A Systematic Review Of Traditional Chinese Medicine In The Treatment Of Liver-kidney Yin Deficiency Type Hyperlipidemia

Objective:To evaluate the clinical efficacy and safety of traditional Chinese medicine(TCM)in the treatment of hyperlipidemia with liver-kidney Yin deficiency,and to provide evidence-based medical evidence for TCM treatment of hyperlipidemia with liver-kidney Yin deficiency.Methods:The included literatures in this study all met the diagnostic criteria of western medicine for dyslipidemia(diagnostic criteria of dyslipidemia in the 2016 guidelines for the prevention and treatment of dyslipidemia in Chinese adults).The diagnostic criteria of traditional Chinese medicine refer to the diagnostic criteria of liver and kidney Yin deficiency syndrome of dyslipidemia formulated in the 2002 edition of guidelines for clinical research of new Chinese medicine.Through a comprehensive system of searching Literature,Chinese document database include:China National Knonwledge Infrastructure Database(CNKI),Wanfang Data,Chineseiomedical Literature Database,Sinomed,VIP.Retrieval of foreign literature databases included:national library of medicine biomedical information database(PubMed)and Embase database.To be included in the literature of randomized controlled trial(RCTs)on TCM treatment of hyperlipidemia of liver and kidney Yin deficiency from self-established database to February 2019,and the treatment group was the intervention measures of TCM or TCM plus western medicine.The control group received conventional western medicine drugs approved by FDA or CFDA.Establish inclusion and exclusion criteria,conduct literature screening and statistical work.Using RevMan 5.3 software developed by the International Evidence-based Medicine Cochrane Collaborative Network,some of the outcome indicators were analyzed by Meta,the results were verified,and Forest maps and Funnel maps were made.Results:This study participants included 16 studies,subjects were included in the 1613 cases.Among them,the minimum is 42 and the maximum is 418.This study included 16 research reports were observed before and after treatment of blood lipid levels,there are 12 study is given before and after treatment the levels of TG,HDL-C,which both expressed as mean ± standard deviation.There are 10 study is given before and after treatment the levels of TC,LDL-C,which both expressed as mean±standard deviation,and the rest of the study did not put the specific lipid levels listed.10 articles gives the effective rate of western medicine treatment.The effective rate of TCM symptom improvement was given in 4 articles.The effective rate of improving symptoms of western medicine is given in 2 papers.Statistical outcome indicators TC,TG,HDL-C,and LDL-C were meta analyzed for continuity variables,and the results were TC:WMD:-0.30,95%CI:[-0.59,-0.02],I2=95%,P<0.00001,TG:WMD:-0.17,95%CI:[-0.22,-0.12],I2=92%,P<0.00001,HDL-C:0.01,95%CI:[-0.01,0.03],I2=81%,P<0.00001,LDL-C:WMD:-0.18,95%CI:[-0.24,-0.11],I2=84%,P<0.00001;Meta analysis of two classification variables for the efficiency of lipids and symptoms of TCM in Western medicine.The results showed that the efficacy of western medicine in terms of blood lipid was:OR:3.84,95%CI:[2.41,6.12],I2=9%,P=0.36,OR:13.35,95%CI:[7.09,25.13],I2=50%,P=0.11.Subgroup analysis was performed on 3 of the included literatures with a course of 12 weeks,and the results were:HDL-C:WMD:-0.01,95%CI:[-0.04,0.021],I2=87%,P<0.00001.TC:WMD:-0.51,95%CI:[-0.66,0.37],I2=94%,P<0.00001;TG:WMD:0.54,95%CI:[-0.64,0.43],I2=96%,P<0.00001;The results suggest that the heterogeneity is large.Conclusion:In the included literature studies,the results showed that Chinese medicine was superior to the control group in the treatment of hyperlipidemia with liver-kidney Yin deficiency,and Chinese medicine may be effective in adjusting the overall level of hyperlipidemia with liver-kidney Yin deficiency.However,due to the relatively small sample size included in this study,the number of cases studied in the literature is small,the duration of medication is different,the course of treatment is different,the blindness is mostly unclear,the sampling method is different,and the selective outcome report,leading to the high heterogeneity in the independent analysis of TC,TG,HDL-C and LDL-C.Expect more high quality large sample RCTs for verification.