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Hyperlipidemia;
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Traditional Chinese Medicine;
Diabetes mellitus;
Blood;
Reviews;
Herbal medicines;
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Herbs;
Drugs;
Side effects
Anticoagulants;
Lipids;
Hyperlipidemia;
Clinical trials;
Traditional Chinese Medicine;
Diabetes mellitus;
Blood;
Reviews;
Herbal medicines;
Cardiovascular diseases;
Herbs;
Drugs;
Side effects
Currently there are more than 50 TCM formulae in the form of patent
drugs that have been approved by China Food and Drug Administration used
for treating hyperlipidemia [16]. This implies that there is a great
demand on hyperlipidemic TCM products in the market.
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Chinese herbal
medicines
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Sources
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Possible bioactive
compounds
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Effects mentioned in TCMs [54,
94]
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Possible hypolipidemic
mechanisms
|
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Alismatis Rhizoma
(Zexie)
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Dried rhizome of Alisma
orientale (Sam.) Juzep.
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Alisol-triterpenes
[59]
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(i) Promoting urination to drain
dampness(ii) Discharging heat(iii) Resolving turbidity and lowering
lipid
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(i) Decreasing the liver synthesis
of cholesterol [57](ii) Lessening lipid peroxidation and activating
antioxidant enzymes [58]
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Coptidis
Rhizoma(Huanglian/Goldthread)
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Dried rhizome of Coptis
chinensis Franch. or C. deltoidea C. Y. Cheng et
Hsiao.
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Alkaloids [64], esp. berberine
[66, 67]
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(i) Clearing heat and drying
dampness(ii) Discharging fire and removing toxin
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(i) Reducing lipid peroxidation
[63, 64](ii) Upregulating PPARα (iii) Negative modulation of FXR to
upregulate the gene expression of CYP7A1 for cholesterol conversion into bile
acids [64](iv) Decreasing degradation of dietary polysaccharides [65](v)
Upregulation of LDLR in vitro and in vivo [66]
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Crataegi Fructus
(Shanzha/Hawthorn)
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Dried ripe fruit of Crataegus
pinnatifida Bge. and C. pinnatifida Bge. var. major
N. E. Br.
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Polyphenols [70] and triterpenic
acids for example oleanolic acid and ursolic acid [71]
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(i) Promoting digestion and
invigorating the stomach(ii) Resolving turgidity and lowering lipid(iii)
Moving Qi and dissipating blood stasis
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(i) Activating PPARα [69](ii)
Inhibiting intestinal ACAT activity in human colon carcinoma cell line Caco-2
[71]
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Ginseng Radix et Rhizoma
(Renshen/Asian ginseng)
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Dried root of Panax ginseng
C. A. Mey.
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(i) Saponins [78, 79](ii) Acidic
polysaccharides [81](iii) Phenolic extract [83]
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(i) Greatly tonifying the original
Qi (ii) Resuming pulse and securing collapse(iii) Replenishing "lung
" and "spleen "(iv) Engendering fluid and nourishing
blood(v) Calming the mental state and enhancing intelligence
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(i) Improving lipid peroxidation
in liver by reduction in serum MDA [76, 83, 87](ii) Activating LPL activity
[81](iii) Inhibiting pancreatic lipase [82](iv) Inhibiting food appetite via
modifying the serum content and mRNA expression of neuropeptide Y, Y2
receptor, and peptide YY [85]
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Notoginseng Radix et Rhizoma
(Sanqi)
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Rhizome and root of Panax
notoginseng (Burk.) F. H. Chen
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Sanqi saponins [95]
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(i) Dissipating stasis and
stanching bleeding(ii) Dispelling swelling and relieving pain
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(i) Reducing HMG-CoA reductase
(ii) Reducing lipid peroxidation by increase in the activity of antioxidant
hepatic SOD and glutathione peroxidase [95](iii) Inducing the biosynthesis of
bile acids from cholesterol and promoting the β -oxidation of FA in the liver
[96](iv) Acting as a dual FXR/LXR α agonist [124]
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Oryzae cum Monasco Semen (Red
yeast rice/Hongqu)
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Washed and cooked rice fermented
with Monascus purpureus Went
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Monacolins, esp. monacolin K [104,
110]
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(i) Strengthening "spleen
" to improve food digestion(ii) Promoting blood circulation to dissipate
blood stasis
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Containing a family of monacolins
that resemble HMG-CoA reductase inhibitors [104]
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Puerariae Lobatae Radix
(Gegen/Kudzu root)
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Dried root of Pueraria lobata
(Willd.) Ohwi
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Puerarin [113]
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(i) Resolving the flesh and
reducing fever(ii) Engendering fluid to quench thirst(iii) Promoting
eruption(iv) Uprasing the middle Qi to relieve diarrhea(v) Unblocking
meridian and activating collaterals(vi) Removing wine toxin
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(i) Promoting cholesterol and bile
acids excretion in liver [113](ii) Estrogen-like effect on lipid metabolism
in liver and adipose tissues [116](iii) Hepatoprotective effect in
OVX-induced hepatic steatosis [114]
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Rhei Radix et Rhizoma
(Dahuang)
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Root and rhizome of Rheum
palmatum L., R . tanguticum Maxim or R . officinale
Baill.
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Rhein [123-125]
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(i) Relaxing the bowels(ii)
Cooling the blood and removing toxin(iii) Expelling stasis to unblock the
meridian
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(i) Inhibitory effect on HMG-CoA
reductase [123](ii) Having LXR antagonism and regulation of uncoupling
protein-1 expression in brown adipose tissues [125]
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Salviae Miltiorrhizae Radix
(Danshen)
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Dried root of Salvia
miltiorrhiza Bunge.
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(i) Danshensu(ii) Rosmarinic
acid(iii) Salvianolic acid A and B [133]
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(i) Promoting blood circulation
and dispelling stasis(ii) Nourishing the blood and calming mental state(iii)
Regulating menstruation and suppressing pains(iv) Cooling blood and
eliminating carbuncle
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(i) Containing antioxidant (esp.
salvianolic acid B) for prevention of endothelial damage and inhibition of
LDL oxidation [133](ii) Acting as a FXR/LXR α coagonist [134]
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Table 3: A summary of
antihyperlipidemic effects of different TCM formulae.
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TCM formulae
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Herbs (weight ratio in dose if
applicable)
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Effects mentioned in
TCMs
|
Effects on blood lipid
profile
|
Possible hypolipidemic
mechanisms
|
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Danggui-Buxue
decoction
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Astragali Radix and Angelicae
Sinensis Radix (1 : 5) [153]
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(i) Raising the Qi (ii) Nourishing
the blood [17]
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(i) Lowering serum TC and LDL-C
levels(ii) Increasing HDL-C level(iii) No significant difference in TG level
as compared with diabetic atherosclerosis model group [49, 154]
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Downregulating the mRNA expression
of MCP-1, ICAM-1, and CD36 [49, 154]
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Danshen-Gegen formula
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Salviae Miltiorrhizae Radix and
Puerariae Lobatae Radix (7 : 3) [53]
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(i) Promoting blood circulation
(ii) Removing blood stasis [200]
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(i) A significant dose-dependent
decrease in free and esterified TC in the human monocyte derived macrophages in
vitro [147](ii) Lowering TC and LDL-C levels mildly in patients suffering
from coronary artery disease compared with placebo [56](iii) Lowering TC and
LDL levels in postmenopausal women with hypercholesterolemia [52]
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Dose-related suppression of
acetylated LDL uptake by human macrophages [53]
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Erxian decoction
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Curculiginis Rhizoma, Epimedii
Folium, Angelicae Sinensis Radix, Morindae Officinalis Radix, Anemarrhenae
Rhizoma, and Phellodendri Chinensis Cortex (no fixed ratio) [60]
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(i) Warming "kidney
" Yang (ii) Nourishing "kidney " Yin (iii)
Clearing ministerial fire (iv) Harmonizing thoroughfare and conception
vessels(v) Balancing Yin-Yang [60]
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(i) Suppressing serum TC and LDL-C
levels(ii) No significant effect on HDL-C and TG levels in a menopausal rat
model [54]
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(i) Downregulating HMG-CoA(ii)
Upregulating the LDL receptor [54]
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Ling-Gui-Zhu-Gan
decoction
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Poria, Cinnamomi Ramulus,
Atractylodis Macrocephalae Rhizoma, and Glycyrrhizae Radix (4 : 3 : 3 : 2)
[63]
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(i) Warming Yang for
resolving fluid retention(ii) Strengthening the "spleen" to
resolve dampness [63]
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(i) Reducing TG and TC levels in
HFD induced rat models of NAFLD [57](ii) Lowering ghrelin level in HFD rat
groups fasting intermittently supplemented with LGZD [63]
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(i) Increasing serum thyroid
hormone levels [57](ii) Improving β -oxidation via modulation of TRβ 1 and
CPT1A expression in liver [57](iii) Enhancing metabolism and transport of FA
through modulation of SREBP-1c, ACSL and ApoB100 expression [57]
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Shengmai Yin
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Ginseng Radix et Rhizoma,
Ophiopogonis Radix, and Schisandra Chinensis Fructus (2 : 1 : 2)
[58]
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(i) Replenishing both Qi and Yin
energies(ii) Generating body fluids(iii) Restoring the pulses
[17]
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(i) No significant effect on
lipids of Wistar rats fed with HCD(ii) Lowering hepatic cholesterol and TG
contents (iii) No effect on fecal cholesterol excretion but higher fecal bile
acid content [59]
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(i) Stimulating the biosynthesis
of bile acid using cholesterol as the precursor (ii) Increasing hepatic cholesterol
catabolism [59]
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Turtle jelly
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Testudinis Plastrum, plus various
Chinese medicinal herbs such as Smilacis Glabrae Rhizoma, Millettiae
Speciosae Radix, Mesonae Chinensis Herba, and Lonicerae Japonicae Flos
[173]
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(i) Clearing heat(ii) Removing
toxin(iii) Promoting urination [51]
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(i) Lowering serum TC and LDL
levels(ii) Increasing HDL level diet-induced hypercholesterolemic SD rats
[50]
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(i) Blocking the downregulation of
LDLR and PEPCK mRNA and protein expressions (ii) Suppressing the upregulation
of PPARα mRNA and protein expressions in the liver [173]
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Xuefu-Zhuyu decoction
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Bupleuri Chinensis Radix,
Angelicae Sinensis Radix, Rehmanniae Radix, Paeoniae Rubra Radix, Carthami
Flos, Persicae Semen, Aurantii Fructus Immaturus, Glycyrrhizae Radix,
Platycodi Radix, Chuanxiong Rhizoma, and Achyranthis Bidentatae Radix
[61]
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(i) Promoting blood circulation to
remove blood stasis (ii) Moving Qi to relieve pain [17]
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(i) Lowering serum TC and LDL-C
levels (ii) Increasing HDL-C level(iii) No significant difference in TG level
in HFD fed SD rats as compared with the model group [62](iv) Lowering TG
level and TC/HDL-C ratio in HCD fed Wistar rats [182]
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(i) Reversing energy and lipid
metabolism disturbance(ii) Decreasing the accumulation acetyl-glycoproteins
(iii) Enhancing glutathione biosynthesis [62](iv) Inhibiting proinflammatory
interleukin 8 production [182]
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