Statin in Combination with Xuezhikang Capsules Get More Lipid-Regulating Effects Than Statin Only: A Systematic Review and Meta-Analysis

Background To compare the lipid-regulating effects and safety of statin combined with Xuezhikang capsules and statin used alone for hyperlipidemia. Methods CNKI, Wanfang database, VIP Chinese Journals, PubMed, Embase, and Cochrane library were searched to comprehensively collect and screen RCTs of Xuezhikang combined with statin compared with statin used alone for lipid modifying treatment in hyperlipidemia patients from the database built as of September 2021, and the Cochrane 5.1.0 quality evaluation form was used to evaluate the quality of the included literature and The Cochrane 5.1.0 quality assessment form was used to evaluate the quality of the included literature and bias analysis, extract basic study information, primary and secondary outcome indicators, and meta-analysis of the outcome indicators was performed using RevMan 5.3. Results A total of 14 studies with a total of 2042 patients were included, and the quality of the included studies was low to medium. ①Effectiveness rate: OR=3.63,95%CI[2.69,4.90]; Funnel plot: all within the funnel, but not in accordance with the principle of "aggregation at the top and dispersion at the bottom". ②Total cholesterol: MD=-0.61,95%CI[-0.84,-0.39], The forest plots of each subgroup are to the left. ③Triglycerides: MD=-0.30,95%CI[-0.41,-0.19], The forest plots of each subgroup are to the left,. ④ LDL: MD=-0.33,95%CI[-0.46,-0.20], The forest plots of each subgroup are to the left. ⑤ HDL: MD=0.23,95%CI[0.12,0.35], The forest plots of each subgroup are to the right. ⑥Adverse effects: OR=0.32, 95% CI[0.19,0.55]. Conclusion The combination of statin with Xuezhikang capsule has better effect on lipid regulation in patients with hyperlipidemia, and can effectively reduce the incidence of adverse events and has better safety. It is recommended that the treatment of Xuezhikang combined with statin can be used as a safer and more effective treatment for patients with hyperlipidemia.

Statin in Combined With Xuezhikang Capsules Get More Lipid-Regulating Effective Than Statin Only: A Systematic Review and Meta-Analysis

Background: To compare the lipid-regulating effects and safety of statin combined with Xuezhikang capsules and statin used alone for hyperlipidemia. Methods: CNKI, Wanfang database, VIP Chinese Journals, PubMed, Embase, and Cochrane library were searched to comprehensively collect and screen RCTs of Xuezhikang combined with statin compared with statin used alone for lipid modifying treatment in hyperlipidemia patients from the database built as of July 2020, and the Cochrane 5.1.0 quality evaluation form was used to evaluate the quality of the included literature and The Cochrane 5.1.0 quality assessment form was used to evaluate the quality of the included literature and bias analysis, extract basic study information, primary and secondary outcome indicators, and meta-analysis of the outcome indicators was performed using RevMan 5.3. Results: A total of 14 studies with a total of 2042 patients were included, and the quality of the included studies was low to medium. ①Effectiveness rate: OR=3.63,95%CI[2.69,4.90],P<0.00001; Funnel plot: all within the funnel, but not in accordance with the principle of "aggregation at the top and dispersion at the bottom". ②Total cholesterol: MD=-0.61,95%CI[-0.84,-0.39],P<0.00001, The forest plots of each subgroup are to the left, P<0.05. ③Triglycerides: MD=-0.30,95%CI[-0.41,-0.19],P<0.00001, The forest plots of each subgroup are to the left, P<0.05. 0.05. ④ LDL: MD=-0.33,95%CI[-0.46,-0.20],P<0.00001, The forest plots of each subgroup are to the left, P<0.05 in atorvastatin and fluvastatin groups, P=0.09 in simvastatin group. ⑤ HDL: MD=0.23, 95%CI [0.12,0.35], P<0.00001, The forest plots of each subgroup are to the right, P<0.05. 6) Adverse effects: OR=0.32, 95% CI[0.19,0.55],P<0.0001. Conclusion: The combination of statin with Xuezhikang capsule has better effect on lipid regulation in patients with hyperlipidemia, and can effectively reduce the incidence of adverse events and has better safety. It is recommended that the treatment of Xuezhikang combined with statin can be used as a safer and more effective treatment for patients with hyperlipidemia.

Xuezhikang Capsule for Type 2 Diabetes with Hyperlipemia: A Systematic Review and Meta-Analysis of Randomized Clinical Trails

Objective. To evaluate the efficacy and safety of Xuezhikang capsule treating type 2 diabetes with hyperlipidemia.Methods. We searched six databases to identify relevant studies published before January 2015. Two review authors independently extracted data and assessed the Cochrane risk of bias tool. We resolved disagreements with this assessment through discussion and a decision was achieved by consensus.Results. We included 21 studies (1548 participants). Treatment courses were at least 8 weeks. Overall, the risk of bias of included trials was unclear. Among them, 16 studies could conduct meta-analysis. The result showed that compared with routine group (5 studies), Xuezhikang group had more effect on decreasing TC, TG, LDL-C, and rising HDL-C. However, compared with statins group (11 studies), Xuezhikang group has less effect on decreasing TC, TG, and rising HDL-C. Meanwhile, two groups had no statistical differences of LDL-C level.Conclusion. Xuezhikang capsule may be effective for treating type 2 diabetes with hyperlipemia. Our findings should be considered cautiously due to unclear risk of bias of the included studies and low methodological quality. Therefore, more strictly designed large-scale randomized clinical trials are needed to evaluate the efficacy of Xuezhikang capsule in type 2 diabetes with hyperlipemia.

A Validated RP-HPLC Method for the Determination of Citrinin in Xuezhikang Capsule and otherMonascus-Fermented Products

Citrinin is a toxic product usually produced during theMonascusfermentation. The presence of citrinin in xuezhikang capsule has been a concern due to its ingredient which is derived frommonascus-fermented rice. A rapid and sensitive RP-HPLC method with fluorescence detection at λex= 331 nm and λem= 500 nm for analysis of citrinin inMonascus-fermented products was developed to analyze citrinin inMonascus-fermented products. The chromatography was performed with mobile phase containing acidified water and acetonitrile. The calibration curve was linear (r = 0.9999) over a range of 0.0107- 0.537 μg/mL. The limit of detection (LOD) and the limit of quantitation (LOQ) were 0.187 ng/mL and 0.6 ng/mL respectively. The analysis of xuezhikang capsules using the developed method suggested that the product does not contain detectable citrinin and the result has been further confirmed using independent LC-MS/MS analysis. The proposed method has also been applied to analyze 11 samples of otherMonascus-fermented products. The results suggested that there were no detectable citrinin in 4 of the 11 samples, however citrinin with the levels between 0.10-594 ng/kg has been detected in the other 7 samples. It indicates that the proposed method can also be applied to carry out the quantitative detection of citrinin for otherMonascus-fermented products.