电针治疗高脂血症合并动脉粥样硬化动物实验的系统评价
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摘要
目的:系统评价电针治疗高脂血症合并动脉粥样硬化动物实验的有效性和安全性。方法:计算机检索中国期刊全文数据库、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库、PubMed、Embase和Cochrane图书馆自建库至2018年3月19日的电针治疗高脂血症合并动脉粥样硬化相关动物实验。由课题组2位研究员分别独立筛选文献并提取实验对象、实验步骤、实验结果等信息,进行质量评价,采用软件RevMan5.3进行Meta分析。结果:最终纳入29个研究,质量评价平均为5.1分,处于中等水平。Meta分析结果显示,与模型对照组相比,电针治疗后总胆固醇[SMD-2.29,95%CI(-2.94,-1.64),P<0.000 01]、三酰甘油[SMD-1.30,95%CI(-1.76,-0.84),P<0.000 01]、低密度脂蛋白胆固醇[SMD-2.64,95%CI(-3.29,-1.99),P<0.000 01]含量显著降低,高密度脂蛋白胆固醇[SMD 0.55,95%CI(0.06,1.04),P=0.03]含量升高,差异均有统计学意义。结论:根据目前有限的证据,电针治疗高脂血症合并动脉粥样硬化动物模型可降低胆固醇、三酰甘油、低密度脂蛋白胆固醇含量,轻度升高高密度脂蛋白胆固醇含量。
Objective To systematically review the effectiveness and safety of electroacupuncture(EA) on hyperlipidemia combined with atherosclerosis in animal experiments. Methods The relevant animal experiments of EA treatment for hyperlipidemia combined with atherosclerosis were retrieved from the CNKI, WANFANG, VIP, CBM, PubMed, Embase and the Cochrane Library up to March 19, 2018 since the establishment of databases. Two researchers in the project team screened the literature and extracted the information such as experiment objects, experiment steps and experiment results separately. The literature assessment was evaluated. Meta analysis was performed with RevMan 5.3 software. Results Eventually, 29 eligible experimental researches were included and the average score in the quality assessment was 5.1, at the moderate level. Meta analysis showed that compared with the model control group, after EA treatment, the levels of the total cholesterol(TC) [SMD-2.29, 95% CI(-2.94,-1.64), P<0.000 01], triglyceride(TG) [SMD-1.30, 95% CI(-1.76,-0.84), P<0.000 01] and low density lipoprotein-cholesterol(LDL-C) [SMD-2.64, 95% CI(-3.29,-1.99), P<0.000 01] were significantly reduced and the level of high density lipoprotein-cholesterol(HDL-C) [SMD 0.55, 95% CI(0.06, 1.04), P =0.03] was increased, indicating the significant differences. Conclusion On the base of the current limited evidences, EA significantly reduces the levels of TC, TG and LDL-C and slightly increases the level of HDL-C in the animal models of hyperlipidemia combined with atherosclerosis.
Objective To systematically review the effectiveness and safety of electroacupuncture(EA) on hyperlipidemia combined with atherosclerosis in animal experiments. Methods The relevant animal experiments of EA treatment for hyperlipidemia combined with atherosclerosis were retrieved from the CNKI, WANFANG, VIP, CBM, PubMed, Embase and the Cochrane Library up to March 19, 2018 since the establishment of databases. Two researchers in the project team screened the literature and extracted the information such as experiment objects, experiment steps and experiment results separately. The literature assessment was evaluated. Meta analysis was performed with RevMan 5.3 software. Results Eventually, 29 eligible experimental researches were included and the average score in the quality assessment was 5.1, at the moderate level. Meta analysis showed that compared with the model control group, after EA treatment, the levels of the total cholesterol(TC) [SMD-2.29, 95% CI(-2.94,-1.64), P<0.000 01], triglyceride(TG) [SMD-1.30, 95% CI(-1.76,-0.84), P<0.000 01] and low density lipoprotein-cholesterol(LDL-C) [SMD-2.64, 95% CI(-3.29,-1.99), P<0.000 01] were significantly reduced and the level of high density lipoprotein-cholesterol(HDL-C) [SMD 0.55, 95% CI(0.06, 1.04), P =0.03] was increased, indicating the significant differences. Conclusion On the base of the current limited evidences, EA significantly reduces the levels of TC, TG and LDL-C and slightly increases the level of HDL-C in the animal models of hyperlipidemia combined with atherosclerosis.
引文
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[21]李梦,蔡荣林,孙旭,等.针刺对冠状动脉粥样硬化性心脏病模型大鼠血脂水平及CD40L、基质金属蛋白酶-9表达的影响[J].针刺研究,2013,38(2):123-128.
[22]陶文剑.电针对ApoE-/-小鼠LDLR和PPARγ表达的影响[D].南京:南京中医药大学,2014.
[23]王琼,田佳玉,肖颖,等.电针丰隆穴对高脂血症大鼠腹腔巨噬细胞CD11b、ICAM-1表达的影响[J].上海针灸杂志,2014,33(10):951-954.
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[25]张国鑫,苗晋玲,张中原,等.电针不同腧穴组方对高脂血症大鼠血脂的调节作用[J].中国针灸,2014,34(9):894-897.
[26]张国鑫.腧穴“降脂方”的筛选及其对血脂异常大鼠调脂作用的实验研究[D].太原:山西中医学院,2015.
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[28]张中原,王海军,苗晋玲,等.腧穴“降脂方”对高脂血症大鼠肝脏胆固醇代谢相关基因表达的影响[J].中华针灸电子杂志,2015,4(4):172-175.
[29]武欢,林威,张照庆,等.电针丰隆穴对高脂血症大鼠血液流变学的影响[J].时珍国医国药,2016,27(9):2292-2293.
[30]兰彩莲,万隆,萨喆燕,等.电针足三里和丰隆对高脂血症新西兰兔血脂影响[J].辽宁中医药大学学报,2016,18(10):85-87.
[31]成泽东,宁玉楼,王芮.电针对动脉粥样硬化兔腹腔巨噬细胞受体CD36表达的影响[J].中国针灸,2018,38(2):179-183.
[32]熊玮,魏强,刘雪梅.动物实验研究的系统评价简介[J].中国循证医学杂志,2005,5(2):161-163,173.
[33]Malcolm R Macleod,Tori O’Collins,Laura L Horky,et al.FK506对实验性卒中疗效的系统评价和Meta分析[J].中国循证医学杂志,2006,6(6):430-438.
[34]刘迈兰,李成文,汪厚莲,等.电针对高脂血症动物模型有效性和安全性的Meta分析[J].中国循证医学杂志,2015,15(3):353-357.
[35]李珩,肖宁,邵明璐,等.针刺内关预处理干预心肌缺血再灌注大鼠实验效应的系统评价[J].中国中医基础医学杂志,2016,22(12):1665-1669.
[36]Ren J,Grundy SM,Lin J,et al.Long-term coronary heart disease risk associated with very-low density lipoprotein cholesterol in Chinese:the results of a 15-year Chinese multi-provincial cohort study(CMCS)[J].Atherosclerosis,2010,211(1):327-332.
[2]Peters JL,Sutton AJ,Jones DR,et al.A systematic review of systematic reviews and meta-analyses of animal experiment with guidelines for reporting[J].J Environ Sci Health B,2006,41(7):1245-1258.
[3]齐凤军,孙国杰.电针对高脂血症大鼠血浆TXA_2 PGI_2水平的影响[J].中医药学刊,2006,24(8):1570-1571.
[4]李蔚.电针丰隆穴调节血脂的优化参数研究及机理探讨[D].北京:北京中医药大学,2006.
[5]Li M,Zhang YZ.Modulation of gene expression in cholesterol-lowering effect of electroacupuncture at Fenglong acupoint(ST 40):a cDNA microarray study[J].Int J Mol Med,2007,19(4):617-29.
[6]解秸萍,农艳,贾君君,等.针刺丰隆单穴及其配穴调节高脂血症大鼠血脂的效应比较[J].北京中医药大学学报,2008,31(2):141-144.
[7]周利,万文俊,刘灵光,等.电针“丰隆”穴对高脂血症大鼠NO、ET及CGRP的影响[J].中国针灸,2008,28(1):57-60.
[8]袁爱红,蔡辉.针刺对高脂大鼠主动脉脂联素受体基因表达的影响[J].中西医结合心脑血管病杂志,2010,8(10):1201-1203.
[9]江丽霞.针刺对高脂血症模型大鼠干预作用的研究[D].广州:广州中医药大学,2010.
[10]栾瑞芝.电针对实验家兔颈动脉粥样硬化斑块MMP-2及VCAM-1的影响[D].哈尔滨:黑龙江省中医研究院,2010.
[11]刘军,周振坤,李静华,等.电针对颈动脉粥样硬化模型家兔血脂的影响[J].中国中医药咨讯,2011,3(10):325-326.
[12]王志波,肖红玲,肖丽梅,等.针刺丰隆、曲池及三阴交对高脂血症小鼠血脂的影响[J].河北中医,2011,33(12):1860-1862.
[13]杨金梅,张唐法,张红星,等.电针丰隆穴早期干预金黄地鼠高脂血症的机制[J].中国康复,2011,26(2):89-90.
[14]张红星,王英淑,周利,等.电针丰隆穴对高血脂症型地鼠肝脏LPL、HL的影响[J].中国康复,2011,26(4):250-252.
[15]覃鹏飞.电针丰隆调脂的实验和临床研究[D].武汉:湖北中医药大学,2011.
[16]张红星,王琼,黄浩,等.电针“丰隆”穴对高脂血症大鼠的调控及其作用机制[J].中国针灸,2012,32(3):241-245.
[17]乐薇,肖颖,田佳玉,等.电针丰隆穴对高脂血症模型大鼠巨噬细胞炎症因子表达的影响[J].中国中西医结合杂志,2013,33(10):1361-1366.
[18]肖颖.针药结合治疗高脂血症的临床与实验研究[D].武汉:湖北中医药大学,2013.
[19]武欢,王东,田佳玉,等.电针丰隆穴对高脂血症大鼠肝脏及主动脉弓ABCA_1 m RNA表达的影响[J].中国中医急症,2013,22(1):1-2,31.
[20]严志康,杨智杰,陈锋.电针对高脂血症大鼠血脂、超敏C反应蛋白、脂联素的调节作用[J].针刺研究,2013,38(5):365-368,385.
[21]李梦,蔡荣林,孙旭,等.针刺对冠状动脉粥样硬化性心脏病模型大鼠血脂水平及CD40L、基质金属蛋白酶-9表达的影响[J].针刺研究,2013,38(2):123-128.
[22]陶文剑.电针对ApoE-/-小鼠LDLR和PPARγ表达的影响[D].南京:南京中医药大学,2014.
[23]王琼,田佳玉,肖颖,等.电针丰隆穴对高脂血症大鼠腹腔巨噬细胞CD11b、ICAM-1表达的影响[J].上海针灸杂志,2014,33(10):951-954.
[24]田佳玉,陈盈芳,王琼,等.电针丰隆穴对高脂血症大鼠腹腔巨噬细胞MCP-1、IL-1γ表达的影响[J].中国中医急症,2014,23(7):1212-1215.
[25]张国鑫,苗晋玲,张中原,等.电针不同腧穴组方对高脂血症大鼠血脂的调节作用[J].中国针灸,2014,34(9):894-897.
[26]张国鑫.腧穴“降脂方”的筛选及其对血脂异常大鼠调脂作用的实验研究[D].太原:山西中医学院,2015.
[27]乐薇,张红星,王琼,等.电针丰隆穴对高脂血症大鼠血脂及肝脏组织炎症细胞因子的调控作用[J].中国康复,2015,30(1):7-9.
[28]张中原,王海军,苗晋玲,等.腧穴“降脂方”对高脂血症大鼠肝脏胆固醇代谢相关基因表达的影响[J].中华针灸电子杂志,2015,4(4):172-175.
[29]武欢,林威,张照庆,等.电针丰隆穴对高脂血症大鼠血液流变学的影响[J].时珍国医国药,2016,27(9):2292-2293.
[30]兰彩莲,万隆,萨喆燕,等.电针足三里和丰隆对高脂血症新西兰兔血脂影响[J].辽宁中医药大学学报,2016,18(10):85-87.
[31]成泽东,宁玉楼,王芮.电针对动脉粥样硬化兔腹腔巨噬细胞受体CD36表达的影响[J].中国针灸,2018,38(2):179-183.
[32]熊玮,魏强,刘雪梅.动物实验研究的系统评价简介[J].中国循证医学杂志,2005,5(2):161-163,173.
[33]Malcolm R Macleod,Tori O’Collins,Laura L Horky,et al.FK506对实验性卒中疗效的系统评价和Meta分析[J].中国循证医学杂志,2006,6(6):430-438.
[34]刘迈兰,李成文,汪厚莲,等.电针对高脂血症动物模型有效性和安全性的Meta分析[J].中国循证医学杂志,2015,15(3):353-357.
[35]李珩,肖宁,邵明璐,等.针刺内关预处理干预心肌缺血再灌注大鼠实验效应的系统评价[J].中国中医基础医学杂志,2016,22(12):1665-1669.
[36]Ren J,Grundy SM,Lin J,et al.Long-term coronary heart disease risk associated with very-low density lipoprotein cholesterol in Chinese:the results of a 15-year Chinese multi-provincial cohort study(CMCS)[J].Atherosclerosis,2010,211(1):327-332.