Meta-Analysis of Animal Experiments on Astragali Radix or Its Ingredients for Acute Pancreatitis

doi:10.12300/j.issn.1674-5817.2025.026

Abstract

Abstract:

Objective Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to obtain precise and reliable comprehensive effect conclusions by quantitatively combining pharmacodynamic results from animal experiments investigating Astragali Radix (single-entity Astragali Radix preparation) or its ingredients for treatment of acute pancreatitis (AP) in literature reports through meta-analysis. Methods Databases including CNKI, CSTJ, Wanfang, CBM, PubMed, and Web of Science were searched from inception to March 2025 for animal studies related to Astragali Radix (single-entity Astragali Radix preparation) or its ingredients for AP treatment. Risk of bias for included studies was assessed with SYRCLE tool. Heterogeneity among studies was evaluated according to Cochrane Handbook using Cochrane's Q test and I2 statistic. Results A total of 297 articles were retrieved, and after screening and evaluation, 19 animal studies were finally included for meta-analysis. These 19 studies covered four strains: SD rats, C57BL/6 mice, BALB/c mice, and Kunming mice. SYRCLE scores ranged from 3 to 4. Egger's test indicated potential publication bias (P<0.05), and Cochrane's Q test and I2 statistic indicated substantial heterogeneity among studies. Meta-analysis results of 19 animal studies showed that single-entity Astragali Radix preparation (Astragali Radix injection) could reduce serum amylase (AMS) levels, an AP-specific indicator. The Astragali Radix ingredients could decrease both AMS and lipase (LPS) levels. Astragali Radix injection or Astragali Radix ingredients could reduce serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1 beta (IL-1β), while increasing interleukin-10 (IL-10) levels; could increase serum levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) , and decrease malondialdehyde (MDA) levels. High-dose groups of Astragali Radix injection or Astragali Radix ingredients were more effective than low-dose groups in reducing AMS, TNF-α, and IL-6 levels and increasing SOD levels, but dosage effect on MDA levels was not demonstrated. Conclusion Evidence-based analysis of animal experiment results shows that in various animal models including SD rats, C57BL/6 mice, BALB/c mice, and Kunming mice, Astragali Radix injection or Astragali Radix ingredients can effectively reduce expression or secretion levels of AP-specific indicators (AMS and LPS). The mechanisms may be related to some inflammatory mediators, including reducing TNF-α, IL-6, and IL-1β levels and increasing IL-10 levels; may also intervene in oxidative/antioxidative equilibrium, such as increasing SOD and GSH-PX levels and reducing MDA levels. Except for MDA, dose–response relationships are shown for reducing AMS, TNF-α, and IL-6 levels and increasing SOD levels with Astragali Radix injection or ingredients. However, due to high heterogeneity, potential publication bias risk, and species differences between animal models and human diseases in existing studies, further high-quality clinical trials or animal experiments are still needed in the future.

Key words: Astragali Radix, Astragali Radix injection, Acute Pancreatitis, Animal experiment, Meta-analysis, Rat, Mouse

CLC Number:

R576

CAO Xingxin,LI Aiyi,HOU Jinghan,et al. Meta-Analysis of Animal Experiments on Astragali Radix or Its Ingredients for Acute Pancreatitis[J]. Laboratory Animal and Comparative Medicine. DOI: 10.12300/j.issn.1674-5817.2025.026.

Figures/Tables 8

References 45

[1]	MEDEROS M A, REBER H A, GIRGIS M D. Acute pancreatitis: a review[J]. JAMA, 2021, 325(4):382-390. DOI:10.1001/jama.2020.20317 .
[2]	SCHEPERS N J, BAKKER O J, BESSELINK M G, et al. Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis[J]. Gut, 2019, 68(6):1044-1051. DOI:10.1136/gutjnl-2017-314657 .
[3]	HAN K, CHEN S M, SONG Y, et al. Burden of pancreatitis and associated risk factors in China, 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Chin Med J (Engl), 2022, 135(11):1340-1347. DOI:10.1097/CM9.0000000000002164 .
[4]	GARDNER T B. Acute pancreatitis[J]. Ann Intern Med, 2021, 174(2): ITC17-ITC32. DOI:10.7326/aitc202102160 .
[5]	李芝萍, 汪娅君, 张菊萍, 等. 通腑逐瘀方联合常规西药治疗腑实热结证急性胰腺炎临床研究[J]. 新中医, 2024, 56(10):81-85. DOI: 10.13457/j.cnki.jncm.2024.10.016 .
	LI Z P, WANG Y J, ZHANG J P, et al. Clinical study on Tongfu Zhuyu decoction combined with conventional western medicine for acute pancreatitis with syndrome of bowel excess and heat bind[J]. New Chin Med, 2024, 56(10):81-85. DOI: 10.13457/j.cnki.jncm.2024.10.016 .
[6]	BOXHOORN L, VOERMANS R P, BOUWENSE S A, et al. Acute pancreatitis[J]. Lancet, 2020, 396(10252):726-734. DOI:10.1016/s0140-6736(20)31310-6 .
[7]	WANG P P, WANG Z, ZHANG Z P, et al. A review of the botany, phytochemistry, traditional uses, pharmacology, toxicology, and quality control of the Astragalus memeranaceus[J]. Front Pharmacol, 2023, 14:1242318. DOI:10.3389/fphar.2023.1242318 .
[8]	张琪, 张会芳, 李兆洋, 等. 黄芪注射液对急性胰腺炎患者氧化应激状态及肠黏膜屏障功能的影响[J]. 吉林中医药, 2021, 41(12):1616-1619. DOI: 10.13463/j.cnki.jlzyy.2021.12.021 .
	ZHANG Q, ZHANG H F, LI Z Y, et al. Effects of Huangqi Injection on the oxidative stress and intestinal mucosal barrier function in patients with acute pancreatitis[J]. Jilin J Chin Med, 2021, 41(12):1616-1619. DOI: 10.13463/j.cnki.jlzyy.2021.12.021 .
[9]	王嫄嫄, 郑洋, 周哲, 等. 黄芪注射液对急性胰腺炎肠道屏障功能和微炎性反应状态的影响[J]. 世界中医药, 2018, 13(4):818-821. DOI: 10.3969/j.issn.1673-7202.2018.04.008 .
	WANG Y Y, ZHENG Y, ZHOU Z, et al. Clinical study on Huangqi injection on intestinal barrier function and micro inflammatory state in patients with acute pancreatitis[J]. World Chin Med, 2018, 13(4):818-821. DOI: 10.3969/j.issn.1673-7202.2018.04.008 .
[10]	AL-MASAWA M E, ALSHAWSH M A, NG C Y, et al. Efficacy and safety of small extracellular vesicle interventions in wound healing and skin regeneration: a systematic review and meta-analysis of animal studies[J]. Theranostics, 2022, 12(15):6455-6508. DOI:10.7150/thno.73436 .
[11]	LIU D S, SONG D X, NING W H, et al. Efficacy and safety of prophylaxis for venous thromboembolism in brain neoplasm patients undergoing neurosurgery: a systematic review and Bayesian network meta-analysis[J]. J Thromb Thrombolysis, 2023, 55(4):710-720. DOI:10.1007/s11239-023-02780-3 .
[12]	孙海燕, 黄民, 关溯. 黄芪总苷对实验性急性胰腺炎的保护作用[J]. 时珍国医国药, 2006, 17(10):1980-1981. DOI: 10.3969/j.issn.1008-0805.2006.10.044 .
	SUN H Y, HUANG M, GUAN S. Effects of astragalosides on experimental acute pancreatitis[J]. Lishizhen Med Mater Med Res, 2006(10):1980-1981. DOI: 10.3969/j.issn.1008-0805.2006.10.044 .
[13]	傅强, 崔乃强, 邵伟, 等. 急性出血坏死性胰腺炎小鼠辅助性T细胞亚群1/2的变化规律及中药干预作用研究[J]. 中国中西医结合急救杂志, 2006, 13(4):214-217. DOI: 10.3321/j.issn: 1008-9691.2006.04.006 .
	FU Q, CUI N Q, SHAO W, et al. Study on regularity of changes of helper T cell subgroup Th1/Th2 and interference effect of traditional Chinese medicine in mice with acute hemorrhage necrotizing pancreatitis[J]. Chin J Integr Tradit West Med Intensive Crit Care, 2006, 13(4):214-217. DOI: 10.3321/j.issn: 1008-9691.2006.04.006 .
[14]	郭文学. 重症急性胰腺炎时MDA、SOD与肝脏微循环变化及黄芪干预的实验研究[D]. 石家庄: 河北医科大学, 2008. DOI: 10.7666/d.y1353969 .
	GUO W X. Severe acute pancreatitis MDA, SOD and liver microcirculation changes and the experimental intervention study of Astragalus[D]. Shijiazhaung: Hebei Medical University, 2008. DOI: 10.7666/d.y1353969 .
[15]	朱渊红, 王真, 蔡宛如. 黄芪注射液对SAP肺损伤大鼠的实验研究[J]. 中华中医药学刊, 2009, 27(12):2608-2609. DOI: 10.13193/j.archtcm.2009.12.146.zhuyh.041 .
	ZHU Y H, WANG Z, CAI W R. The experimental study on Astragalus to rats with lung injury associated with severe acute pancreatitis[J]. Chin Arch Tradit Chin Med, 2009, 27(12):2608-2609. DOI: 10.13193/j.archtcm.2009.12.146.zhuyh.041 .
[16]	朱渊红, 王新华, 陈芝芸. 黄芪注射液对SAP肺损伤大鼠SOD、MDA及肺组织bcl-2、bax蛋白表达的影响[J]. 中国中医药科技, 2012, 19(5):416-417, 441. DOI: 10.3969/j.issn.1005-7072.2012.05.022 .
	ZHU Y H, WANG X H, CHEN Z Y. Effects of Astragalus injection on SOD, MDA and the expression of bcl-2 and bax protein in lung tissue of rats with SAP lung injury[J]. Chin J Tradit Med Sci Technol, 2012, 19(5):416-417, 441. DOI: 10.3969/j.issn.1005-7072.2012.05.022 .
[17]	邱雷, 史建华, 殷国建, 等. 黄芪甲苷对实验性大鼠重症急性胰腺炎的治疗作用[J]. 上海医学, 2014, 37(3):227-230, 178. DOI: CNKI:SUN:SHYX.0.2014-03-020.QIU L ,
	WANG S Y, CHU W W, HUO Y, et al. Effect of Huangqi injection on oxidative relevant materials of peripheral serum in rats with severe acute pancreatitis[J]. Med Pharm J Chin People's Liberation Army, 2014, 26(12):5-7. DOI: 10.3969/j.issn.2095-140X.2014.12.002 .
[18]	SHI J H, YIN G J, et al. Therapeutic effects of astragaloside Ⅳ on severe acute pancreatitis in rats[J]. Shanghai Med J, 2014, 37(3):227-230, 178. DOI: CNKI:SUN:SHYX.0.2014-03-020 .
	王少言, 初巍巍, 霍阳, 等. 黄芪注射液对重症急性胰腺炎大鼠外周血清氧化相关物质的影响[J]. 解放军医药杂志, 2014, 26(12):5- 7. DOI: 10.3969/j.issn.2095-140X.2014.12.002 .
[19]	QIU L, YIN G J, CHENG L, et al. Astragaloside IV ameliorates acute pancreatitis in rats by inhibiting the activation of nuclear factor-κB[J]. Int J Mol Med, 2015, 35(3):625-636. DOI:10.3892/ijmm.2015.2070 .
[20]	王秉钧, 王先坤, 晏波, 等. 黄芪多糖对大鼠重症急性胰腺炎的作用及机制[J]. 中国医院药学杂志, 2016, 36(16):1366-1368. DOI: 10.13286/j.cnki.chinhosppharmacyj.2016.16.08 .
	WANG B J, WANG X K, YAN B, et al. Effects of Astragalus polysaccharides on rats with severe acute pancreatitis and underlying mechanisms[J]. Chin J Hosp Pharm, 2016, 36(16):1366-1368. DOI: 10.13286/j.cnki.chinhosppharmacyj.2016.16.08 .
[21]	郑洋, 于晶晶, 杜鹃, 等. 黄芪注射液对急性胰腺炎大鼠肠道屏障功能的影响[J]. 中国临床研究, 2016, 29(12):1614-1617. DOI: 10.13429/j.cnki.cjcr.2016.12.006 .
	ZHENG Y, YU J J, DU J, et al. Effects of Astragalus injection on intestinal barrier functions in rats with acute pancreatitis[J]. Chin J Clin Res, 2016, 29(12):1614-1617. DOI: 10.13429/j.cnki.cjcr.2016.12.006 .
[22]	邓蓓蓓. 黄芪多糖对重症急性胰腺炎大鼠肠粘膜屏障损伤的保护作用[D]. 长春: 吉林大学, 2017. DOI: CNKI:CDMD:2.1017.148739 .
	ZHENG B B. Protection of astragalus polysacharin on intestinal barrier dysfunction in rats with severe acute pancreatitis[D]. Changchun: Jilin University, 2017. DOI: CNKI:CDMD:2.1017.148739 .
[23]	MA R, YUAN F, WANG S X, et al. Calycosin alleviates cerulein-induced acute pancreatitis by inhibiting the inflammatory response and oxidative stress via the p38 MAPK and NF-κB signal pathways in mice[J]. Biomed Pharmacother, 2018, 105:599-605. DOI:10.1016/j.biopha.2018.05.080 .
[24]	吴爱祥. 黄芪甲苷对重症急性胰腺炎小鼠胰腺的影响[J]. 中国临床药理学杂志, 2019, 35(18):2065-2067. DOI: 10.13699/j.cnki.1001-6821.2019.18.028 .
	WU A X. Effects of Astragalus glycoside in severe acute pancreatitis mice[J]. Chin J Clin Pharmacol, 2019, 35(18):2065-2067. DOI: 10.13699/j.cnki.1001-6821.2019.18.028 .
[25]	ZHU C J, YANG W G, LI D J, et al. Calycosin attenuates severe acute pancreatitis-associated acute lung injury by curtailing high mobility group box 1 - induced inflammation[J]. World J Gastroenterol, 2021, 27(44):7669-7686. DOI:10.3748/wjg.v27.i44.7669 .
[26]	金玲玲, 汤斌斌, 周晶晶, 等. 黄芪总皂苷对重症急性胰腺炎大鼠肠道损伤的保护作用及对肠组织p38MAPK/NF-κB表达的影响[J]. 新中医, 2021, 53(7):6-10. DOI: 10.13457/j.cnki.jncm.2021.07.002 .
	JIN L L, TANG B B, ZHOU J J, et al. Total saponins of Astragalus has protective effect on intestinal injury in rats with severe acute pancreatitis and its effect on P38MAPK/NF-κB expressions in intestinal tissues[J]. J New Chin Med, 2021, 53(7):6-10. DOI: 10.13457/j.cnki.jncm.2021.07.002 .
[27]	王欣, 周文勇, 孙月. 黄芪总皂苷通过激活Nrf2/HO-1信号通路缓解L-精氨酸诱导的小鼠急性胰腺炎氧化损伤的研究[J]. 现代中药研究与实践, 2022, 36(3):38-42. DOI: 10.13728/j.1673-6427.2022.03.008 .
	WANG X, ZHOU W Y, SUN Y. Study on the effect of Astragalus saponins on oxidative damage of L-arginine induced acute pancreatitis in mice by activating Nrf2/HO-1 signaling pathway[J]. Res Pract Chin Med, 2022, 36(3):38-42. DOI: 10.13728/j.1673-6427.2022.03.008 .
[28]	洪春霞, 张照伟, 陈伟前. 黄芪注射液通过调控mTOR/p70S6K信号通路对急性出血坏死型胰腺炎肺损伤炎症反应的影响[J]. 世界华人消化杂志, 2023, 31(5): 184-192. DOI: 10.11569/wcjd.v31.i5.184 .
	HONG C X, ZHANG Z W, CHEN W Q. Astragalus injection improves inflammatory response in lung injury in acute hemorrhagic necrotizing pancreatitis by regulating the mTOR/p70S6K signal pathway[J]. World Chin J Digestol, 2023, 31(5): 184-192. DOI: 10.11569/wcjd.v31.i5.184 .
[29]	李振国, 孔德生, 李文科. 黄芪多糖对大鼠急性胰腺炎的作用及其机制研究[J]. 海南医学, 2024, 35(1):6-9. DOI: 10.3969/j.issn.1003-6350.2024.01.002 .
	LI Z G, KONG D S, LI W K. Effect of Astragalus polysaccharides on acute pancreatitis in rats and its mechanism[J]. Hainan Med J, 2024, 35(1):6-9. DOI: 10.3969/j.issn.1003-6350.2024.01.002 .
[30]	HOU X T, YU M, XU Y, et al. Antioxidative effect of astragalosides on acute pancreatitis in mice[J]. Front Vet Sci, 2024, 11:1418899. DOI:10.3389/fvets.2024.1418899 .
[31]	PEERY AF, CROCKETT SD, MURPHY CC, et al. Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018. Gastroenterology. 2019, 156(1):254-272.e11. DOI: 10.1053/j.gastro.2018.08.063 .
[32]	尉洪利, 单连美, 孙玉欣, 等. 柴胡龙骨牡蛎汤对肝胆湿热证急性胰腺炎患者的临床疗效[J]. 中成药, 2025, 47(1):338-341. DOI: 10.3969/j.issn.100-1528.2025.01.056 .
	YU H L, SHAN L M, SUN Y X, et al. Clinical effect of Chaihu Longgu Muli decoction on acute pancreatitis with hepatobiliary damp-heat syndrome[J]. Chin Tradit Pat Med, 2025, 47(1):338-341. DOI: 10.3969/j.issn.100-1528.2025.01.056 .
[33]	林杉, 秦文昊, 代崧霖, 等. 中药辅助治疗经内镜逆行胰胆管造影术后急性胰腺炎研究进展[J]. 中国中西医结合杂志, 2024, 44(11):1400-1404. DOI: 10.7661/j.cjim.20240910.272 .
	LIN S, QIN W H, DAI S L, et al. Research progress on traditional Chinese medicine assisted treatment of acute pancreatitis after endoscopic retrograde cholangiopancreatography[J]. Chin J Integr Tradit West Med, 2024, 44(11):1400-1404. DOI: 10.7661/j.cjim.20240910.272 .
[34]	谢红英, 罗晓丽, 卢慧. 黄芪注射液对病毒性心肌炎患者外周血NLRP3炎性小体表达的影响[J]. 西部中医药, 2021, 34(7):94-97. DOI: 10.12174/j.issn.2096-9600.2021.07.24 .
	XIE H Y, LUO X L, LU H. Influence of Huangqi injection on the expressions of NLRP3 inflammasome in peripheral blood of patients with viral myocarditis[J]. West J Tradit Chin Med, 2021, 34(7):94-97. DOI: 10.12174/j.issn.2096-9600.2021.07.24 .
[35]	张燕. 黄芪注射液联合布地奈德对支气管哮喘急性发作患者肺功能的影响[J]. 实用中西医结合临床, 2021, 21(17):71-72. DOI: 10.13638/j.issn.1671-4040.2021.17.033 .
	ZHANG Y. Effect of Astragalus injection combined with budesonide on lung function in patients with acute attack of bronchial asthma[J]. Pract Clin J Integr Tradit Chin West Med, 2021, 21(17):71-72. DOI: 10.13638/j.issn.1671-4040.2021.17.033 .
[36]	中华医学会外科学分会胰腺外科学组. 中国急性胰腺炎诊治指南(2021)[J]. 浙江实用医学, 2021, 26(6):511-519, 535. DOI: 10.16794/j.cnki.cn33-1207/r.2021.06.003 .
	Study Group Of Pancreatic Surgery In China Society Of Surgery Of Chinese Medical Association. Guidelines for diagnosis and treatment of acute pancreatitis in China(2021)[J]. Zhejiang Pract Med, 2021, 26(6):511-519, 535. DOI: 10.16794/j.cnki.cn33-1207/r.2021.06.003 .
[37]	LEPPÄNIEMI A, TOLONEN M, TARASCONI A, et al. 2019 WSES guidelines for the management of severe acute pancreatitis[J]. World J Emerg Surg, 2019, 14:27. DOI:10.1186/s13017-019-0247-0 .
[38]	宋艳, 何永恒, 杨芳, 等. 黄芪多糖调节脂联素/TLR/NF-κB信号通路对溃疡性结肠炎小鼠的治疗作用[J]. 中国免疫学杂志, 2021, 37(11):1319-1324. DOI: 10.3969/j.issn.1000-484X.2021.11.008 .
	SONG Y, HE Y H, YANG F, et al. Regulatory effect of Astragalus polysaccharide on adiponectin/TLR/NF-κB signal pathway in mice with ulcerative colitis[J]. Chin J Immunol, 2021, 37(11):1319-1324. DOI: 10.3969/j.issn.1000-484X.2021.11.008 .
[39]	HABTEZION A, GUKOVSKAYA A S, PANDOL S J. Acute pancreatitis: a multifaceted set of organelle and cellular interactions[J]. Gastroenterology, 2019, 156(7):1941-1950. DOI:10.1053/j.gastro.2018.11.082 .
[40]	LIU D L, WEN L L, WANG Z D, et al. The mechanism of lung and intestinal injury in acute pancreatitis: a review[J]. Front Med, 2022, 9:904078. DOI:10.3389/fmed.2022.904078 .
[41]	JIAO J Y, LIU J J, LUO F, et al. Qingyi granules ameliorate severe acute pancreatitis in rats by modulating the gut microbiota and serum metabolic aberrations[J]. Pharm Biol, 2023, 61(1):927-937. DOI:10.1080/13880209.2023.2222755 .
[42]	WANG L J, JIN Y L, PEI W L, et al. Amuc_1100 pretreatment alleviates acute pancreatitis in a mouse model through regulating gut microbiota and inhibiting inflammatory infiltration[J]. Acta Pharmacol Sin, 2024, 45(3):570-580. DOI:10.1038/s41401-023-01186-4 .
[43]	PALATHINGAL BAVA E, GEORGE J, TARIQUE M, et al. Pirfenidone increases IL-10 and improves acute pancreatitis in multiple clinically relevant murine models[J]. JCI Insight, 2022, 7(2): e141108. DOI:10.1172/jci.insight.141108 .
[44]	LI H Y, WU D, ZHANG H D, et al. Autophagy-mediated ferroptosis is involved in development of severe acute pancreatitis[J]. BMC Gastroenterol, 2024, 24(1):245. DOI:10.1186/s12876-024-03345-1 .
[45]	周龙云, 田子睿, 刘书芬, 等. 黄芪对中枢神经系统的药理作用及毒理研究现状[J]. 中草药, 2018, 49(20):4935-4944. DOI: 10.7501/j.issn.0253-2670.2018.20.034 .
	ZHOU L Y, TIAN Z R, LIU S F, et al. Review on neuroprotection effect of Astragali Radix on central nervous system and related toxicology[J]. Chin Tradit Herb Drugs, 2018, 49(20):4935-4944. DOI: 10.7501/j.issn.0253-2670.2018.20.034 .