Objective To assess the efficacy and safety of Xuezhikang capsule (XZK) for hyperlipidemia. Methods MEDIINE，EMBASE, Cochrane Central Register of Controlled Trials(CCTR), Cochrane Metabolic and Endocrine Disorders Group data bank, and Chinese Biomedical Database(CBM), China Hospital Knowledge Database(CHKD) were searched，and the published/unpublished information was handsearched (updated to Dec., 2005) to identify randomized controlled trials (RCTs) or quasi-RCT of XZK versus statins or other lipid lowering drugs in treating hyperlipidemia patients. The quality evaluation, data extraction and analysis were conducted by the method recommended in Cochrane Reviewer’s Handbook 4.2.2. Data were analyzed using Review Manager (Version 4.2). Results Eleven trials (conducted in China) were identified, including 1 073 patients with hyperlipidemia met the inclusion criteria. All the included RCTs were graded as B or C. ① The effect of XZK in reducing TC: There were no significant differences between XZK and statins ( WMD 0.06, 95%CI-0.09 to 0.20 and RR1.02, 95%CI 0.93 to 1.12), XZK and fibrates (WMD 0.05, 95%CI -0.22 to 0.31) and XZK and probucol(WMD 0.42, 95%CI -0.01 to 0.85). XZK was superior to hexanicit (WMD 0.96, 95%CI 0.73 to 1.18). ② The effect of XZK in reducing TG: XZK had the same effect as statins (WMD 0.02, 95%CI -0.10 to 0.14 and RR 1.17, 95%CI 0.92 to 1.49) and hexanicit (WMD 0.28, 95%CI -0.17 to 0.73 ).Meanwhile, XZK was superior to probucol (WMD 0.71, 95%CI 0.22 to 1.20), but it was not as good as fibrates (WMD -0.81, 95%CI -1.40 to -0.23). ③ The effect of XZK in increasing HDL-C：XZK had the same effect as that of statins (WMD -0.03, 95%CI -0.10 to 0.04 and RR 1.03, 95% CI 0.80 to 1.33). The effect of XZK was better than that of hexanicit (WMD 0.15, 95%CI 0.01 to 0.29). XZK had the same effect of fibrates (WMD 0.03, 95%CI -0.08 to 0.15) and probucol (WMD 0.04, 95%CI -0.16 to 0.24). ④ The effect of XZK in reducing LDL-C：The effects of XZK and statins were the same (WMD -0.23, 95%CI -0.61 to 0.15 and RR 1.15, 95%CI 0.75 to 1.77). The effect of XZK was better than that of hexanicit (WMD 0.53, 95%CI 0.16 to 0.90). Meanwhile, XZK had the same effect as those of fibrates (WMD 0.19, 95%CI -0.12 to 0.50) and probucol (WMD 0.35, 95%CI -0.03 to 0.73). ⑤ The adverse reactions of XZK were mainly the gastrointestinal tract reaction, while liver function abnormality and myalgia were scarcely found. Conclusion Xuezhikang capsule have the same effects as those of statins in reducing the levels of TC, TG, LDL-C and raising HDL-C in patients with hyperlipidemia. No obvious adverse reactions are found during the short-term treatment. But further confirmation with clinical randomized controlled trials of high quality, large sample and long-term follow-up is needed.
Therapeutic effect of fixed-dose combination therapy (Polypill) for cardiovascular disease is a hot spot in the field of cardiovascular medicine. A variety of Polypill have been developed for the prevention and treatment of cardiovascular disease, and a plenty of clinical evidence of Polypills for cardiovascular disease has been accumulated all over the world. In this paper, we raise ideas and expectation about research & development thinking of Polypill and Chinese herbal compound prescription based on a meta-analysis of efficacy and safety of Polypill in the prevention of cardiovascular disease (published in JAMA in Nov. 2014) as well as main clinical research literature in this field in recent years.
The theoretical innovation and new drug research on the prevention and treatment of cardiovascular diseases by activating blood circulation has been one of the most active and outstanding achievements in the field of integrated Chinese and western medicine for the past 60 years. Research on blood stasis syndrome (BSS) and activating blood circulation (ABC) was the first to be awarded the first prize of National Award for Science and Technology Progress in Chinese Medicine since the founding of the People's Republic of China. The research team headed by prof. Keji CHEN has obtained abundant research achievements. Taking coronary heart disease, a major clinical cardiovascular disease as the entry point, the team explored the development of the diagnostic criteria for the combination of BSS, the interpretation of the modern connotation of ABC, the development of a series of new drugs for ABC, clinical efficacy evaluation and mechanism of its action. It promotes the standardization and internationalization of traditional Chinese medicine and forms high-quality evidence for clinical transformation. It has also made outstanding contributions to the prevention and treatment of cardiovascular diseases with original features. In this paper, the history of prevention and treatment of cardiovascular diseases by ABC after the founding of the People's Republic of China was reviewed. The representative research findings of several domestic academic teams, including prof. Keji CHEN's team, over the past 60 years were expounded emphatically so as to provide reference for promoting and innovating research in activating blood circulation and removing blood stasis.
ObjectiveTo systematically evaluate the methodological quality of traditional Chinese medicine (TCM) guidelines and expert consensuses for the diagnosis and treatment of coronary heart diseases (CHD).MethodsDatabases including PubMed, CNKI, CBM, WanFang Data and the official websites of the China Association of Traditional Chinese Medicine, and the Chinese Association of Integrated Traditional and Western Medicine were electronically searched to collect guidelines (or expert consensus) of TCM for CHD from January 1st, 2010 to January 1st, 2021. Methodological evaluation of the included guidelines was conducted by 3 researchers independently using the AGREE Ⅱ instrument.ResultsA total of 16 guidelines were included. The AGREE Ⅱ scores for each domain were: clarity and presentation (63.89%), followed by scope and purpose (55.90%), stakeholder involvement (42.13%), the rigor of development (41.42%), editorial independence (32.12%), and applicability (21.99%). Nine guidelines were rated as level B (recommended after being revised), and 7 were rated as level C (not recommended).ConclusionsGuidelines and expert consensuses of TCM for CHD provide a standard for clinical practice, however, the methodological quality remains to be improved. It is suggested that future guidelines be formulated in accordance with international standards and using the methods of evidence-based medicine to improve the quality of guidelines further and promote international acceptability.
Diabetic panvasculopathy refers to a clinical syndrome in which a wide range of blood vessels (including heart, brain, kidney, eye, peripheral and other large vessels and microvessels) in diabetic patients have atherosclerosis as the common pathological feature, cardiovascular and cerebrovascular events as the main outcome, and active intervention of metabolic abnormalities is helpful to improve the prognosis. Early diagnosis, early prevention and active exploration of clear therapeutic targets are very important to prevent and delay the occurrence and development of diabetic panvasculopathy, but they are also challenges at present. The cardiorenal benefit of new hypoglycemic drugs is independent of blood glucose control, which has attracted increasing academic attention. The concept of panvasculopathy in diabetes plays an important role in improving the comprehensive management of the disease and multidisciplinary collaborative diagnosis and treatment, which is helpful to promote the vigorous development of the subspecialty of panvasculopathy and the continuous improvement of the comprehensive prevention and treatment level.