Luo Xin, Niu Jing-Yuan, Chen Hui-Sheng
Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, China.
Department of Neurology, General Hospital of Northern Theater Command, 83 Wen Hua Road, Shenyang, 110016, China.
BMC Complement Med Ther. 2025 May 5;25(1):163. doi: 10.1186/s12906-025-04899-7.
Cerebral ischemia-reperfusion injury (CIRI) is a complex pathological process, which can further aggravate the damage of ischemic tissues. Traditional Chinese medicine (TCM) monomers, bioactive compounds extracted from Chinese herbal medicines, have been demonstrated to have various protective effects against reperfusion injury. This network meta-analysis (NMA) aimed to investigate the optimal treatment strategy of TCM monomers for CIRI in animal models.
Four databases including PubMed, Embase, Web of Science, and Cochrane were searched up to January 06, 2024. First, prospective registration was done at PROSPERO (ID: CRD42024496289), the quality of the included studies was evaluated with SYRCLE's risk of bias tool, and statistical analysis was conducted with Stata Version 18.0 and RStudio.
In total, 26 studies were included, involving 506 animals and 12 TCM monomers. The results of a meta-analysis demonstrated that, compared to the control group, puerarin, paeoniflorin, hydroxysafflor yellow A, sinomenine, and salvianolic acid significantly reduced mNSS scores. Furthermore, ginsenoside, scutellarin, and baicalein significantly reduced Longa scores. In addition, salvianolic acid treatment significantly decreased brain water content. Regarding infarct volume, bilobalide, baicalein and puerarin all demonstrated remarkable effects. The network meta-analysis suggested that paeoniflorin might be the most effective intervention in terms of mNSS score, with a surface under the cumulative ranking curve (SUCRA) value of 92.8%; Scutellarin might be the most effective intervention to reduce Longa score (SUCRA = 87.6%); And salvianolic acid might be the most effective intervention to reduce brain water content (SUCRA = 98.2%); For infarct volume specifically, bilobalide may be the most effective intervention (SUCRA = 95.5%). In our meta-regression, we found that dose and duration of treatment may contribute to heterogeneity among mNSS studies.
TCM monomers could provide a favorable neuroprotection on CIRI, with heterogeneous protective effects. Given the small number and the differences in quality of included studies, more high-quality, programmatic animal studies were needed to validate our findings.
Not applicable.
脑缺血再灌注损伤（CIRI）是一个复杂的病理过程，可进一步加重缺血组织的损伤。中药单体，即从中药材中提取的生物活性化合物，已被证明对再灌注损伤具有多种保护作用。本网络荟萃分析（NMA）旨在探讨中药单体对动物模型中CIRI的最佳治疗策略。
检索了截至2024年1月6日的四个数据库，包括PubMed、Embase、Web of Science和Cochrane。首先，在PROSPERO（ID：CRD42024496289）进行前瞻性注册，使用SYRCLE偏倚风险工具评估纳入研究的质量，并使用Stata 18.0版和RStudio进行统计分析。
共纳入26项研究，涉及506只动物和12种中药单体。荟萃分析结果表明，与对照组相比，葛根素、芍药苷、羟基红花黄色素A、青藤碱和丹酚酸显著降低了改良神经功能缺损评分（mNSS）。此外，人参皂苷、灯盏花素和黄芩苷显著降低了Longa评分。此外，丹酚酸治疗显著降低了脑含水量。关于梗死体积，双氢青蒿素、黄芩苷和葛根素均显示出显著效果。网络荟萃分析表明，就mNSS评分而言，芍药苷可能是最有效的干预措施，累积排序曲线下面积（SUCRA）值为92.8%；灯盏花素可能是降低Longa评分最有效的干预措施（SUCRA = 87.6%）；丹酚酸可能是降低脑含水量最有效的干预措施（SUCRA = 98.2%）；对于梗死体积而言，双氢青蒿素可能是最有效的干预措施（SUCRA = 95.5%）。在我们的荟萃回归中，我们发现治疗剂量和持续时间可能导致mNSS研究之间的异质性。
中药单体可为CIRI提供良好的神经保护作用，但其保护作用存在异质性。鉴于纳入研究的数量较少且质量存在差异，需要更多高质量、有计划的动物研究来验证我们的发现。
不适用。
