Objective To assess the efficacy and safety of Xuezhikang capsule (XZK) for hyperlipidemia. Methods MEDIINE，EMBASE, Cochrane Central Register of Controlled Trials(CCTR), Cochrane Metabolic and Endocrine Disorders Group data bank, and Chinese Biomedical Database(CBM), China Hospital Knowledge Database(CHKD) were searched，and the published/unpublished information was handsearched (updated to Dec., 2005) to identify randomized controlled trials (RCTs) or quasi-RCT of XZK versus statins or other lipid lowering drugs in treating hyperlipidemia patients. The quality evaluation, data extraction and analysis were conducted by the method recommended in Cochrane Reviewer’s Handbook 4.2.2. Data were analyzed using Review Manager (Version 4.2). Results Eleven trials (conducted in China) were identified, including 1 073 patients with hyperlipidemia met the inclusion criteria. All the included RCTs were graded as B or C. ① The effect of XZK in reducing TC: There were no significant differences between XZK and statins ( WMD 0.06, 95%CI-0.09 to 0.20 and RR1.02, 95%CI 0.93 to 1.12), XZK and fibrates (WMD 0.05, 95%CI -0.22 to 0.31) and XZK and probucol(WMD 0.42, 95%CI -0.01 to 0.85). XZK was superior to hexanicit (WMD 0.96, 95%CI 0.73 to 1.18). ② The effect of XZK in reducing TG: XZK had the same effect as statins (WMD 0.02, 95%CI -0.10 to 0.14 and RR 1.17, 95%CI 0.92 to 1.49) and hexanicit (WMD 0.28, 95%CI -0.17 to 0.73 ).Meanwhile, XZK was superior to probucol (WMD 0.71, 95%CI 0.22 to 1.20), but it was not as good as fibrates (WMD -0.81, 95%CI -1.40 to -0.23). ③ The effect of XZK in increasing HDL-C：XZK had the same effect as that of statins (WMD -0.03, 95%CI -0.10 to 0.04 and RR 1.03, 95% CI 0.80 to 1.33). The effect of XZK was better than that of hexanicit (WMD 0.15, 95%CI 0.01 to 0.29). XZK had the same effect of fibrates (WMD 0.03, 95%CI -0.08 to 0.15) and probucol (WMD 0.04, 95%CI -0.16 to 0.24). ④ The effect of XZK in reducing LDL-C：The effects of XZK and statins were the same (WMD -0.23, 95%CI -0.61 to 0.15 and RR 1.15, 95%CI 0.75 to 1.77). The effect of XZK was better than that of hexanicit (WMD 0.53, 95%CI 0.16 to 0.90). Meanwhile, XZK had the same effect as those of fibrates (WMD 0.19, 95%CI -0.12 to 0.50) and probucol (WMD 0.35, 95%CI -0.03 to 0.73). ⑤ The adverse reactions of XZK were mainly the gastrointestinal tract reaction, while liver function abnormality and myalgia were scarcely found. Conclusion Xuezhikang capsule have the same effects as those of statins in reducing the levels of TC, TG, LDL-C and raising HDL-C in patients with hyperlipidemia. No obvious adverse reactions are found during the short-term treatment. But further confirmation with clinical randomized controlled trials of high quality, large sample and long-term follow-up is needed.
ObjectTo observe the clinical efficacy and safety of the combination therapy of atorvastatin and JiangZhi Decoction (ZJD) for primary hyperlipidemia (Tan Zhuo Zu E Zheng) and to analyze the interactions of drugs in hypolipidemic effect. MethodsA 2*2 factorial design, single-blind, stratified randomized controlled trial according to the level of lipid was conducted. Primary hyperlipidemia (Tan Zhuo Zu E Zheng) patients met the inclusion criteria were divided into 5 groups:ATV 10 mg group (group A), ATV 20 mg group (group B), ATV 10 mg+JZD group (group C), ATV 20 mg+JZD group (group D), JZD group (group E). After two weeks treatment, the efficacy and safety among the 5 groups were compared. ResultsA total of 92 patients were included, of which, 20 were in group A, 25 in group B, 21 in group C, 17 in group D, and 9 in group E. The results showed that:(1) There was no significant difference between group C and group B in the reduction of serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) (PTC=0.226, PLDL-C=0.818). (2) The results of 2*2 factorial analysis showed that, there was no significant interaction between TCM factor and western medicine factor (PTC=0.605, PLDL-C=0.843). (3) There were no significant differences in safety outcomes among 5 groups (all P values >0.05). ConclusionATV 10 mg+JZD and ATV 20 mg have a similar efficacy in reducing TC and LDL-C. There is no obvious interaction between JZD and ATV in hypolipidemic effect, and the combination therapy of ATV and JZD is safe.
ObjectiveTo assess whether hyperlipoidemia affects the occurrence and progression of prostate cancer (PCA). MethodsA hospital based retrospective study was carried out in Zhangzhou Affiliated Hospital of Fujian Medical University using data from a total of 112 cases of PCA, which underwent radical prostatectomy due to suspected PCA and confirmed by prostate biopsy pathology. ResultsOf the 112 PCA patients, 64 (57.14%) were PCA with hyperlipoidemia (PCA-H). Compared with PCA patients, the patients of PCA-H patients had younger onset age (65.0±5.0 vs. 67.8±3.7, P=0.001), increased prostate volume (75.0±11.7 mL vs. 54.5±8.5 mL, P < 0.001), increased level of TPSA (61.4±23.3 ng/mL vs. 33.4±14.9 ng/mL, P < 0.001), and Gleason grade (6.9±1.8 vs. 5.0±1.9, P < 0.001), later clinical stage (P < 0.001), shorter survival time (49.8±12.7 months vs. 57.3±6.2 months, P < 0.001) and decreased 5 years of survival rate (51.6% vs. 77.1%, P=0.006). The level of cholesterol, triglyceride and high density lipoprotein was significantly associated with the rejuvenation of onset age, the enlargement of prostate volume, increasing of serum TPSA, the progression of TNM clinical stage, increasing of Gleason grade, shorten of survival time and dropping of 5 years of survival rate (P < 0.05). In multiplefactor regression analysis, only hyperlipoidemia (OR=3.204, P=0.022) and Gleason grade (OR=8.611, P < 0.001) were the independent risk factors of prognosis. ConclusionThe situation of PCA with hyperlipoidemia is frequently noted in clinics, and hyperlipoidemia may be one of the risk factors in the processes of PCA growth and progression.
Objective To study the influence of hyperlipemia on rats with acute pancreatits during pregnancy and its mechanism. Methods Seventy two pregnant Sprague-Dawley rats were randomly divided into the test group and the control group， and then they were fed with high fat diet and balanced diet for 16 days separately. Pregnant rats were given intraperitoneal injection with L-arginine for 2 times (one time is 250 mg/100 g, the other is 200 mg/100 g) at an interval of 1 h. The serum triglyceride (TG), serum amylase (AMS), and lipase (LPS) from blood samples were tested just after injection, and 12 h， 18 h， 24 h， 30 h and 48 h after injection respectively, and wet/dry ratio of pancreas were measured. The histopathological score of pancreatic tissue was evaluated based on microscopic changes, and the expression of TNF-α protein was determined by SP immunohistochemical technique. Results After the last injection, the level of TG in the test group was obviously higher than that in the control group in each time (P＜0.05). The peak values of AMS and LPS in the test group appeared at 24， 18 h respectively, while the peaks appeared at 30， 24 h in the control group, respectively, which were significantly lower than those in the test group (P＜0.05). Compared with the control group, the wet/dry ratio of pancreas in the test group increased at 12, 18 and 24 h after injection (P＜0.05); The pathological changes of pancreas in test group was more serious with higher histopathological score at 0, 12, 18 and 24 h (P＜0.05), and expression of the TNF-α protein was higher at 12, 18 and 24 h (P＜0.05), too. Conclusion Hyperlipemia can make L-arginine-induced-acute-pancreatitis during pregnancy earlier occur and lead to more serious injury in pancreas. This study demonstrates that hyperlipemia may be a high risk factor for acute pancreatitis during pregnancy, making a great amount of free fatty acid released from TG and up-regulated the expression of TNF-α.
Objective To study the clinical protective effect of hemoperfusion combined with hemofiltration on inflammatory reaction of hyperlipidemia severe acute pancreatitis (HLSAP). Methods Thirty-seven patients with HLSAP treated between January 2012 and December 2014 were selected and divided into three groups based on different treatments. Thirteen patients were allocated into hemoperfusion combined with continuous veno-venous hemofiltration group (HP+CVVH group) and treated with hemoperfusion combined with hemofiltration; 11 patients were allocated into continuous veno-venous hemofiltration group (CVVH group) and treated with hemofiltration; and all the other patients were allocated into control group and treated with conventional treatment. The levels of blood triglyceride, C-reactive protein, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) and acute physiology and chronic health evaluation (APACHE)Ⅱ score of the patients after treatment were observed. The hospital stay, organ dysfunction rate and mortality of the patients were measured. Results Compared with the control group, the levels of blood triglyceride, C-reactive protein, TNF-α, IL-6, IL-8 and APACHE Ⅱ score of the patients in the HP+CVVH group and CVVH group were both significantly reduced 72 hours after therapy (P<0.05). However, the levels of blood triglyceride, C-reactive protein, TNF-α, IL-6, IL-8 and APACHE Ⅱ score of the patients in the HP+CVVH group were significantly lower than those in the CVVH group at the same time point (P<0.05). The hospital stay of the patients in the HP+CVVH group and CVVH group was significantly shorter than that in the control group (P<0.05). Compared with the CVVH group, the hospital stay of patients in the HP+CVVH group was significantly shorter (P<0.05). There was no statistical difference in organ dysfunction rate and mortality among the three groups (P>0.05). Conclusion Hemoperfusion combined with hemofiltration is an effective method for HLSAP by cleaning the inflammatory mediators availably and inhibiting the excessive inflammatory reaction.
目的:探讨普罗布考对动脉粥样硬化性脑梗死并高脂血症患者血脂及预后的影响。方法:将87例脑梗死并高脂血症患者随机分为两组,治疗组44例,对照组43例,两组除按动脉粥样硬化性脑梗死常规治疗外,停用一切降脂药物。治疗组给予普罗布考500mg bid/d。疗程为6个月。随访一年观察两组患者治疗后血脂水平及脑血管事件发生情况。结果:治疗组患者治疗前、后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)间差异均有显著性意义(Plt;0.05)。两组患者治疗后各项血脂指标间差异均有显著性意义(Plt;0.05)。随访一年,显示治疗组患者心脑血管事件14次,对照组19次(Plt;0.05)。结论:普罗布考降脂疗效可靠、副作用轻微,降低心脑血管事件发生。可作为动脉粥样硬化性脑梗死并高脂血症患者的一、二级预防药物。
目的:比较伴或不伴高脂血症的系统性红斑狼疮(SLE)患者的狼疮性肝损害的构成比例,了解高脂血症与狼疮性肝损害的相关性。方法:收集SLE患者100例,根据高脂血症和狼疮性肝损害的诊断标准,将患者分为高脂血症组,非高脂血症组和肝损害组,非肝损害组,收集其相关临床数据进行比较分析。结果:1高脂血症组发生肝损害的比例高于非高脂血症组(χ2=9.908,P=0.002);2血脂水平中甘油三酯与γGT(r=0366,P=0.000),碱性磷酸酶(r=0.241,P=0.018),强的松剂量(r=0.31,P=0.006),24h尿蛋白定量(r=0.273,P=0.007)相关;TC与24h尿蛋白定量(r=0.273,P=0.007)相关;HDL与γ谷氨酸转肽酶(r=0.233,P=0.022),碱性磷酸酶(r=0.265,P=0.009)相关;3-SLE活动组出现高脂血症的比例高于非活动组(χ2=6.986,P=0.008)。结论:长期的高脂血症可导致或加重SLE患者肝功能损害,高脂血症是狼疮性肝损害的危险因素之一。