血脂康胶囊治疗血脂异常的Meta分析
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摘要
目的评价血脂康胶囊治疗血脂异常的临床效果和安全性。方法计算机检索PubMed、Web of Science核心集、中国知网、万方、维普等数据库中血脂康治疗血脂异常随机对照试验,检索时间截至2018年6月。采用Revman 5.3软件进行Meta分析,系统评价血脂康对总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)的影响。结果共纳入25项随机对照试验、7875例患者。Meta分析显示:与空白对照组比较,血脂康明显降低TC(WMD=-1.05,95%CI:-1.40,-0.70,P <0.01)和LDL-C(WMD=-0.76,95%CI:-0.94,-0.58,P <0.01)水平,升高LDL-C水平(WMD=0.17,95%CI:0.08,0.27,P <0.01)。与他汀对照组比较,血脂康能升高HDL-C水平(WMD=0.17,95%CI:0.04,0.30,P <0.05),虽然也降低TC和LDL-C水平,但差异无统计学意义(P>0.05)。与对照组比较,血脂康不良反应/主要心脑血管事件发生率明显降低(WMD=0.55,95%CI:0.47,0.64,P <0.01)。结论血脂康能够有效、全面地调脂,并且不良事件发生率低。
Objective To evaluate the clinical efficacy and safety of Xuezhikang Capsules in the treatment of patients with dyslipidemia. Methods The databases of PubMed, Science Citation Index-Expanded, China National Knowledge Infrastructure, Wanfang Databases, Chinese VIP Information were searched up to June 2018 for randomized controlled trials about Xuezhikang in the treatment of dyslipidemia. Revman 5.3 software was used to make Meta-analysis. The effects of Xuezhikang Capsules on the serum levels of total cholesterol(TC), low density lipoprotein-cholesterol(LDL-C)and high density lipoprotein-cholesterol(HDL-C) were evaluated. Results A total of 25 trials containing 7875 participants were analyzed. Meta-analysis showed that compared with blank control group, Xuezhikang could lower serum levels of TC(WMD =-1.05, 95%CI:-1.40,-0.70, P < 0.01) and LDL-C(WMD =-0.76, 95%CI:-0.94,-0.58, P < 0.01)more effectively, and increase HDL-C(WMD = 0.17, 95%CI: 0.08, 0.27, P < 0.01) more effectively. Compared with statins control group, Xuezhikang could increase HDL-C(WMD = 0.17, 95%CI: 0.04, 0.30, P < 0.05) more effectively,and also decrease serum TC and LDL-C levels, while there were no significant differences(P > 0.05). Compared with control group, Xuezhikang showed advantages in decreasing serious side effects or major adverse cardiovascular events(WMD = 0.55, 95%CI: 0.47, 0.64, P < 0.01). Conclusion Xuezhikang can regulate dyslipidemia effectively and comprehensively, with low rates of adverse events.
Objective To evaluate the clinical efficacy and safety of Xuezhikang Capsules in the treatment of patients with dyslipidemia. Methods The databases of PubMed, Science Citation Index-Expanded, China National Knowledge Infrastructure, Wanfang Databases, Chinese VIP Information were searched up to June 2018 for randomized controlled trials about Xuezhikang in the treatment of dyslipidemia. Revman 5.3 software was used to make Meta-analysis. The effects of Xuezhikang Capsules on the serum levels of total cholesterol(TC), low density lipoprotein-cholesterol(LDL-C)and high density lipoprotein-cholesterol(HDL-C) were evaluated. Results A total of 25 trials containing 7875 participants were analyzed. Meta-analysis showed that compared with blank control group, Xuezhikang could lower serum levels of TC(WMD =-1.05, 95%CI:-1.40,-0.70, P < 0.01) and LDL-C(WMD =-0.76, 95%CI:-0.94,-0.58, P < 0.01)more effectively, and increase HDL-C(WMD = 0.17, 95%CI: 0.08, 0.27, P < 0.01) more effectively. Compared with statins control group, Xuezhikang could increase HDL-C(WMD = 0.17, 95%CI: 0.04, 0.30, P < 0.05) more effectively,and also decrease serum TC and LDL-C levels, while there were no significant differences(P > 0.05). Compared with control group, Xuezhikang showed advantages in decreasing serious side effects or major adverse cardiovascular events(WMD = 0.55, 95%CI: 0.47, 0.64, P < 0.01). Conclusion Xuezhikang can regulate dyslipidemia effectively and comprehensively, with low rates of adverse events.
引文
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[2] Ibanez B,James S,Agewall S,et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation:The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology(ESC)[J]. Eur Heart J,2018,39(2):119-177.
[3]诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953.
[4]中国老年学和老年医学学会心脑血管病专业委员会,血脂康临床应用中国专家共识组.血脂康(胶囊)临床应用中国专家共识(2017修订版)[J].中华内科杂志,2018,57(2):97-100.
[5] Xu CB,Hu DY,Kang LP. Comparative Study of Relatively Long-term Therapy for Dyslipidemia with Low-dose Xuezhikang or Pravastatin in Chinese Patients[J]. Journal of Chinese Pharmaceutical Sciences,2000,9(4):218-230.
[6] Zhao SP,Liu L,Cheng YC,et al. Effect of xuezhikang,a cholestin extract,on reflecting postprandial triglyceridemia after a high-fat meal in patients with coronary heart disease[J]. Atherosclerosis,2003,168(2):375-380.
[7]陈凤娟,阮琼,祁慧薇,等.血脂康治疗中老年原发性高脂血症的临床观察[J].上海预防医学杂志,2003,15(5):222-223.
[8]朱琦峰,江凌,王瑛.血脂康与辛伐他汀对高脂血症患者载脂蛋白B和A1的影响[J].光明中医,2003,18(5):24-25.
[9] Zhao SP,Liu L,Cheng YC,et al. Xuezhikang,an extract of cholestin,protects endothelial function through antiinflammatory and lip id-lowering mechanisms in patients with coronary heart disease[J]. Circulation,2004,110(8):915-920.
[10] Liu ZG,Yu XY. Effects of Xuezhikang Capsule on Blood Lipids,Platelet Activation and Coagulation-Fibrinolysis Activity in Patients with Hyperlipidemia[J]. Chinese Journal of Integrative Medicine,2004,10(4):259-262.
[11] Li JJ,Hu SS,Fang CH,et al. Xuezhikang,an extract of cholestin,administration before percutaneous coronary intervention:Impact on frequency of periprocedural myocardial injury[J]. American Journal of Cardiology,2005,96(7A):122H.
[12]符春晖,严华,陈丽媛,等.洛伐他汀与血脂康治疗老年高脂血症效果对比分析[J].右江民族医学院学报,2005,27(5):618-620.
[13]血脂康调整血脂对冠心病二级预防研究协作组.中国冠心病二级预防研究[J].中华心血管病杂志,2005,2(33):109-115.
[14] Hu CL,Li YB,Tang YH,et al. Effects of withdrawal of Xuezhikang,an extract of cholestin,on lipid profile and C-reactive protein:a short-term time course study in patients with coronary artery disease[J]. Cardiovasc Drugs Ther,2006,20(3):185-191.
[15]刘波,王月侠,周颖,等.阿托伐他汀和血脂康对2型糖尿病血脂的疗效观察[J].吉林医学,2006,27(3):305.
[16]孙明晓,汪耀,迟家敏.血脂康胶囊对初诊2型糖尿病患者血脂调节及抗早期动脉粥样硬化的作用[J].中华老年医学杂志,2007,26(8):584-586.
[17]全胜麟,王卫,屈晓雯.血脂康和辛伐他汀对高胆固醇血症的调脂作用[J].中国临床实用医学,2008,2(11):91-92.
[18]王敏,姚强,王士生.血脂康对高脂血症患者血脂、血管内皮功能及颈动脉内膜中层厚度的影响[J].浙江中西医结合杂志,2010,20(8):463-465.
[19]滕秋叶,唐召力,覃碧云,等.血脂康与辛伐他汀对不稳定型心绞痛患者调脂作用比较[J].现代中西医结合杂志,2011,20(10):1171-1172.
[20]樊国芳,郑捷,徐伍洪.血脂康胶囊对冠心病患者血脂和C反应蛋白变化的影响[J].中国初级卫生保健,2012,26(9):114-115.
[21]盘圣明,李晓一,邢葆平.血脂康胶囊治疗奥氮平引起的高脂血症疗效评价[J].浙江医学,2012,34(10):835-836.
[22]张开凤,李婉儿,钟凤芳.不同剂量血脂康治疗老年颈动脉粥样硬化斑块的临床研究[J].现代实用医学,2012,24(1):39-41.
[23] Moriarty PM,Roth EM,Karns A,et al. Effects of Xuezhikang in patients with dyslipidemia:a multicenter,randomized,placebo-controlled study[J]. J Clin Lipidol,2014,8(6):568-575.
[24]马雪兴,李渊,韩震,等.血脂康与辛伐他汀对不稳定型心绞痛患者调脂作用临床对比分析[J].中外医疗,2014,33(30):144-146.
[25] Cui F,Zhang YL,Wei QM,et al. A Novel Medical Treatment for Lipid Control in Patients with Unstable Angina Pectoris and Statin-Induced Liver Dysfunction[J]. Acta Cardiologica Sinica,2015,31(1):66-71.
[26]赵国玉,耿学斌,李莉,等.血脂康预防急性心肌梗死冠脉支架置入术后冠脉再狭窄疗效及安全性评价[J].河北联合大学学报:医学版,2015,17(4):22-24.
[27]葛晓春,王英南,刘晓燕,等.血脂康胶囊治疗绝经后女性2型糖尿病合并非酒精性脂肪肝的临床观察[J].中国药房,2016,27(33):4641-4643.
[28]郭柏华,明光福,张昭,等.血脂康胶囊治疗原发性高血压左室肥厚合并高脂血症的效果观察[J].中国当代医药,2016,23(1):38-41.
[29]牛杰,黎敬锋,王超,等.血脂康胶囊对急性冠脉综合征患者经皮冠状动脉介入治疗术后血脂及主要不良心血管事件的影响[J].实用心脑肺血管病杂志,2016,24(12):70-73.
[2] Ibanez B,James S,Agewall S,et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation:The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology(ESC)[J]. Eur Heart J,2018,39(2):119-177.
[3]诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953.
[4]中国老年学和老年医学学会心脑血管病专业委员会,血脂康临床应用中国专家共识组.血脂康(胶囊)临床应用中国专家共识(2017修订版)[J].中华内科杂志,2018,57(2):97-100.
[5] Xu CB,Hu DY,Kang LP. Comparative Study of Relatively Long-term Therapy for Dyslipidemia with Low-dose Xuezhikang or Pravastatin in Chinese Patients[J]. Journal of Chinese Pharmaceutical Sciences,2000,9(4):218-230.
[6] Zhao SP,Liu L,Cheng YC,et al. Effect of xuezhikang,a cholestin extract,on reflecting postprandial triglyceridemia after a high-fat meal in patients with coronary heart disease[J]. Atherosclerosis,2003,168(2):375-380.
[7]陈凤娟,阮琼,祁慧薇,等.血脂康治疗中老年原发性高脂血症的临床观察[J].上海预防医学杂志,2003,15(5):222-223.
[8]朱琦峰,江凌,王瑛.血脂康与辛伐他汀对高脂血症患者载脂蛋白B和A1的影响[J].光明中医,2003,18(5):24-25.
[9] Zhao SP,Liu L,Cheng YC,et al. Xuezhikang,an extract of cholestin,protects endothelial function through antiinflammatory and lip id-lowering mechanisms in patients with coronary heart disease[J]. Circulation,2004,110(8):915-920.
[10] Liu ZG,Yu XY. Effects of Xuezhikang Capsule on Blood Lipids,Platelet Activation and Coagulation-Fibrinolysis Activity in Patients with Hyperlipidemia[J]. Chinese Journal of Integrative Medicine,2004,10(4):259-262.
[11] Li JJ,Hu SS,Fang CH,et al. Xuezhikang,an extract of cholestin,administration before percutaneous coronary intervention:Impact on frequency of periprocedural myocardial injury[J]. American Journal of Cardiology,2005,96(7A):122H.
[12]符春晖,严华,陈丽媛,等.洛伐他汀与血脂康治疗老年高脂血症效果对比分析[J].右江民族医学院学报,2005,27(5):618-620.
[13]血脂康调整血脂对冠心病二级预防研究协作组.中国冠心病二级预防研究[J].中华心血管病杂志,2005,2(33):109-115.
[14] Hu CL,Li YB,Tang YH,et al. Effects of withdrawal of Xuezhikang,an extract of cholestin,on lipid profile and C-reactive protein:a short-term time course study in patients with coronary artery disease[J]. Cardiovasc Drugs Ther,2006,20(3):185-191.
[15]刘波,王月侠,周颖,等.阿托伐他汀和血脂康对2型糖尿病血脂的疗效观察[J].吉林医学,2006,27(3):305.
[16]孙明晓,汪耀,迟家敏.血脂康胶囊对初诊2型糖尿病患者血脂调节及抗早期动脉粥样硬化的作用[J].中华老年医学杂志,2007,26(8):584-586.
[17]全胜麟,王卫,屈晓雯.血脂康和辛伐他汀对高胆固醇血症的调脂作用[J].中国临床实用医学,2008,2(11):91-92.
[18]王敏,姚强,王士生.血脂康对高脂血症患者血脂、血管内皮功能及颈动脉内膜中层厚度的影响[J].浙江中西医结合杂志,2010,20(8):463-465.
[19]滕秋叶,唐召力,覃碧云,等.血脂康与辛伐他汀对不稳定型心绞痛患者调脂作用比较[J].现代中西医结合杂志,2011,20(10):1171-1172.
[20]樊国芳,郑捷,徐伍洪.血脂康胶囊对冠心病患者血脂和C反应蛋白变化的影响[J].中国初级卫生保健,2012,26(9):114-115.
[21]盘圣明,李晓一,邢葆平.血脂康胶囊治疗奥氮平引起的高脂血症疗效评价[J].浙江医学,2012,34(10):835-836.
[22]张开凤,李婉儿,钟凤芳.不同剂量血脂康治疗老年颈动脉粥样硬化斑块的临床研究[J].现代实用医学,2012,24(1):39-41.
[23] Moriarty PM,Roth EM,Karns A,et al. Effects of Xuezhikang in patients with dyslipidemia:a multicenter,randomized,placebo-controlled study[J]. J Clin Lipidol,2014,8(6):568-575.
[24]马雪兴,李渊,韩震,等.血脂康与辛伐他汀对不稳定型心绞痛患者调脂作用临床对比分析[J].中外医疗,2014,33(30):144-146.
[25] Cui F,Zhang YL,Wei QM,et al. A Novel Medical Treatment for Lipid Control in Patients with Unstable Angina Pectoris and Statin-Induced Liver Dysfunction[J]. Acta Cardiologica Sinica,2015,31(1):66-71.
[26]赵国玉,耿学斌,李莉,等.血脂康预防急性心肌梗死冠脉支架置入术后冠脉再狭窄疗效及安全性评价[J].河北联合大学学报:医学版,2015,17(4):22-24.
[27]葛晓春,王英南,刘晓燕,等.血脂康胶囊治疗绝经后女性2型糖尿病合并非酒精性脂肪肝的临床观察[J].中国药房,2016,27(33):4641-4643.
[28]郭柏华,明光福,张昭,等.血脂康胶囊治疗原发性高血压左室肥厚合并高脂血症的效果观察[J].中国当代医药,2016,23(1):38-41.
[29]牛杰,黎敬锋,王超,等.血脂康胶囊对急性冠脉综合征患者经皮冠状动脉介入治疗术后血脂及主要不良心血管事件的影响[J].实用心脑肺血管病杂志,2016,24(12):70-73.
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