Meta analysis of clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver

Objective:To evaluate the clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver.Methods:Randomized controlled studies were searched in Chinese and English databases from March 30,2020.The quality was evaluated after literature screening and statistical analysis by RevMan5.3 software.Results:Nine studies were included,involving 780 patients.Meta analysis showed that berberine alone or in combination could reduce total cholesterol(MD=-0.50,95%CI),low density lipoprotein(MD=-0.34,95%CI)and glutamyltransferase(MD=-20.79,95CI%).Subgroup analysis showed that berberine combined with berberine could reduce glycosylated hemoglobin level[MD=-0.68,95%CI(-0.98 maxim 0.38)],while in patients with diabetes treated with berberine,alanine aminotransferase(MD=-9.38,95CI%)and aspartate oxaloacetic transaminase(MD=-9.03,95CI%)decreased significantly.The above differences were statistically significant(P<0.01).In addition,berberine has a tendency to decrease triglyceride,fasting blood glucose,body mass index and improve insulin resistance.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Berberine can regulate glucose and lipid metabolism in patients with non-alcoholic fatty liver and has a tendency to improve liver function and insulin resistance.

A Systematic Review and Meta-Analysis of Randomized Controlled Trials on Treating Ulcerative Colitis by the Integration Method of Heat-Clearing, Damp-Excreting, Spleen-Strengthening, and Stasis-Removing of Traditional Chinese Medicine with Western Medicine

Objective:The objective of this study was to systematically evaluate the clinical efficacy of the integration method of heat-clearing, dampness-excreting,spleen-strengthening, and stasis-removing from traditional Chinese medicine (TCM) combined with Western medicine for the treatment of ulcerative colitis(UC).Materials and Methods:The databases China National Knowledge Infrastructure,China Biology Medicinedisc(CBMdisc),WANFANG, VIP, and PubMed were searched for randomized controlled trials investigating the integration of the TCM methods of clearing heat,draining dampness, invigorating the spleen, and removing stasis, combined with Western medicine to treat UC from January 2009 to March 2019. Two reviewers independently conducted literature searches, screenings, data extractions, and literature bias evaluations. A meta-analysis was conducted using RevMan 5.3 and Stata 13.0 software. Results:In total, 15 studies involving 1289 patients were included. The results of the meta-analysis showed that the total effective rate of treatment in the experimental groups was higher than that of the control groups (relative risk [RR]=1.27, 95%confidence interval [CI]:1.21, 1.35, Z=8.74, P <0.00001). In the subgroup analysis, the total effective rate of oral TCM combined with Western medicine was higher than that of the control groups (RR=1.24, 95%CI:1.15, 1.33, Z=5.88, P <0.00001). The total effective rate of oral TCM with enemas combined with Western medicine was higher than that of the control group (RR=1.30, 95%CI:1.12, 1.50, Z=3.52, P=0.0004).The comparison between Western medicine alone and oral TCM combined with enteroscopy and Western medicine showed that the effective rate of enteroscopy (RR=1.18, 95%CI:1.05, 1.33, Z=2.86, P=0.004) and the symptom scores before and after treatment all improved more in the combined treatment groups than in those of the Western medicine group alone, with statistically significant differences (RR=-4.23, 95%CI:-4.93,-3.53, Z=11.84, P <0.00001). Conclusion:The integration of the TCM methods of heat clearing, dampness excreting, spleen strengthening, and stasis removing combined with Western medicine can significantly improve the cure rate of UC, and is an effective method to treat UC.