黄连素治疗糖尿病肾病鼠和人的系统评价

Systematic Evaluation of Berberine in Treatment of Diabetic Nephropathy in Rats and Humanity

目的:研究黄连素对糖尿病肾病鼠和人的影响,借助循证医学评价黄连素的肾脏保护作用。方法:收集黄连素对糖尿病肾病鼠和人的治疗,运用ARRIVE指南和SYRCLE动物实验偏倚风险评估工具评价动物实验,CONSORT声明和Cochrane风险偏倚评估工具评价临床试验,系统评价和Meta分析评估治疗效果。结果:动物实验中黄连素可降低尿蛋白、肾脏指数和血肌酐,与其降低血糖、血浆胆固醇和三酰甘油水平、肾脏组织TLR4表达及上调肾脏组织PI3K和Nrf2表达有关;临床试验中黄连素可降低尿蛋白、血糖、浆胆固醇和三酰甘油水平,但对血肌酐无影响。结论:黄连素对糖尿病肾病鼠和人的治疗作用是安全、可靠的,但仍需大样本、高质量的研究加以证实。

Objective:To study the influence of berberine on diabetic nephrophy in rats and humanity,and evaluate the protective effect of berberine on diabetes with the help of evidence-based medicine.Methods:The relevant literatures on berberine in animal experiments and clinical studies of diabetic nephropathy were collected.ARRIVE guidelines and SYRCLE animal experiment bias risk assessment tools were used to evaluate animal experiments,CONSORT statements and Cochrane risk bias assessment tools were used to evaluate clinical trials,and a Meta analysis was used to evaluate the therapeutic effect.Results:In animal experiments,berberine could reduce urinary protein,renal indexes and serum creatinine,which was related to the decrease of blood glucose,plasma cholesterol and triglyceride levels,the expression of TLR4 in kidney tissue and the up regulation of PI3 K and Nrf2 in kidney tissue.In clinical trials,berberine could reduce urinary protein,blood glucose,plasma cholesterol and triglyceride levels,but had no effect on serum creatinine.Conclusion:Berberine is effective and safe in the treatment of diabetic nephropathy,but it still needs large sample and high quality research to confirm its efficacy.