 2022 年 12 月 23 日，检索了十个电子数据库中关于小檗碱单独或与他汀类药物联合使用与他汀类药物或常规治疗 CVDs 的文章。根据 Cochrane 手册进行荟萃分析。
共纳入 44 项 RCT，共 4606 名患者。小檗碱单独与常规或他汀类药物在改善总胆固醇（TC）（SMD，0.43；95%CI，-0.39 至 1.24；p=0.30；I=95%）、甘油三酯（TG）（SMD，-0.14；95%CI，-0.49 至 0.21；p=0.44；I=76%）、低密度脂蛋白胆固醇（LDL-C）（SMD，0.69；95%CI，-0.23 至 1.60；p=0.14；I=96%）、高密度脂蛋白胆固醇（HDL-C）（SMD，0.55；95%CI，-0.48 至 1.57；p=0.30；I=96%）和 Crouse 评分水平方面无差异。小檗碱单独治疗可显著降低国立卫生研究院卒中量表（NIHSS）评分、高敏 C 反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和内膜-中层厚度（IMT）水平，优于常规治疗。与常规或他汀类药物相比，小檗碱联合他汀类药物可显著降低 TC、TG、LDL-C、NIHSS 评分、hs-CRP、TNF-α、IMT、Crouse 评分、不稳定斑块数量和白细胞介素-6（IL-6）水平。然而，各组在改善 HDL-C 和白细胞介素-6（IL-6）水平方面无差异。各组不良反应发生率无显著差异。
本研究表明，小檗碱可能是一种有前途的 CVDs 治疗方法，且无严重不良反应。然而，我们的结果可能受到现有研究质量的限制。需要高质量的 RCT 来提供更有说服力的证据。
