大柴胡汤中化学成分干预胰腺炎动物模型效果的贝叶斯网状Meta分析

Effect of chemical components in Dachaihu Decoction on animal model of pancreatitis:a Bayesian network Meta analysis

[目的]系统评价大柴胡汤方中化学成分干预胰腺炎动物模型的效果,探究大柴胡汤发挥药效的物质基础。[方法]运用计算机检索中国知网、万方数据、维普网、PubMed、Embase、Cochrane Library等数据库,检索时间范围均为自数据库建立起到2019年10月。检索到的文献全部输入NoteExpress软件进行筛选和管理,将纳入的文献进行质量评价和资料提取,运用Stata 16、GeMTC 0.14.3等软件进行统计分析。[结果]共收集筛选到化学成分75个,共检索到文献1870篇,最终纳入文献36篇,涉及5种化学成分。网状Meta分析显示,降低胰腺病理评分效果排序:槲皮素>大黄素联合黄芩苷>大黄素>奥曲肽>黄芩苷>芍药苷>β-胡萝卜素;降低血清淀粉酶效果排序:大黄素>奥曲肽>黄芩苷>大黄素联合黄芩苷>槲皮素>β-胡萝卜素;降低肿瘤坏死因子-α(TNF-α)效果排序:大黄素>大黄素联合黄芩苷>奥曲肽>黄芩苷>芍药苷;降低白细胞介素-6(IL-6)效果排序:大黄素>黄芩苷>芍药苷>大黄素联合黄芩苷>β-胡萝卜素。[结论]大柴胡汤中5种化学成分在干预胰腺炎动物模型,降低胰腺病理评分,降低血清淀粉酶、TNF-α、IL-6的水平上均有显著的效果,并且安全无不良反应。这5种成分共同构成了大柴胡汤治疗胰腺炎的功效物质基础,协同发挥治疗作用。另外,在不同的指标上不同化学成分发挥不同的疗效,提示这5种化学成分干预胰腺炎病情发展的途径可能不同,同时这也可能是大柴胡汤配伍的科学内涵。研究为今后胰腺炎治疗的实验研究和临床转化提供了可靠的参考,同时需要更高质量的实验研究和更多的临床样本对这5种化学成分有效性和安全性进一步加以证实。

[Objective]To systematically evaluate the efficacy of chemical components in Dachaihu Decoction in the intervention of animal models of pancreatitis.[Methods]Computers were used to search databases such as CNKI,Wanfang Data,VIP,PubMed,Embase,Cochrane Library.The search time range was from database establishment to October 2019;all the retrieved documents were imported into NoteExpress software for screening and management,the quality of the included literature and data extraction,using Stata 16,GeMTC 0.14.3 and other software for statistical analysis.[Results]A total of 75 chemical components were collected and screened,and 1870 documents were retrieved,and 36 articles were finally included in the literature,involving five chemical components.Network Meta analysis showed:reduction of pancreatic pathological scores,quercetin>emodin combined with baicalin>emodin>otreotide>baicalin>paeoniflorin>β-carotene;lowering serum amylase effect ranking,emodin>octreotide>baicalin>emodin combined with baicalin>quercetin>β-carotene;reduce the order of TNF-αeffect,emodin>emodin combined with baicalin>octreotide>baicalin>paeoniflorin;reduce the sorting effect of IL-6,emodin>baicalin>paeoniflorin>emodin combined with baicalin>β-carotene.[Conclusion]The five chemical components in Dachaihu Decoction have significant effects on intervention of animal models of pancreatitis,reduction of pancreatic pathological scores,and reduction of serum amylase,TNF-α,and IL-6 levels,and are safe without adverse reactions.These five ingredients together form the material basis for the efficacy of Dachaihu Decoction in the treatment of pancreatitis and play a synergistic role in the treatment.In addition,different chemical components exert different effects on different indicators,suggesting that the five chemical components may have different approaches to the development of pancreatitis,and this may also be the scientific connotation of the compatibility of Dachaihu Decoction.This study provides a reliable reference for future research and needs more high quality clinical trials and more clinical samples further confirm the efficacy and safety of these five chemical components.