包丹丹 宋宗良 赵峰 覃歌 闵星 程雅靖

摘要 目的：分析基于贝叶斯模型框架下市面上几种降脂中成药联合他类药物治疗高脂血症的疗效。方法：检索PubMed、中国知网、维普中文期刊服务平台、万方数据库、中国生物医学文献数据，同时手工检索相关灰色文献、会议资料，时间从各数据库建库起至2019年3月，收集他汀类联合降脂中成药的随机对照研究，使用NoteExpress进行文献管理、gemtc对数据进行统计分析。结果：共纳入20项随机对照试验，共涉及5种常用降脂中成药。脂康颗粒、丹田降脂丸、降脂灵片联合他汀类降脂药能显著降低总胆固醇（TC）水平，差异有统计学意义（P<0.05）;脂康颗粒、丹田降脂丸、荷丹片联合他汀类降脂药均能显著降低三酰甘油（TG）水平，差异有统计学意义（P<0.05），且丹田降脂丸显著高于血脂康胶囊，差异有统计学意义（P<0.05）;降脂灵片、丹田降脂丸、荷丹片联合他汀类降脂药均能显著增加高密度脂蛋白胆固醇（HDL-C）水平，差异有统计学意义（P<0.05）;脂康颗粒、荷丹片、降脂灵片、血脂康胶囊联合他汀类降脂药均能显著降低低密度脂蛋白胆固醇（LDL-C），差异有统计学意义（P<0.05）。结论：丹田降脂丸降低TC、TG以及提高HDL-C疗效最显著;脂康颗粒降低LDL-C疗效最佳的概率最大。

关键词 降脂中成药;脂康颗粒;丹田降脂丸;降脂灵片;血脂康胶囊;荷丹片;高脂血症;Meta分析

Abstract Objective：Based on the Bayesian model framework，to analyze the network Meta-analysis of several kinds of lipid-lowering traditional Chinese patent medicine combined with other drugs in the treatment of hyperlipidemia.Methods：Major databases were searched by computer，and relevant gray literature and conference materials were manually searched，from the establishment of the database to March 2019.Randomized controlled studies of statins and lipid-lowering Chinese patent medicines，were collected.NoteExpress was used for literature management and statistical analysis of the data was made by gemtc.Results：A total of 20 randomized controlled trials were included，involving 5 commonly used Chinese patent medicines for reducing lipid.The results of network Meta-analysis showed that Zhikang Granules，Dantian Jiangzhi Pills，Jiangzhiling Tablets combined with statins could significantly reduce TC level （P<0.05）; Zhikang Granules，Dantian Jiangzhi Pills，Hedan Tablets combined with statins could significantly reduce TG level （P<0.05），while Dantian Jiangzhil Pills is significantly higher than Xuezhikang Capsules （P<0.05）.Jiangzhiling Pills，Dantian Jiangzhi Pills，Hedan Tablets combined with statins could significantly lower HDL-C level （P<0.05）.Zhikang Granules，Hedan Tablets，Jiangzhiling Tablets，Xuezhikang Capsules combined with statins could significantly reduce LDL-C significantly （P<0.05）.Conclusion：In terms of reducing TC，TG and increasing HDL-C，Dantian Jiangzhi Pills have the most significant therapeutic effects，while Zhikang Granules have the most significant therapeutic effects in reducing LDL-C.

Keywords Lipid-lowering Chinese patent medicine; Zhikang Granules; Dantian Jiangzhi Pills; Jiangzhiling Tablets; Xuezhikang Capsules; Hedan Tablets; Hyperlipidemia; Network Meta-analysis

中圖分类号：R289.5文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.13.018

高脂血症（Hyperlipidemia，HLP）是由于人体脂代谢异常引起血清脂质和脂蛋白水平升高，表现为血清中胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）水平的升高，或者高密度脂蛋白胆固醇（HDL-C）水平的下降，是心脑等重要靶器官动脉粥样硬化极为重要的危险因素。多见于老年人，但随着近些年我国人民生活水平的提高、饮食结构的变化以及高强度的工作节奏，高脂血症的发病率已呈现逐渐年轻化。据统计，我国血脂异常患病率为20%左右，人数已高达1.6亿。其中，低高密度脂蛋白血症患病率为44.8%;高三酰甘油血症为11.3%;高胆固醇血症为3.3%;高低密度脂蛋白血症为2.1%[1]。截至2012年农村（40.8%）已超过城市（39.9%）、不论男女均呈现随年龄增加而升高等特点[2]。……