黄连素(小檗碱)治疗糖尿病肾病疗效和安全性的系统评价

Efficacy and safety of berberine in treatment of diabetic nephropathy:a Meta analysis

目的通过Meta分析的方法对黄连素(小檗碱)治疗糖尿病肾病的临床疗效和安全性进行客观评价。方法我们对PUBMED、EMBASE、万方、CNKI、维普和中国生物医学数据库等数据库进行筛选,检索词为"糖尿病肾病"和"黄连素"。只有关于黄连素与安慰剂或者其他药物比较的在非妊娠成人糖尿病肾病患者的随机对照试验被纳入。按照纳入排除标准进行文献筛查、数据提取、文献质量评估和异质性分析,进一步完成Meta分析。结果纳入的7个研究均为临床随机对照试验,共包括研究对象437例,异质性分析表明纳入的7个研究之间的异质性可以接受(I2<50%,P>0.1),用固定性效应模型进行分析。结果表明:黄连素能降低糖尿病肾病患者的空腹血糖(MD=-0.23,95%CI:-0.38,-0.09)、尿蛋白(MD=-0.52,95%CI:-0.83,-0.22)、胆固醇(MD=-0.11,95%CI:-0.19,-0.03)和C-反应蛋白(MD=-1.50,95%CI:-2.03,-0.96)的水平,且副作用小。结论我们的研究表明黄连素(小檗碱)能够降低糖尿病肾病患者的血糖、尿蛋白、胆固醇和C-反应蛋白水平,且无明显毒副作用。然而研究结果有待于进一步完善和充实。

Objective To assess the efficacy and safety of berberine in treatment of diabetic nephropathy. Methods We searched the following databases, PUBMED, EMBASE, Wan Fang, CNKI, VIP and Sinomed with the following terms, ?diabetic nephropathy‘ and ?berberine‘. Only randomized controlled trials comparing berberine with placebo or other drugs in non-pregnant drug-naive adults with diabetic nephropathy were included. According to the predefined strategy, we progressed screening, data extraction, quality assessment, test of heterogeneity and analysis the results. Results Seven controlled clinical trials enrolled, including 437 cases. Heterogeneity test showed that I2<50%(P>0.1), indicating that these seven trials were in good homogeneity. So fixed effect model was used and the results showed that berberine lowered the blood glucose level(MD=-0.23, 95% CI-0.38,-0.09), urinary protein(MD=-0.52, 95% CI-0.83,-0.22), cholesterol(MD=-0. 11, 95% CI-0.19,-0.03) and C-reactive protein(MD=-1.50, 95% CI-2.03,-0.96) in the treatment of diabetic. Beside, it‘s relatively safe. Conclusion Our study shows that berberine can low the blood glucose, urinary protein, cholesterol and C-reactive protein in patients with diabetic nephropathy without obvious side effects. However, further study is needed to confirm that.