基于动物实验系统评价大黄素治疗糖尿病肾病的可行性

Evaluation of the feasibility of emodin in the treatment of diabetic nephropathy based on animal experimental system

目的:系统评价大黄素对糖尿病肾病动物肾脏的保护作用。方法:计算机检索中国知网、维普、万方、中国生物医学文献及PubMed等数据库,检索从建库至2023年2月25日关于大黄素治疗糖尿病肾病的动物实验。采用RevMan 5.4.1软件进行分析。结果:共纳入14个研究,结果显示,相比于对照组,大黄素组更能降低糖尿病动物血糖[SMD=-2.51,95%CI(-3.77,-1.24),I^(2)=89%]、肌酐[SMD=-3.05,95%CI(-4.75,-1.34),I^(2)=91%]、尿素氮[SMD=-2.69,95%CI(-3.88,-1.50),I^(2)=82%]、24 h尿蛋白定量[SMD=-3.35,95%CI(-4.85,-1.85),I^(2)=87%]、相对肾重[SMD=-7.72,95%CI(-12.55,-2.88),I^(2)=90%]、三酰甘油[SMD=-1.24,95%CI-1.94,-0.54),I^(2)=0%]等指标。而大黄素与对照组在胆固醇[SMD=-1.19,95%CI(-2.29,-0.55),I^(2)=77%]等方面的差异无统计学意义。同时Meta分析提示大黄素保护肾脏与nephrin的表达、相关信号通路等有关。此类研究相关的严重不良反应鲜有报道。结论:大黄素对糖尿病肾病动物肾脏有保护作用,但有待于更高质量、严谨规范的大样本临床试验进一步证实。

Objective:To systematically evaluate the protective effect of emodin on the kidney of diabetes nephropathy animals.Methods:The databases of CNKI,VIP,Wanfang,Chinese biomedical literature and PubMed were searched by computer,and the animal experiments of emodin in the treatment of diabetes nephropathy from the establishment of the database to February 25,2023 were searched.RevMan 5.4.1 software was used for analysis.Results:Totally 12 studies were included.The results showed that compared with the control group,the emodin group was more effective in reducing blood glucose[SMD=-2.51,95%CI(-3.77,-1.24),I^(2)=89%],creatinine[SMD=-3.05,95%CI(-4.75,-1.34),I^(2)=91%],urea nitrogen[SMD=-2.69,95%CI(-3.88,-1.50),I^(2)=82%],24 h urine protein quantification[SMD=-3.35,95%CI(-4.85,-1.85),I^(2)=87%],relative kidney weight[SMD=-7.72,95%CI(-12.55,-2.88),I^(2)=90%],triacylglycerol[SMD=-1.24,95%CI(-1.94,-0.54),I^(2)=0%]and other indicators.There was no significant difference between the emodin and control groups in cholesterol[SMD=-1.19,95%CI(-2.29,-0.55),I^(2)=77%].At the same time,meta-analysis showed that emodin protection of kidney was related to the expression of nephrin and related signal pathways.Few serious adverse reactions related to such studies have been reported.Conclusion:Emodin has a protective effect on the kidney of diabetes nephropathy animals,but it needs to be further confirmed by a large sample clinical trial with higher quality and strict specifications.