自拟调脂汤治疗高脂血症60例

为观察中西医结合治疗高脂血症的临床疗效,将120例高脂血症患者随机分为治疗组(中西医结合治疗)与对照组(单纯西药治疗)各60例,治疗6周后分别观察患者的临床疗效和血脂、血液流变学变化。结果:治疗组总有效率为95.00%,明显优于对照组的78.33%(P<0.05); 治疗组与对照组均能升高高密度脂蛋白(HDL-C),降低血清总胆固醇(TC)、甘油三酯(TC)、低密度脂蛋白(LDL-C),改善血液流变学指标,且治疗组明显优于对照组(P<0.05)。结论:中西医结合治疗高脂血症疗效确切,优于单纯西药治疗。

调脂减肥胶囊治疗高脂血症肥胖症的临床研究

目的观察调脂减肥胶囊治疗高脂血症肥胖症的临床疗效。方法随机将185例高脂血症肥胖症的患者分为服调脂减肥胶囊治疗组93例,烟酸肌醇脂片对照组92例,均服药60d,同时将各组TC、TG、HDL-C、LDL-C、CL-A1、LC-B100、和BW治疗前后的变化情况进行临床指标观察。结果治疗组有效率为90.32%,对照组有效率为81.52%(P<0.05),治疗组TC、TG、LDL-C、LC-B100显著降低,HDL-C、CL-A1显著升高,与治疗前比较差异均有显著性(P<0.01);对照组TC、TG显著降低,HDL-C显著升高,与治疗前比较差异均有显著性(P<0.01)。两组治疗后比较,治疗组降低TC、TG、LDL-C、LC-B100和升高HDL-C、CL-A1均显著(P<0.01)好于对照组。结论调脂减肥胶囊治疗高脂血症肥胖症可显著降低TC、TG、LDL-C、CL-B100、BW和升高HDL-C、CL-A1,且与烟酸肌醇脂片比较差异有显著性,临床疗效优于对照组。

Comparative Study of Relatively Long-term Therapy for Dyslipidemia with Low-dose Xuezhikang or Pravastatin in Chinese Patients

目的：观察小剂量血脂康、普伐他汀对高血脂病人的长期调脂作用。方法：多中心，195例高血脂病人，分血脂康组每晚睡前口服血脂康2粒（含他汀类物质6mg)与普伐他汀组（每晚睡前口服5mg)治疗6个月，比较治疗前、后血脂水平变化及两组间差异，用方差分析法检验及X^2检验。结果：血脂康与普伐他汀治疗6个月时，TC下降16％及17％，TG下降13％及15％，LDL下降23％及21％；HDL在血脂康组上升2％，在普伐他汀组上升10％。两组均能有效降低LDL／HDL。两组间比较普伐他汀升HDL作用较血脂康稍好（P＝0．05）。两组TC、LDL、LDL／HDL下降均有统计学意义。两组TG下降及HDL升高无统计学意义，血脂康及普伐他汀组降TC疗效分别为54．6％、68．4％；升HDL疗效分别为49．1％、53．9％；降TG为46．2％、40．8％。两组疗效差异均无显著性。两组均未见严重副作用。结论：小剂量他汀类药物（如血脂康和普伐他汀）长期口服治疗成人血脂紊乱，安全、有效。

Hypertriglyceridemia-induced pancreatitis: A case-based review

Hypertriglyceridemia is an established cause of pancreatitis. In a case-based approach, we present a review of hypertriglyceridemJa and how it can cause pancreatitis. We outline how to investigate and manage such patients. A 35 year old man presented to the emergency department with abdominal pain and biochemical evidence of acute pancreatitis. There was no history of alcohol consumption and biliary imaging was normal. The only relevant past medical history was that of mild hyperlipidemia, treated with diet alone. Physical exam revealed epigastric tenderness, right lateral rectus palsy, lipemia retinalis, bitemporal hemianopsia and a delay in the relaxation phase of his ankle reflexes. Subsequent laboratory investigation revealed marked hypertriglyceridemia and panhypopituarism. An enhanced CT scan of the head revealed a large suprasellar mass impinging on the optic chiasm and hypothalamus. The patient was treated supportively; thyroid replacement and lipid lowering agents were started. He underwent a successful resection of a craniopharyngioma. Postoperatively, the patient did well on hormone replacement therapy. He has had no further attacks of pancreatitis. This case highlights many of the factors involved in the regulation of triglyceride metabolism. We review the common causes of hypertriglyceridemia and the proposed mechanisms resulting in pancreatitis. The incidence and management of hypertriglyceridemiainduced pancreatitis are also discussed.

Effects of n-3 polyunsaturated fatty acids from seal oils on nonalcoholic fatty liver disease associated with hyperlipidemia

AIM: To investigate the efficacy and safety of n-3 polyunsaturated fatty acids (PUFA) from seal oils for patients with nonalcoholic fatty liver disease (NAFLD) associated with hyperlipidemia. METHODS: One hundred and forty-four patients with NAFLD associated with hyperlipidemia were included in the 24-wk, randomized, controlled trial. The patients were randomized into two groups. Group A (n = 72) received recommended diet and 2 g n-3 PUFA from seal oils, three times a day. Group B (n = 72) received recommended diet and 2 g placebo, three times a day. Primary endpoints were fatty liver assessed by symptom scores, liver alanine aminotransferase (ALT) and serum lipid levels after 8, 12, 16, and 24 wk. Hepatic fat inf iltration was detected by ultrasonography at weeks 12 and 24 after treatment. RESULTS: A total of 134 patients (66 in group A, 68 in group B) were included in the study except for 10 patients who were excluded from the study. After 24 wk of treatment, no change was observed in body weight, fasting blood glucose (FBG), renal function and blood cells of these patients. Total symptom scores, ALT and triglyceride (TG) levels decreased more significantly in group A than in group B (P < 0.05). As expected, there was a tendency toward improvement in aspartate aminotransferase (AST), γ-glutamyltranspeptidase (GGT), and total cholesterol (TCHO) and high- density lipoprotein (HDL) cholesterol levels (P < 0.05) after administration in the two groups. However, no significant differences were found between the two groups. The values of low-density lipoprotein (LDL) were significantly improved in group A (P < 0.05), but no significant change was found in group B at different time points and after a 24-wk treatment. After treatment, complete fatty liver regression was observed in 19.70% (13/66) of the patients, and an overall reduction was found in 53.03% (35/66) of the patients in group A. In contrast, in group B, only f ive patients (7.35%, 5/68) achieved complete fatty liver regression (P = 0.04), whereas 24 patients (35.29%, 24/68) had a certain improvement in fatty liver (P = 0.04). No serious adverse events occurred in all the patients who completed the treatment. CONCLUSION: Our results indicate that n-3 PUFA from seal oils is safe and effi cacious for patients with NAFLD associated with hyperlipidemia and can improve their total symptom scores, ALT, serum lipid levels and normalization of ultrasonographic evidence. Further study is needed to confi rm these results.

Treatment of Hyperlipemia by Acupoint Catgut-embedding in 34 Cases

With the therapeutic method of acupoint catgut embedding, the authors have in recent years treated hyperlipemia and achieved satisfactory therapeutic results. A report follows.

Effect of alternate-day-fasting combined with Lingguizhugan Decoction on blood lipid profiles of hyperlipidemic rats

Objective： To explore the effects of alternate-day-fasting （ADF） therapy combined with Lingguizhugan Decoction （LD）on blood lipid profiles of hyperlipidemic rats. Methods： Rats were randomly assigned into high-fat-diet （HF） group andnormal-diet （ND） group. Hyperlipidemic rats fed with high-fat-diet for 5 weeks were randomly divided into ADF group,alternate-day-fasting with LD （ALG） group and model control （MC） group. The rats in ALG and ADF group weredeprived of food for 24 h every other day for 4 weeks. Rats in ALG group were administrated with LD at fasting day.After 4 weeks of ADF therapy, plasma TC, TG, LDL-c and HDL-c were measured in each group. Expression of miR-143and PPAR-γ protein from adipose was also analyzed. Results： When compared with MC group, after 4 weeks of ADF orcombined ADF and LD therapy, the body weight was evidently reduced in ADF and ALG groups （P = 0.028, P = 0.036by wk 8）. The levels of plasma TC and TG decreased in ADF group and ALG group, which were significantly lower thanthose in MC group （P 〈 0.001, P = 0.045; P 〈 0.001, P = 0.005）. However, the body weight and level of TC and TG inALG group showed non-statistical difference in comparison with ADF group （ALG vs. ADF, P 〉 0.05）. Expression ofmiR-143 and PPAR-γ were higher in MC group than that in NC group （P 〈 0.001）. Compared with MC group,expression of miR-143 and PPAR-γ were significantly decreased in ADF （P = 0.038, P = 0.015） and ALG （P = 0.007, P〈 0.001） groups. When compared with ADF group, expression of miR-143 and PPAR-γ were significantly decreased inALG （P = 0.041, P = 0.046） group. Conclusion： ADF therapy alone not only reduced blood lipids, but also inhibitedmiR-143 and PPAR-γ protein expression in visceral adipose tissue. However, LD couldn’t reduce the levels of bloodlipid profiles more effectively than using ADF alone. Perhaps the effects of LD combined with ADF in the prevention ofhyperlipidemia need further exploration.

Effect of acupuncture on antioxidant capacities and protection of vascular endothelium in hyperlipidemia mice

Objective To observe the effect and explore the mechanism of acupuncture on hyperlipemia in mice. Methods One hundred and twenty male Kunming mice of clean grade were randomly divided into a normal group （40 mice）, a model group （40 mice）, an acupuncture group （20 mice）, and a drug group （20 mice）. The hyperlipidemia model was prepared in the latter 3 groups by feeding with high fat diet. After the successful modeling, bilateral ＂Fenglong＂ （丰隆 ST 40）, ＂Quchi＂ （曲池 LI 11）, and ＂Sanyinjiao＂ （三阴交 SP 6） were selected in the acupuncture group and Han＇s Acupuncture Stimulator was connected to intervent for 10 rain, once daily, for 10 successive days. Mice in the drug group were orally given Simvastatin, once daily, for 10 successive days. No intervention was given to the normal group and the model group. Serum contents of total cholesterol （TC）, triglyeeride （TG）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, malondialdehyde （MDA）, nitric oxide （NO）, endothelin （ET）, and the activity of superoxide dismutase （SOD） were detected. Results The serum contents of TG, TC and LDL-C in the model group detected on the 15th day were all higher than those of the normal group [（1.31±0.32） mmol/L vs （0.70±0.21） retool/L, （5.72±0.85） mmol/L vs （3.08±0.74） retool/L, （2.68±0.55） mmol/L vs （1.83±0.36） retool/L, respectively]. The serum content of HDL-C in the model group was lower than that in the normal group [（0.60±0.26） mmol/L vs （0.94±0.30） mmol/L], showing successful modeling. On the lOth day of successful modeling, the serum contents of MDA and ET in the acupuncture group were lower than those in the model group [（21.58±3.54） p, mol/mL vs （29.94±2.79） p, mol/mL, （44.51±5.23） pg/mL vs （67.07±11.98） pg/mL]. The serum SOD activities and NO content in the acupuncture group were higher than those in the model gropu [（264.57±14.46） U/mL vs （222.66±25.48） U/mL, （85.02±10.06） μmol/L vs （63.83±9.19） μmol/L]. Conclusion Acupuncture could lower serum contents of MDA and ET, improve SOD activities and NO content, showing acupuncture could fight against lipid peroxidation, clear free radicals, regulate as well as ameliorate the metabolic balance of free radicals, and protect the vascular endothelium in hyperlipidemia mice.

Effects of acupuncture on blood-lipids, anti-oxidizing ability and vascular endothelial protective function in hyperlipemia mice

Objective To observe therapeutic effects of acupuncture on the mouse of hyperlipemia and to explore the mechanisms. Methods One hundred and twenty Kunming mice, male, sanitary degree, were randomly divided into normal group （n=40）, a model group （n=40）, an acupuncture group （n=20） and a medicine group （n=20）. Except the normal group, the mice were fed with high fat forage to prepare mouse hyperlipemia model. On the 15th day of modeling, serum total cholesterol （TC）, triglyceride （TG）, low density lipoprotein-cholesterol （LDL-C）, high density lipoprotein-cholesterol （HDL-C） levels were detected in 20 normal mice and 20 model mice; electroacupuncture was given at bilateral ＂Fēnglóng＂ （丰隆 ST 40）, ＂Qūchí＂ （曲池 LI 11）, ＂Sānyīnjiāo＂ （三阴交 SP 6） in the acupuncture group, once a day, for 10 consecutive days; in the medicine group, the mice were intragastrically administrated with Simvastatin, once daily , for 10 consecutive days. After the end of treatment, serum TC, TG, LDL-C, HDL-C, malondialdehyde （MDA）, nitric oxide （NO） and endothelin （ET） contents and superoxide dismutase （SOD） activities were detected in the groups. Results On the 15th day of modeling, in the model group serum TG, TC, LDL-C contents were significantly higher （all P〈0.05） and HDL-C content was significantly lower （P〈0.01） than those in the normal group. After treatment for 10 days, in the acupuncture group and the medicine group serum TG, TC, LDL-C, MDA and ET contents were significantly lower and serum HDL-C and NO contents and SOD activities were significantly higher than those in the model group （P〈0.05, P〈0.01）, and the improving action in the acupuncture group was better than that in the medicine group （P〈0.05, P〈0.01）. Conclusion Acupuncture can regulate fat metabolism, resist lipid peroxidation and protect vascular endothelial function in the mouse of hyperlipemia.

Progress of Clinical Study on Treatment of Hyperlipidemias with Acupuncture

Objective： To summarize the clinical study on acupuncture treatment of hyperlipidemia for figuring out the existing issues and guiding the future study. Methods： Obtained by searching the scientific and technological journals database with computer, the relevant literature on acupuncture treatment of hyperlipidemia in the recent ten years is summarized and analyzed. Results and Conclusion： Forty-two pieces of the articles in conformity to the criteria of recruitment mainly refer to acupuncture, moxibustion, and simultaneous application of acupuncture and moxibustion, catgut-embedding method of the acupoints, external application of herbal products on the acupoints, and acupoint-injecting method, mostly by the acupoints of the Spleen and Stomach Meridians. But, the methods to select the acupoints by pattern identification, the application of the needling techniques and design of the test plans need to be further amended.

Effects of different transdermal penetration enhancers applied to herbal cake-partitioned moxibustion on liver lipids,HSL and HMG-CoA reductase in hyperlipidemia rabbits

Objective:To observe the effects of laurocapram and borneol as transdermal penetration enhancers applied to herbal cake-partitioned moxibustion on liver lipids,hormone-sensitive lipase(HSL)and hydroxymethylglutaryl CoA(HMG-CoA)reductase in hyperlipidemia rabbits.Methods:Forty New-Zealand rabbits were randomly divided into 5 groups using the random number table method,with 8 rats in each group.Rabbits in the blank group were fed routinely with a normal diet;rabbits in the other groups were fed with high-fat diet for 12 weeks to establish the hyperlipidemia model.Rabbits in the blank and the model groups were not given any intervention.After the model was prepared successfully,rabbits in the non-transdermal penetration enhancer group received herbal cake-partitioned moxibustion without transdermal penetration enhancers;rabbits in the laurocapram group and the borneol group received herbal cake-partitioned moxibustion with laurocapram or borneol respectively.After 4 weeks of treatment,the serum was isolated and enzyme-linked immunosorbent assay(ELISA)was applied for the detection of HSL and HMG-CoA reductase.The liver tissues were isolated,and total cholesterol(TC)and triglycerides(TG)were measured by enzymatic methods.One-step method was applied for high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)detection,and transmission turbidimetry was for apolipoprotein A1(Apo-A1)and apolipoprotein B(Apo-B)detection.Results:The serum concentrations of the drugs in the laurocapram and the borneol groups were significantly higher than those in the non-transdermal penetration enhancer group(both P<0.05);all drug penetrations in the borneol group were significantly higher than those in the laurocapram group(both P<0.05),except for tanshinoneⅡA.Compared with the non-transdermal penetration enhancer group,the HSL was significantly increased while the HMG-CoA reductase was significantly decreased in the laurocapram and the borneol groups(both P<0.05);between groups,the HSL in the borneol group was significantly higher than that in the laurocapram group(P<0.05).Compared with the blank group,the levels of LDL-C,TG,TC and Apo-B in rabbit liver were significantly increased in the model group(P<0.05);compared with the model group,the levels of LDL-C,TG,TC and Apo-B in the non-transdermal penetration enhancer,the laurocapram,and the borneol groups were significantly decreased(all P<0.05);between groups,the TG and TC in the laurocapram group and the LDL-C,TG,TC and Apo-B in the borneol group were significantly lower than those in the non-transdermal penetration enhancer group(all P<0.05),and the TG,LDL-C and Apo-B in the borneol group were significantly lower than those in the laurocapram group(all P<0.05).Compared with the blank group,the HDL-C and Apo-A1 were significantly decreased in the model group(both P<0.05),while compared with the model group,the HDL-C and Apo-A1 were significantly increased in the non-transdermal penetration enhancer,the laurocapram,and the borneol groups(all P<0.05).Between groups,the Apo-A1 in the laurocapram group,the HDL-C and Apo-A1 in the borneol group were significantly higher than those in the non-transdermal penetration enhancer group(all P<0.05).Conclusion:The application of laurocapram and borneol,as transdermal penetration enhancers,in herbal cake-partitioned moxibustion can promote the penetration of the drugs in the herbal cake,increase the levels of HDL-C and Apo-A1,improve the metabolism of HSL and HMG-CoA reductase,and also simultaneously reduce the levels of TC,TG,LDL-C and Apo-B in the liver.The transdermal penetration enhancement effect of borneol is slightly better than or equivalent to that of laurocapram.

Effect of herbal cake-partitioned moxibustion on Leptin/JAK#STAT3 in lipid-lowering pathway of hyperlipidemia rabbits

Objective:To observe the lipid-lowering effect of different transdermal absorption enhancers applied to the herbal cake-partitioned moxibustion in hyperlipidemia model rabbits,and to explore the possible mechanism.Methods:Forty New-Zea I a nd rabbits were ran domly divided into 5 groups using the ran dom nu mber table method,with 8 rats in each group.Rabbits in the blank group were fed routinely with normal diet;rabbits in the other groups were fed with high-fat diet for 12 weeks to establish the hyperlipidemia model.Rabbits in the blank and the model groups were not treated.After the model was prepared,rabbits in the non-transdermal absorption enhancer group received herbal cake-partitioned moxibustion without transdermal absorption enhancer;rabbits in the laurocapram group and the borneol group received herbal cake-partitioned moxibustion with laurocapram or borneol respectively.After 4 weeks of treatment,serum was collected for enzyme-linked immunosorbent assay(ELISA),and the liver tissues were isolated for imm uno histochemistry,qua ntitative polymerase chain reactio n(qPCR)and Western-blotting(WB)detecti on.Results:Serum ELISA results showed that leptin was significantly decreased in the model group compared with the blank group(P<0.05);compared with the model group,lepti n was significa ntly in creased in the non-tran sdermal absorpti on enhanee。the laurocapram and the borneol groups(all P<0.05);compared with the non-transdermal absorption enhancer group,leptin was significantly increased in the laurocapram group and the borneol group(both P<0.05);there was no significant differenee in leptin between the laurocapram and the borneol groups(P>0.05).The qPCR results of rabbit liver tissues showed that the mRNA expressions of leptin,Janus kinase 2(JAK2)and signal transducer and activator of transcription 3(STOT3)in the model group were significantly lower than those in the blank group(all P<0.05);compared with the model group,the mRNA expressions of leptin,leptin receptor(LR),JAK2 and S1AT3 in the non-transdermal absorptio n enhan cer,the laurocapram and the born eol groups were significantly in creased(all P<0.05);compared with the non-transdermal absorption enhancer group,the mRNA expressions of leptin,LR,JAK2 and S77VT3 in the laurocapram and the bor neol groups were sign ificantly in creased(all P<0.05);compared with the laurocapram group,the mRNA expressi ons of lepti n,LR,JAK2 and SW3 in the bor neol group were significa ntly in creased(P<0.05).The trend of immun ohistochemistry and WB detecti on results was basically con siste nt with the qPCR assay results.The immuno histochemistry and WB detection results of phosphorylated JAK2(phospho-JAK2)and phosphorylated S7AT3(phospho-STAT3)were basically consistent with those of JAK2 and S7AT3.Conclusion:The molecular expression of Leptin/JAK"S7AT3 pathway in the hyperlipidemia model rabbits was decreased.The molecular expression of Leptin/JAK0STCT3 pathway was significantly increased after the herbal cake-partitioned moxibustion.The application of laurocapram and borneol,as transdermal absorption enhancers,in the herbal cake-partitioned moxibustion could more obviously up-regulate the factors of the Leptin/JAK^SIAT3 lipid-regulating pathway than the herbal cake-partitioned moxibustion alone.

Xuefuzhuyu decoction for hyperlipidemia: a systematic review and Meta-analysis of randomized clinical trails

OBJECTIVE:To evaluate the efficacy and safety of Xuefuzhuyu decoction for hyperlipidemia.METHODS:Randomized clinical trials on hyperlipidemia treated by Xuefuzhuyu decoction,either alone or with Western Medicine,were searched in electronic databases.Databases searched were:MEDLINE,Allied and Complementary Medicine Database,EMBASE,The Cochrane Library 2013(Issue4),China National Knowledge Infrastructure Database,Chinese Biomedical Literature Database,and Wanfang Database up to 2 May,2013.Study selection,data extraction,quality assessment,and data analysis were conducted according to the Cochranestandards.RESULTS:Six randomized clinical trials involving748 patients(373 patients in the treatment group,375 patients in the control group)were included in the analysis.The studies were of low methodological quality.Meta-analysis indicated that the effect of Xuefuzhuyu decoction on hyperlipidemia was better than that in the control group[n=748,OR=5.07,95%CI(3.40,7.58),P<0.01].Weighted mean differencesin total cholesterol,low-densitylipoprotein cholesterol,triglycerides,and high-density lipoprotein cholesterol were﹣0.79,﹣0.74,﹣0.44,0.16,respectively,and Meta-analysis revealed that the treatment group was better than the control group with 95%CI(﹣1.21,﹣0.36),(﹣0.94,﹣0.55),(﹣0.77,﹣0.11),(0.04,0.27),respectively(all P<0.05).Some adverse events in evaluated studies wererecorded.CONCLUSION:Xuefuzhuyu decoction may be effective for treating hyperlipidemia.The studies we analyzed were of low methodological quality,which indicates that the above findings should be considered cautiously.Therefore,more strictly designed large-scale randomized clinical trials are needed to evaluate the efficacy of Xuefuzhuyu decoction in hyperlipidemia.

Clinical Observation on Hyperlipemia Treated with Antihyperlipidemic Decoction

Objective： To observe the therapeutic effect of antihyperlipidemic decoction on hyperlipemia. Methods： 77 hyperlipemia patients are selected and randomly divided into two groups. 37 cases in the treatment group received the treatment of antihyperlipidemic decoction, and 40 cases in the control group received western medicine, zhinbiticose. The course of treatment for both groups was 8 weeks. Results： The difference in total effective rate between the two groups was significant （P〈0.05）. Conclusion： Antihyperlipidemic decoction has a better therapeutic effect for hvoerlioemia, with a lower recurrence rate and less side effect.