| Background:Low density lipoprotein cholesterol(LDL-C)is the most important risk factor for atherosclerotic cardiovascular disease(ASCVD).Statins can reduced LDL-C and cardiovascular events significantly,but its lipid-lowering effect could be weakened by increasing the absorption of cholesterol by contraries.A number of clinical trials have approved that Xuezhikang is not inferior to statins in lowering lipid effect and reducing cardiovascular events,However,whether its lipoid-lowering effect can be achieved by inhibiting cholesterol absorption has not been reported yet.Therefore,it is of great significance to reduce the LDL-C effectively and the prevention of ASCVD to study the mechanism of Xuezhikang.Objective:To explore the lipid-lowering effect of Xue Zhi Kang and its influence on Cholesterol metabolism marker,Firstly,This paper compares the Lowering-effect of Xuezhikang and Simvastatin and difference of their influence on Cholesterol metabolism marker,explanating preliminarily discrepancy between this two agents' effect on lipid and cholesterol metabolism markers;Then we compare the Lipidlowering effect and changes in Cholesterol metabolism marker between those using Xuezhikang for 4 weeks with those using Xuezhikang for up to12 weeks,to identify whether the treatment course will effect the lipid lowering effect and have further influence on Cholesterol metabolism marker.Methods:1.The questionnaire was designed to collect the basic information of the patients,including height,weight,family history,medication and complications;2.A total of 90 patients with high cholesterol were enrolled in the outpatient department,without gender restriction,age between 20-70 years,were randomly divided into Xuezhikang group(n=60)and simvastatin control group(n=30);3.Xuezhikang group(n=60)was divided into two groups according to the course of treatment:(1)Xuezhikang 4 W group and(2)Xuezhikang 12 Wgroup,each group of 30 cases,taking Xuezhikang 0.6g,twice a day;4.The ourse of treatment of simvastatin control group is4 weeks,taking 20 mg Simvastatin every night.5.The collection of serum samples :patients were taken fasting venous blood before and after the treatment respectively,then keeped in reserve;6.The blood lipid indexes included total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and triglyceride(TG)were tested by technicians in Department of clinical laboratory;7.Safety indicators including creatine kinase,fasting blood glucose and liver and kidney function related indicators were tested by technicians in Department of clinical laboratory;8.Cholesterol synthesis markers(squalene,7-cholesterol and dehydrocholes terol ene)before and after the treatment were detected by gas chromatography;9.cholesterol absorption markers(cholestanol,sitosterol,campesterol and stigmasterol)before and after the treatment were detected by gas chromatography;10.Data were analyzed using SPSS18.0 software,Data accorded with normal distribution were shown using (?)±S,while these accorded with unnormal distribution were shown using median(four percentile interval),P<0.05 is regarded as significant;11.All patients in this study have signed informed consent book and approved by the ethics committee of An Zhen Hospital.Results:1.The results of survey data analysis: there was no significant difference in age,gender,BMI and complications in Xuezhikang 4 weeks group and simvastatin group(P>0.05),there was no significant difference in age,gender,BMI and complications in Xuezhikang 4 weeks group and Xuezhikang 12 weeks group(P>0.05);2.The lipid-lowering effect were similar between Xuezhikang 4 weeks group and simvastatin group: Statistical significance was not found in TC,LDL-C,TG,non-HDL-C and HDL-C(P>0.05);Xuezhikang 4 weeks group :LDL-C,non-HDL-C,TC,and TG of Xuezhikang group are all decreased significantly after treatment(P < 0.05);simvastatin group :TC,LDL-C,TG,and non-HDL-C p are all decreased significantly after medication,and significantly decreased with HDL-C were also observed either(1.19±0.197 vs 1.13±0.234,P=0.045)3.The decline of TC,LDL-C,non-HDL-C and TG in the Xuezhikang 12 weeks group were bigger than that of who treated for4 weeks,TC:-23.10% in group treated Xuezhikang for 4 weeks,-24.10% in another group treated Xuezhikang for 12 weeks;LDL-C:-30.90% in group treated Xuezhikang for 4 weeks,-31.60% in another group treated Xuezhikang for 12 weeks;non-HDL-C:-28.2% in group treated Xuezhikang for 4 weeks,-30.9% in another group treated Xuezhikang for 12 weeks;TG:-8.2% in group treated Xuezhikang for 4 weeks,-25.61% in another group treated Xuezhikang for 12 weeks.4.changes in rate of synthesis markers :Xuezhikang and simvastatin significantly reduced synthesis of Cholesterol metabolism markers including squalene,desmosterol and lathosterol levels as well as Simvastatin(P < 0.05).Xuezhikang 4 weeks group were(0.36±0.315 vs 0.186±0.119),(2.50±1.532 vs 1.94±1.374)and(2.19±1.469 vs 1.26±0.972)respectively,Simvastatin group were(0.27±0.165 vs 0.19±0.135),(2.19±1.502 vs 1.61±1.142)and(2.24±1.326 vs 1.54±1.215)respectively.The reduction extent were both more than 30%,there is no significant diference in groups5.Changes in rates of cholesterol absorption : Statistical significance was found in cholesterol absorption markers-cholestanol/ cholesterol[(2.37±1.341)vs(1.91±1.092),P=0.029].No significant difference was found in other Plant sterols(P >0.05).Conclusions:1.compare to simvastatin,lipid-lowering efficacy of Xuezhikang is not inferior to statins,without adverse effects on HDL-C,Its security is good;2.The lipid-lowering effect in Xuezhikang 12 weeks group is better than that in Xuezhikang 4 weeks group,a further reduction in lipid parameters was observed in the patients who taked Xuezhikang for 12 weeks,and its ecurity is good;3.Cholesterol synthesis marker such as squalene /cholesterol,Lathosterol/ cholesterol and Desmosterol/ cholesterol were reduced by Xuezhikang,and changes in cholesterol absorption markers showed the rate of Cholestanol/ cholesterol was reduced,while without any significant difference observed in simvastatin group,this suggests that Xuezhikang can inhibit both of the rate of cholesterol synthesis and absorption. |
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