他汀类药物联合黄连素治疗高脂血症的疗效评估
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国家自然科学基金资助项目(30271527),江苏省自然科学基金资助项目(BK2002142)


The therapeutic effects of combination of simvastatin with berberine on the patients with hyperlipemia
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    目的:研究辛伐他汀(simvastatin,SIMVA)联合黄连素(berberine,BBR)治疗高脂血症的临床疗效及安全性-方法:99例高脂血症患者随机分为3组:A组(SIMVA组),B组(BBR组),C组(SIMVA+BBR组)连续治疗8周-观察患者治疗前后的血脂-肝肾功能等变化-动物实验研究把高脂大鼠随机分为高脂组(6只,生理盐水),辛伐他汀[SIMVA,9只,6 mg/(kg·d)]组,黄连素[BBR,9只,90 mg/(kg·d)]组,辛伐他汀[SIMVA,6 mg/(kg·d)]+黄连素[BBR,90 mg/(kg·d)]组,辛伐他汀[SIMVA,9只,12 mg/(kg·d)]组,喂养30天,分别检测TC-TG-LDL-C及LDLR-mRNA水平的变化-结果:临床研究发现联合用药组疗效明显优于单用药组,显效病例数是SIMVA组的1倍,有效率达100%;SIMVA组治疗前后TC-LDL-C值差异有统计学意义(P < 0.01),BBR组和BBR+SIMVA组治疗前后比较TC-TG和LDL-C差异显著(P < 0.01);3组间比较,C组降低TC-TG-LDL-C较A组差异有显著性统计学意义(P < 0.01),C组治疗期间未见明显不良反应-同时,动物实验也提示联合治疗在降低血脂和上调低密度脂蛋白受体(LDLR)上有明显的统计学意义(P < 0.01),6 mg/(kg·d) SIMVA联合有效剂量的BBR治疗高脂血症疗效与12 mg/(kg·d) SIMVA相当-结论: 联合治疗比单用SIMVA或BBR更能有效降低LDL-C,增加BBR来治疗高脂血症患者可以减少他汀类药物用量的50%-BBR作为他汀降脂药的理想补充剂给高脂血症患者提供了一种新的治疗方式-

    Abstract:

    Objective:To study the therapeutic effects and security of combination of simvastatin with berberine on the patients with hyperlipemia. Methods:In clinical trial,a total of 99 patients with hyperlipidemia in our hospital were divided into 3 groups. Group A:SIMVA,Group B:BBR,Group C:combination of BBR with SIMVA. After 8 weeks of treatment,the Blood lipid,liver and kidney functions in the three groups were detected and compared. Rats fed the HFHC diet were randomly divided into 5 groups. They were the HFHC diet control group treated with saline (n=6),SIMVA at 6 mg/(kg·d)(n=9),BBR at 90 mg/(kg·d)(n=9),BBR (90 mg/[kg·d]) plus SIMVA(6 mg/[kg·d])(n=10),and SIMVA at 12 mg/(kg·d)(n=9),respectively for 30 days. Serum LDL-C,total cholesterol (TC),triglyceride (TG) and LDLR mRNA levels were assayed. Results:After 8 weeks of treatment,in the group of the patients with hyperlipemia,combination of BBR with SIMVA was more effective than the SIMVA or BBR monotherapy,markedly effective cases in the former group were 1-fold higher than that of SIMVA alone. The total effective rate of group C was 100%. Serum TC,TG were significantly different before and after simvastatin treatment(P < 0.01). Combination therapy reduced serum TC,TG and LDL-C,the levels of them were all significantly lower than these after simvastatin single-used in the hyperlipemia patients(P < 0.01). Comparing the three groups,in decreasing TC,TG,LDL-C,group C was more effective than group A (P < 0.01). Animal experiments piont out that the therapeutic effects of combination of half-simvastatin with berberine is correspond to entire amounts of simvastatin. We had not found any adverse effects in group C. Coadministration of berberine with simvastatin up-regulated LDLR mRNA to a level significantly higher than that of the monotherapies (P < 0.001). Conclusion:As compared with monotherapies,the combination shows an improved lipid-lowering effect with reduction of serum LDL cholesterol. Adding BBR to simvastatin could reduce the dose of simvastatin by at least 50%.The combination therapy display a new and effective regimen for hyperlipemia.

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郑贝贝,魏 敬,蒋建东,龚和禾,张瑞生.他汀类药物联合黄连素治疗高脂血症的疗效评估[J].南京医科大学学报(自然科学版),2009,29(11):1493-1497

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  • 收稿日期:2009-05-06
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