Xuezhikang Tcm Syndrome Hyperlipidemia Efficacy,

Hyperlipemia(HLP), as a model of abnormal lipid hypermetabolism of human body, is a kind of cardiovascular system disease which is very harm to human body, and its primary clinical symptom is that the blood fat level of blood plasma is abnormal. Now according to the research on HLP of every country, we have realized that HLP could make artherosclerosis occur early and accelerate its development, and the incidence of some important diseases such as incidence, cerebral apoplexy, renal arterial sclerosis, and peripheral vessels sclerosis which are related to HLP is increasing. So the world attaches importance on treating HLP, then exploitation and clinical research of many kinds of medicine to HLP is in the ascendant. XueZhiKang capsule(XZK) is a kind of pure Chinese drugs preparation which is widespread used, and its positive curative effect to lower blood lipid is to be proved, but in the clinical practice we can see that different patients of HLP who are treated with XZK have different curative effect. So we design this topic to observe the clinical effect of different types of syndromes of traditional Chinese medicine(TCM) in 300 patients of HLP treated with XZK, and full find out the variability of curative effect, then instruct clinical application more scientifically. The research is full of essentiality and signality.Documents researchThe rationale of TCM treating disease is the recognition of etiology and pathology. In TCM there is no disease called HLP, which is a modern medicinal terminology. At present many experts are researching on HLP, but there is no common knowledge about HLP on pathomechanism and syndrome differentiation in TCM.From the point of view on disease differentiation, many doctors classify HLP to some diseases such as vertigo, thoracic obstruction, apoplexy, blood stasis, phlegmatic hygrosis, and so on. And from the point of view on syndrome differentiation, HLP belongs to Sputum stasis syndrome or blood stasis syndrome. Then from the point of view on differentiation of syndrome according to Zang-fu organs, HLP belongs to liver, spleen and kidney.At present there are three kinds of methods on treating HLP. They are self working out prescription, classical prescription and Chinese patent medicine. Self working out prescription always contains alisma rhizome, hawthorn, fleeceflower root and salvia miltiorrhiza. And classical prescription may be Banxia Baizhu Tianma decoction, XueFuZhuYu decoction, Huanglian WenDan decoction and BuYangHuanWu decoction. Then Chinese patent medicine are always XZK and ZhiBiTuo.Modern medicine thinks the key of pathogenesis in HLP is lipid metabolic disorder. Now there are 6 kinds of drugs which are common used clinically to regulate blood fat. They are cholic acid chelating resin, nicotinic acid, clofibrate, statins, fibrate and some drugs of new mechanism of action.XZK contains a kind of statins calles lovastatin. And some related researches have proved that XZK could regulate blood fat, then it has all-sided functions except that such as inhibiting atherosclerotic to shape, protecting vascular endothelial cell function, inhibiting vascular smooth muscle cell to proliferate, inhibiting lipid deposite in liver, and improving hemorheological effect so on. So according to these documents we make a decision on this research on the test doses and course of treatment about XZK.Clinical researchCases selection:The HLP patients who accepted clinic service or be in hospital whose blood fat levels were satisfied those standards could be selected. The standards contained:①blood plasma low density lipoprotein (LDL-C)≥3.12(120mg/dl) by precipitation;②blood serumtotal cholesterol(TC)≥5.20(200mg/dl) by enzymic method;③high density lipoprotein (HDL-C)< 0.91(35mg/dl) by precipitation。According to the TCM syndrome differentiation of the book clinical research guide to new Chinese patent medicine, 2002 edition 300 patients of HLP were divided 5 groups, every groups have 60 patients. The five groups were the Sputum stasis syndrome group(37men, 23women, mean age 49±11), the Qi-stagnation induced Blood-stasis syndrome group(31men, 29women, mean age53±9), the Yin-deficiency and Yang-excessive group(30men, 30women, mean age52±11), the Hepatic and Renal Yin deficiency syndrome group(36men, 24women, mean age48±10) and Spleen-Yang deficiency and Kidney-Yang deficiency syndrome group(33men, 27women, mean age52±9). The five groups showed no significant difference in ages, sex and the level of blood fat.Methods: All patients were treated with XZK. The dose was 0.6g at a time, Bid, n&m. The course of treatment was 8 weeks. During the course all drugs to lower blood fat should be prohibited. Changes of index of blood fat and TCM syndrome integral were observed after treatment.Observed index:At the normal diet condition, abstract early morning venous blood venous blood after empty stomach for 12～14 hours.①Test the level of LDL-C, TC and HDL-C and the ratio of TC/HDL before and after treatment.②According to the levels of symptoms in TCM before and after treatment, account the TCM syndrome integral.③Observe biochemical indicators before and after treatment, such as liver function, renal function and CK.Study methods:All data of the observed indexs was showed by x±s. During the statistical course, use t-check before and after treatment in the group, use F-check or q-check groupcomparison. And all of these was treated statistically by SPSS13.0 software. At P < 0.05, itshowed significant difference.Results:(1) After 8 weeks, the LDL-C of all groups were lower than before treatment(P<0.01, P<0.05).And the groups of Sputum stasis syndrome and Qi-stagnation induced Blood-stasis syndromewere superior to the three others(P <0.01), and the two groups showed on significant difference.(2)The TC/HDL-C of Sputum stasis syndrome group was lowest in all groups (P<0.01)andsuperior to other groups (P<0.05); the Qi-stagnation induced Blood-stasis, Yin-deficiency andYang-excessive and Hepatic and Renal Yin deficiency syndrome group showed significantdifference in TC/HDL-C (P<0.05); and the Spleen-Yang Deficiency and Kidney-YangDeficiency syndrome group had no significant difference (P>0.05).(3)The TCM syndrome integral of sputum stasis, yin-deficiency and yang-excessive, andqi-stagnation induced blood-stasis syndrome group were lower than before treatment (P<0.01,P<0.05), but the two other groups showed no significant difference (P>0.05), and the sputumstasis syndrome group was superior to the four other groups (P<0.05).(4)During the treating course, all patients were no abnormal in liver function, renal function andCK.DiscussionHLP, as a kind of abnormal lipid hypermetabolism disease, could make artherosclerosis occur early and accelerate its development, and the incidence of some important diseases such as incidence, cerebral apoplexy, renal arterial sclerosis and peripheral vessels sclerosis which are related to HLP is increasing. Now many experts think that two scientific and rational indexes for observing the great hazardness of HLP are the level of LDL and ratio of TC/HDL. So in this research the two indexes were used to weigh the fact about regulating blood fat.XZK is an extract from productive monascus fermentation used by modern biotechnology, its active ingredients are full of HMG-CoA reducing enzyme inhibitor(lovastatin), many kinds of unsaturated fatty acid and unsaturated fatty acid for human body, some unsaturated fatty acid and a little of anthoxanthin. From the research on gene polymorphism of LDL-C, it was showed that the patients of HLP who had the h1 polymorphism were responded badly to XZK, but who had h1 polymorphism were well responded to it. In the research it showed that the curative effect variability was exacted.As a pure Chinese drugs preparation, XZK has characteristics of nature and flavour and meridian distribution about Chinese drugs. It is rational to do this research on effective variability about XZK from the point of view on TCM syndrome differentiation. At present the common knowledge about HLP is that the most essential patho-base is liver, spleen and kidney deficiency, and patho-products like sputum, and blood stasis are patho-links about occurring, development, turnover and prognosis.The essential component of XZK is red rice, which has the function of eliminating blood stasis and phlegm and fortifying spleen and harmonizing stomach. When combined with the helper constituents, XZK could play the role of attacking and invigorating or dealing with both symptoms and body resistance, so it could fortify spleen and harmonize stomach, then eliminate blood stasis and phlegm.In the research, XZK could regulate the level of blood fat, but the differentiation of syndrome types had existed. After treatment, the Sputum stasis syndrome group had the best effect, the Qi-stagnation induced Blood-stasis group had good effect, but the Spleen-Yang Deficiency and Kidney-Yang Deficiency syndrome type had no significant difference. Maybe the reason was that the syndrome didn't unified the methods from TCM theory. From the gene polymorphism research, maybe the reason was that the Sputum stasis syndrome group and the Qi-stagnation induced Blood-stasis group had h2 polymorphism, but the Spleen-YangDeficiency and Kidney-Yang Deficiency syndrome group had h1 polymorphism.Conclusions :To sum up, XZK is a pure natural traditional Chinese drug, it has clear active ingredient, certain mechanism of action, stable curative effect, safe and effective, little toxic action and fewer side effects. After treatment there are best effect on the Sputum stasis syndrome group, then the he Spleen-Yang Deficiency and Kidney-Yang Deficiency syndrome type has no significant difference. If take its effect variability into account in clinic, you can really use medicine scientifically and rationally, then clinical curative effect can be more perfect.