调控肠道菌群的中药口服制剂干预脂代谢紊乱有效性与安全性的Meta分析

Efficacy and Safety of Chinese Medicine Oral Preparations in Intestinal Flora Intervention for Lipid Metabolism Disorder:a Meta-analysis

目的系统评价调控肠道菌群的中药口服制剂干预脂代谢紊乱的有效性与安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、中国知网(CNKI)、万方数据库(WangFang Data)、维普网(VIP)有关调控肠道菌群的中药口服制剂干预脂代谢紊乱的随机对照试验(RCT),检索时限均为各数据库建库至2020年12月,利用RevMan 5.4.1软件对纳入研究结果进行Meta分析。结果共纳入12项研究,涉及1260例脂代谢紊乱相关疾病病人。Meta分析结果显示:试验组三酰甘油(TG)水平[MD=-0.38,95%CI(-0.49,-0.27),P<0.00001]、总胆固醇(TC)水平[MD=-0.64,95%CI(-0.88,-0.41),P<0.00001]、低密度脂蛋白胆固醇(LDL-C)水平[MD=-0.47,95%CI(-0.65,-0.29),P<0.00001]均明显低于对照组,高密度脂蛋白胆固醇(HDL-C)水平[MD=0.21,95%CI(0.09,0.33),P=0.0005]高于对照组。试验组有20例出现腹泻、腹痛、泌尿系感染等不良反应。结论现有证据表明,调控肠道菌群的中药口服制剂可改善血脂代谢紊乱相关疾病病人血脂水平,且安全性良好,有望广泛应用于血脂异常病人的一级、二级预防。

Objective To systematically review the efficacy and safety of Chinese medicine oral preparations to regulated intestinal flora in the lipid metabolism.Methods PubMed,EMbase,The Cochrane Library,CNKI,WangFang Data,and VIP were searched from inception till December 2020,and randomized controlled trials(RCT)about Chinese medicine oral preparations to regulate intestinal flora for patients with lipid metabolism disorder were collected.The Meta-analysis was performed using RevMan5.4.1 software.Results A total of 12 studies were enrolled,involving 1260 patients with lipid metabolism disorder.The results of Meta-analysis showed that the levels of triacylglycerol[MD=-0.38,95%CI(-0.49,-0.27),P<0.00001],total cholesterol[MD=-0.64,95%CI(-0.88,-0.41),P<0.00001],and low-density lipoprotein cholesterol[MD=-0.47,95%CI(-0.65,-0.29),P<0.00001]in treatment group were significantly lower than those in control group,and the high-density lipoprotein cholesterol[MD=0.21,95%CI(0.09,0.33),P=0.0005]was higher in treatment group than that in control group.In the experimental group,diarrhea,abdominal pain,urinary tract infection and other adverse reactions occurred in 20 cases.Conclusion The available evidence suggests that Chinese medicine oral preparations to regulate intestinal flora can improve the blood lipid levels of patients with lipid metabolism disorder safely,and can be widely used in primary and secondary prevention of patients with dyslipidemia.