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Abstract：
Background and Objectives: Cardiovascular disease (CVD) is the leading cause of death globally and hypercholesterolemia is one of the major risk factors associated with CVD. Due to a growing body of research on side effects and long-term impacts of conventional CVD treatments, focus is shifting towards exploring alternative treatment approaches such as Ayurveda. However, because of a lack of strong scientific evidence, the safety and efficacy profiles of such interventions have not been well established. The current study aims to conduct a systematic review and meta-analyses to explore the strength of evidence on efficacy and safety of Ayurvedic herbs for hypercholesterolemia. Methods: Literature searches were conducted using databases including Medline, Cochrane Database, AMED, Embase, AYUSH research portal, and many others. All randomized controlled trials on individuals with hypercholesterolemia using Ayurvedic herbs (alone or in combination) with an exposure period of ≥ 3 weeks were included, with primary outcomes being total cholesterol levels, adverse events, and other cardiovascular events. The search strategy was determined with the help of the Cochrane Metabolic and Endocrine Disorders Group. Two researchers assessed the risk of each study individually and discrepancies were resolved by consensus or consultation with a third researcher. Meta-analysis was conducted using the inverse variance method and results are presented as forest plots and data summary tables using Revman v5.3. Results: A systematic review of 32 studies with 1386 participants found randomized controlled trials of three Ayurvedic herbs, Allium sativum (garlic), Commiphora mukul (guggulu), and Nigella sativa (black cumin) on hypercholesterolemia that met inclusion criteria. The average duration of intervention was 12 weeks. Meta-analysis of the trials showed that guggulu reduced total cholesterol and low-density lipoprotein levels by 16.78 mg/dL (95% C.I. 13.96 to 2.61; p-value = 0.02) and 18.78 mg/dL (95% C.I. 34.07 to 3.48; p = 0.02), respectively. Garlic reduced LDL-C by 10.37 mg/dL (95% C.I. -17.58 to -3.16; p-value = 0.005). Black cumin lowered total cholesterol by 9.28 mg/dL (95% C.I. -17.36, to -1.19, p-value = 0.02). Reported adverse side effects were minimal. Conclusion: There is moderate to high level of evidence from randomized controlled trials that the Ayurvedic herbs guggulu, garlic, and black cumin are moderately effective for reducing hypercholesterolemia. In addition, minimal evidence was found for any side effects associated with these herbs, positioning them as safe adjuvants to conventional treatments.
摘要：
背景和目的：心血管疾病（CVD）是全球死亡的主要原因，高胆固醇血症是与CVD相关的主要危险因素之一。由于对常规CVD治疗的副作用和长期影响的研究越来越多，重点是转向探索替代治疗方法，如阿育吠陀。然而,因为缺乏强有力的科学证据,此类干预措施的安全性和有效性尚未得到很好的证实.本研究旨在进行系统评价和荟萃分析，以探讨阿育吠陀草药治疗高胆固醇血症的有效性和安全性的证据强度。方法：使用包括Medline在内的数据库进行文献检索，Cochrane数据库,AMED,Embase,AYUSH研究门户网站，和许多其他人。包括所有使用阿育吠陀草药（单独或联合使用）暴露期≥3周的高胆固醇血症个体的随机对照试验。主要结果是总胆固醇水平，不良事件,和其他心血管事件。搜索策略是在Cochrane代谢和内分泌疾病组的帮助下确定的。两名研究人员分别评估了每项研究的风险，并通过与第三位研究人员达成共识或协商解决了差异。使用逆方差方法进行荟萃分析，并使用Revmanv5.3将结果显示为森林图和数据汇总表。结果：对32项研究进行了系统评价，1386名参与者发现了三种阿育吠陀草药的随机对照试验，大蒜（大蒜），Commiphoramukul（guggulu），和Nigellasativa（黑孜然）对符合纳入标准的高胆固醇血症。平均干预时间为12周。试验的荟萃分析表明，guggulu使总胆固醇和低密度脂蛋白水平降低了16.78mg/dL（95％C.I.13.96至2.61；p值=0.02）和18.78mg/dL（95％C.I.34.07至3.48；p=0.02），分别。大蒜使LDL-C降低10.37mg/dL（95％C.I.-17.58至-3.16；p值=0.005）。黑孜然可使总胆固醇降低9.28mg/dL（95％C.I.-17.36，至-1.19，p值=0.02）。报告的不良副作用很小。结论:随机对照试验有中等至高水平的证据表明，阿育吠陀草药guggulu，大蒜，大蒜黑孜然对降低高胆固醇血症有中等疗效。此外,发现与这些草药有关的任何副作用的证据很少，将它们定位为常规治疗的安全佐剂。
