Xuezhikang Treatment Hyperlipidemia Effectiveness And Safety Of The System Evaluation

Objective: To assess the efficacy and safety of Xuezhikang capsule(XZK) forhyperlipidemia. Methods: Randomized controlled trials(RCT) of XZK in treating hyperlipidemiawere included, the intervention of the treated group was XZK, and those of the control groupwere placebo, statins, hexanicit, clofibrates, probucol and the other drugs, respectively. Thequality of each trial was assessed based on four quality criteria recommended in CochraneReviewer's Handbook 4.2.2, including assessment of randomization, allocation concealment,blinding, description of withdraws and dropouts. MEDIINE,EMBASE, Cochrane CentralRegister of Controlled Trials(CCTR), Cochrane Metabolic and Endocrine Disorders Groupdata bank, and Chinese Biomedical Database(CBM), China Hospital KnowledgeDatabase(CHKD) were searched , and the published/unpublished information washandsearched (updated to July, 2004). Data was analyzed by using Review Manager (Version4.2). Statistic efficacy was expressed with relative risk (RR) and its 95% confidenceinterval(CI) for dichotomous data, and weighted mean difference(WMD) with its 95% CI forcontinuous data. Meta analysis was conducted for homoeonomous trials with fixed effectmodel, while for the clinical trials of clinical homoeonomous but statistic heterogeneous,Meta analysis was conducted with random effect model. Results: Twenty-two RCTs (conducted in China) were identified, including a total of2016 patients with hyperlipidemia met the inclusion criteria for the review. (1) Quality of the trials: Among 22 RCTs, 13 were conducted with adequate assessmentof randomization, 9 with adequate allocation concealment, 13 with blinding, 6 withdescription of withdrawals or dropouts, none of the trials was conducted by intention to treatanalysis, the RCTs were of moderate quality in general. (2) The effect of XZK in reducing TC: Compared with the placebo, XZK was better thanplacebo, statistically significant difference was shown [RR 1.92, 95%CI (1.48, 2.49);2RCTs].There is insignificant difference between XZK and statins [WMD-0.01, 95%CI (-0.20, 0.17);3 RCTs. RR1.02, 95%CI (0.93, 1.12);3 RCTs]. XZK was superior to hexanicit,statisticalsignificance was shown [WMD 1.03, 95%CI (0.82, 1.24);3 RCTs]. There was no statisticalsignificance between XZK and clofibrates [WMD 0.05, 95%CI (-0.02, 0.31); 2 RCTs]. XZKhad the same effect as that of probucol [WMD 0.42, 95%CI ( -0.01, 0.85)]. Compared withmannose, there was insignificant difference [WMD 0.07, 95%CI (-0.45, 0.59)]. Comparedwith Gynostemma pentaphyllum Tablet(GPT), XZK had better effect [RR 2.89, 95%CI (2.08,4.02); 3 RCTs]. Effect of XZK was better than that of Taizhian capsule (泰脂安胶囊, TZAC)[WMD 0.41, 95%CI (0.06, 0.76)]. XZK had the same effect as those of Zhibituo tablet (脂必妥片, ZBT), Dicikang granule (地赐康冲剂, DCKG), Lipi Tiaozhi capsule (理脾调脂胶囊,LPTZC), there were insignificant difference [WMD and 95%CI were 0.17, (-0.40, 0.74);-0.01, (-0.25, 0.23);-0.25, (-0.59, 0.09), respectively]. (3) The effect of XZK in reducing TG: The effect of XZK was superior to placebo [RR2.43, 95%CI (1.75, 3.37);2RCTs]. XZK had the same effect as statins [WMD 0.64, 95%CI(-0.01, 1.29);3RCTs; RR 1.17, 95%CI (0.92, 1.49); 3RCTs]. XZK was similar to hexanicit[WMD 0.33, 95%CI (0.13, 0.52), 3RCTs]. XZK was not as good as clofibrats, statisticallysignificant difference was shown [WMD -0.87, 95%CI (-1.11, -0.64); 2RCTs]. XZK wassuperior to probucol, the difference was statistical [WMD -0.71, 95%CI (0.22,1.20)]. XZKhad the same effect as mannose [WMD -0.44, 95%CI (-0.89, 0.11)]. Effect of XZK was thesame as that of GPT [RR 1.76, 95%CI (0.86, 3.62); 3RCTs]. XZK had the same effect asthose of ZBT, TZAC, DCKG, LPTZC [WMD and 95%CI were 0.01, (-0.74, 0.76); 0.02,(-0.50, 0.54);0.08, (-0.18, 0.34);-0.12, (-0.26, 0.02), respectively]. (4) The effect of XZK in increasing HDL-C:The effect of XZK was superior to theplacebo [RR 3.14, 95%CI (1.12, 8.79)]. XZK had the same effect as that of statins [WMD0.00, 95%CI (-0.06, 0.06);3RCTs. RR 1.03, 95% CI (0.00, 1.33), 3RCTs]. The effect of XZKwas...