Abstract：
Due to a scarcity of appropriate therapeutic approaches capable of ameliorating or eliminating non-alcoholic fatty liver disease (NAFLD), many researchers have come to focus on natural products based on traditional medicine that can be utilized to successfully treat NAFLD. In this study, we aimed to evaluate the effects exerted by seven natural products (curcumin, silymarin, resveratrol, artichoke leaf extract, berberine, catechins, and naringenin) on patients with NAFLD. For this purpose, PubMed, Embase, Cochrane Library, and Web of Science, were searched for randomized controlled trials (RCTs) exclusively. The selected studies were evaluated for methodological quality via the Cochrane bias risk assessment tool, and data analysis software was used to analyze the data accordingly. The RCTs from the earliest available date until September 2022 were collected. This process resulted in 37 RCTs with a total sample size of 2509 patients being included. The results of the network meta-analysis showed that artichoke leaf extract confers a relative advantage in reducing the aspartate aminotransferase (AST) levels (SUCRA: 99.1%), alanine aminotransferase (ALT) levels (SUCRA: 88.2%) and low-density lipoprotein cholesterol (LDL-C) levels (SUCRA: 88.9%). Naringenin conferred an advantage in reducing triglyceride (TG) levels (SUCRA: 97.3%), total cholesterol (TC) levels (SUCRA: 73.9%), and improving high-density lipoprotein cholesterol (HDL-C) levels (SUCRA: 74.9%). High-density catechins significantly reduced body mass index (BMI) levels (SUCRA: 98.5%) compared with the placebo. The Ranking Plot of the Network indicated that artichoke leaf extract and naringenin performed better than the other natural products in facilitating patient recovery. Therefore, we propose that artichoke leaf extract and naringenin may exert a better therapeutic effect on NAFLD. This study may help guide clinicians and lead to further detailed studies.
摘要：
由于缺乏能够改善或消除非酒精性脂肪性肝病（NAFLD）的适当治疗方法，许多研究人员已经开始关注基于传统医学的天然产物，这些天然产物可用于成功治疗NAFLD。在这项研究中,我们旨在评估七种天然产物(姜黄素，水飞蓟素,白藜芦醇,朝鲜蓟叶提取物，小檗碱,儿茶素,和柚皮素）对NAFLD患者。为此,PubMed,Embase,科克伦图书馆,和WebofScience,仅搜索随机对照试验（RCTs）。通过Cochrane偏倚风险评估工具对选定的研究进行方法学质量评估，并使用数据分析软件对数据进行相应的分析。收集了从最早的可用日期到2022年9月的RCT。该过程导致37个RCT,包括2509个患者的总样本量。网络荟萃分析的结果表明，朝鲜蓟叶提取物在降低天冬氨酸转氨酶（AST）水平方面具有相对优势（SUCRA：99.1％），丙氨酸氨基转移酶（ALT）水平（SUCRA：88.2％）和低密度脂蛋白胆固醇（LDL-C）水平（SUCRA：88.9％）。柚皮素在降低甘油三酯（TG）水平方面具有优势（SUCRA：97.3%），总胆固醇（TC）水平（SUCRA：73.9％），改善高密度脂蛋白胆固醇（HDL-C）水平（SUCRA：74.9%）。与安慰剂相比，高密度儿茶素显着降低了体重指数（BMI）水平（SUCRA：98.5％）。该网络的排名图表明，朝鲜蓟叶提取物和柚皮素在促进患者康复方面比其他天然产品表现更好。因此,我们认为朝鲜蓟叶提取物和柚皮素可能对NAFLD发挥更好的治疗作用。这项研究可能有助于指导临床医生并导致进一步的详细研究。
