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Meta-Analysis
. 2017 Dec;96(49):e9061.
doi: 10.1097/MD.0000000000009061.

The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials

Sheng Zhong  1 , Yuxiang Fan, Qi Yan, Xingyu Fan, Bo Wu, Yujuan Han, Ying Zhang, Yong Chen, Huimao Zhang, Junqi Niu
Affiliations
Meta-Analysis

The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials

Sheng Zhong et al. Medicine (Baltimore). 2017 Dec.

Abstract

Background: Silymarin (SIL) is an active extraction of the silybum marianum, milk thistle, which is an ancient medicinal plant for treatment of various liver diseases for centuries. This study is to assess the therapeutic effect of SIL in the treatment of nonalcoholic fatty liver disease through meta-analysis.

Methods: Published randomized controlled trials (RCTs) were included from electronic databases (PubMed, Embase, Cochrane library, Web of Science, and so forth). Cochrane handbook was applied to evaluate the methodological quality. All statistical analyses were directed by Revman 5.3 software, and statistical significance was defined as P < .05.

Results: Eight RCTs involved 587 patients were included in this study. The results showed that SIL reduced the AST and ALT levels more significantly than the control group (AST UI/L: MD = -6.57; 95% CI, -10.03 to -3.12; P = .0002; ALT UI/L: MD = -9.16; 95% CI, -16.24 to -2.08; P = .01). Compared with other interventions, there were significant differences decreasing AST and ALT levels when SIL was used alone (AST UI/L: MD = -5.44; 95% CI, -8.80 to -2.08; P = .002; ALT UI/L: MD = -5.08; 95% CI, -7.85 to -2.32; P = .0003).

Conclusion: SIL has positive efficacy to reduce transaminases levels in NAFLD patients. SIL can be an encouraging and considerable phytotherapy for NAFLD patients.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowchart of the study selection.
Figure 2
Figure 2
Forest plot of the AST in the meta-analysis and subgroup analysis. There was a significant difference between the 2 arms (AST UI/L: MD = −6.57; 95% CI, −10.03 to −3.12; P = .002).
Figure 3
Figure 3
Forest plot of the ALT in the meta-analysis and subgroup analysis. There was a significant difference between the 2 arms (ALT UI/L: MD = −9.16; 95% CI, −16.24 to −2.08; P = .01).
Figure 4
Figure 4
(A) Forest plot of TG. There was no significant difference between the 2 arms (P = .78). (B) Forest plot of TC. There was no significant difference between the 2 arms (P = .80).
See this image and copyright information in PMC

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