枳椇子解酒护肝功效的系统评价与Meta分析动物模型和临床证据的整合

 摘要：目的 对动物研究和人体随机对照试验进行系统评价和Meta分析，评估枳椇子的解酒护肝功效。方法 检索医学文献数据库，收集枳椇子解酒护肝的相关研究，并进行数据分析。结果 纳入34项动物研究，Meta 分析结果显示，①解酒方面：枳椇子明显延长醉酒潜伏期[MD=16.07,95% CI(10.98,21.16),P<0.00001,缩短睡眠维持时间[MD=-125.54,95% CI(-132.09,-118.99),P<0.0001],并降低乙醇浓度[MD=-0.85,95%CI(-1.25,-0.44),P<0.0001],增加肝脏中乙醇脱氢酶活性[SMD=1.56,95%CI(0.91,2.20),P<0.00001]。②护肝方面：在酒精诱导的肝损伤动物模型中，枳椇子可降低谷丙转氨酶(ALT)[SMD=1.69,95%CI(-2.16,-1.22),P<0.0000]和谷草转氨酶(AST)[SMD=-1.7,95%CI(-2.29,-1.24),P<0.0001],增加超氧化物歧化酶(SOD)[SMD=1.74,95%CI(1.10,2.37),P<0.00001]和谷胱甘肽(GSH)[SMD=3.13,95%CI(1.80,4.46),P<0.00001],降低丙二醛(MDA)[SMD=-2.45,95%CI(-3.15,-1.75),P<0.00001],降低甘油三酯含量[SMD=1.93,95%CI(-2.89,-0.96),P<0.00001]。此外，临床研究证实枳椇子能够降低乙醇和乙醛浓度，增强人体内乙醇代谢，改善酒精代谢和宿醉综合征，缓解乙醇引起的各种宿醉症状，并改善ALT及AST水平。结论 现有的动物实验证据表明，枳椇子可以加速体内酒精代谢，缓解宿醉症状，并保护肝损伤。然而目前临床研究仍较欠缺，未来需要进一步通过大样本、高质量的临床试验加以验证。

关键词：枳椇子；解酒护肝；动物模型；临床研究；系统评价；Meta分析

Abstract:Objective To conduct a systematic review and Meta-analysis of animal studies and randomized controlled trials to evaluate thehepatoprotective and anti-alcohol effects of Hovenia dulcis Thunb.Methods Medical literature databases were searched to collect studies related tothe de-alcoholic and hepatoprotective effects of Hovenia dulcis Thunb.,and data were analyzed.Results 34 animal studies were included.TheMeta-analysis results showed that:①In terms ofanti-alcohol:Hovenia dulcis Thunb.significantly prolonged the latency period of intoxication[MD=16.07,95%CI(10.98,21.16),P<0.0001],shortened the sleep maintenance time [MD=-125.54,95%CI(-132.09,-118.99),P<0.0001],and reduced the ethanol concentration [MD=-0.85,95%CI(-1.25,-0.44),P<0.0001],and increased the activity of alcohol dehydrogenase in theliver [SMD=1.56,95%CI(0.91,2.20),P<0.0001].②In terms of hepatoprotection:In alcohol-induced liver injury animal models,Hoveniadulcis Thunb.could reduce ALT [SMD=-1.69,95%CI(-2.16,-1.22),P<0.00001]and AST[SMD=-1.77,95%CI(-2.29,-1.24),P<0.0000],increase SOD [SMD=1.74,95%CI(1.10,2.37),P<0.0001]and GSH [SMD=3.13,95%CI(1.80,4.46),P<0.00001],reduce MDA[SMD=-2.45,95%CI(-3.15,-1.75),P<0.0001],and reduce tiglyceride content [SMD=-1.93,95%CI(-2.89,-0.96),P<0.0001].In addition,clinical studies have confirmed that Hovenia dulcis Thunb.can reduce ethanol and acetaldehyde concentrations,enhance alcohol metabolism in thehuman body,improve alcohol metabolism and hangover syndrome,allviate various hangover symptoms caused by ethanol,and improve ALT andAST levels.Conclusion The existing animalexperimental evidence indicates that Hovenia dulcis Thunb.can accelerate alcohol metabolism,alleviatehangover symptoms,and protect liver damage.However,curent clinical research is still nufficient.Further verification through large-sample,high-quality clinical trials is needed in the future.

Key words:Hovenia dulcis Thunb.;anti-alcohol and hepatoprotective;animal model;clinical research;systematic review;meta-analysis