小檗碱已广泛应用于数种心血管疾病(CVD)的辅助治疗。然而，它的疗效证据仍然存在争议。本研究旨在评估小檗碱在CVD中的疗效与安全性。采用随机对照试验(RCT)的系统回顾和荟萃分析。我们检索了十个电子数据库的文章，时间从起始到2022年12月23日。包括比较小檗碱单独或联合他汀类药物与他汀类药物或例行药物治疗CVD的RCT。根据Cochrane手册进行了荟萃分析。本研究纳入了44项RCT，共4606名患者。小檗碱单独与常规或他汀类药物在改善总胆固醇(TC)(SMD，0.43；95% CI，-0.39到1.24；p = 0.30；I2 = 95%)、三酰甘油(TG) (SMD，-0.14；95% CI，-0.49到0.21；p = 0.44；I2 = 76%)、低密度脂蛋白胆固醇(LDL-C) (SMD，0.69；95% CI，-0.23到1.60；p = 0.14；I2 = 96%)、高密度脂蛋白胆固醇(HDL-C) (SMD，0.55；95% CI，-0.48到1.57；p = 0.30；I2 = 96%)和Crouse评分水平上没有显著差异。小檗碱单独显著降低了国家卫生研究院中风量表(NIHSS)评分、高敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)和内中膜厚度(IMT)水平，超过了常规治疗的效果。与常规或他汀类药物相比，小檗碱加他汀类药物显著降低了TC、TG、LDL-C、NIHSS评分、hs-CRP、TNF-α、IMT、Crouse评分和不稳定斑块数的水平。然而，在改善HDL-C和IL-6水平方面没有发现组间差异。各组不良反应的发生率也没有显著差异。本研究表明，小檗碱可能是CVD的有前途的替代品，并且没有严重的不良反应。然而，我们的结果可能受到现有研究质量的限制。需要进行高质量的RCT，以提供更有说服力的证据。 版权所有 © 2023 Elsevier GmbH 发布。

Berberine has been widely used for the adjuvant therapy of several cardiovascular diseases (CVDs). However, evidence for its efficacy remains controversial.This study aimed to evaluate the efficacy and safety of berberine in CVDs.A systematic review and meta-analysis of randomized controlled trials (RCTs).We searched ten electronic databases for articles from inception to December 23, 2022. RCTs comparing berberine alone or combined with statins versus statins or routine for CVDs were included. Meta-analysis was performed according to the Cochrane Handbook.Forty-four RCTs were included with 4606 patients. There were no differences between berberine alone and routine or statins in improving total cholesterol (TC) (SMD, 0.43; 95% CI, -0.39 to 1.24; p = 0.30; I2 = 95%), triglyceride (TG) (SMD, -0.14; 95% CI, -0.49 to 0.21; p = 0.44; I2 = 76%), low-density lipoprotein cholesterol (LDL-C) (SMD, 0.69; 95% CI, -0.23 to 1.60; p = 0.14; I2 = 96%), high-density lipoprotein cholesterol (HDL-C) (SMD, 0.55; 95% CI, -0.48 to 1.57; p = 0.30; I2 = 96%), and Crouse score levels. Berberine alone significantly reduced National Institute of Health Stroke Scale (NIHSS) score, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and intima-media thickness (IMT) levels than routine therapy. Berberine plus statins significantly reduced TC, TG, LDL-C, NIHSS score, hs-CRP, TNF-α, IMT, Crouse score, and number of unstable plaques levels than routine or statins. However, no differences were found between groups in improving HDL-C and IL-6 levels. There were no significant differences between groups in the incidence of adverse reactions.This study suggests that berberine may be a promising alternative for CVDs with no serious adverse reactions. However, our results may be limited by the quality of existing research. High-quality RCTs are needed to provide more convinced evidence.Copyright © 2023. Published by Elsevier GmbH.