Chan E K, Schroeder D J
School of Pharmacy, University of California, San Francisco 94143, USA.
Ann Pharmacother. 1995 Jun;29(6):625-7. doi: 10.1177/106002809502900613.
In summary, within a controlled study situation, psyllium seems to be effective in lowering total and LDL cholesterol by 4-8% and 6-13%, respectively. Compared with conventional antilipidemic agents such as lovastatin, which lowers total cholesterol 30%, LDL cholesterol 40%, and triglycerides 20%, the effect of psyllium on lipids is minimal, and its use as a form of drug therapy in patients with moderate-to-severe hypercholesterolemia is not recommended. As an adjunct to AHA step 1 diet therapy, however, psyllium can be useful. The NCEP recently has stressed diet therapy as a first-line primary intervention in patients not a high risk from multiple risk factors or very high LDL cholesterol concentrations. Men ( < or = 45 y) and premenopausal women with no other risk factors and moderately high LDL cholesterol concentrations (4.1-5.7 mmol/l) are at relatively low risk for coronary events in the near future, and would therefore be suitable for diet therapy combined with adjunctive psyllium therapy. Psyllium is well tolerated with minor transient adverse effects (abdominal distention, excessive gas, flatulence) and has a good compliance record ( > or = 90%). It would be a useful adjunct to dietary intervention in low-risk patients with mild-to-moderate hypercholesterolemia. Further research is needed to evaluate psyllium's effect in women and its efficacy in long-term use.
总之，在对照研究的情况下，车前草似乎能分别有效降低总胆固醇和低密度脂蛋白胆固醇4 - 8%和6 - 13%。与传统的降血脂药物如洛伐他汀相比，洛伐他汀可降低总胆固醇30%、低密度脂蛋白胆固醇40%和甘油三酯20%，车前草对血脂的影响很小，不建议将其作为中重度高胆固醇血症患者的药物治疗形式。然而，作为美国心脏协会第一步饮食疗法的辅助手段，车前草可能会有用。美国国家胆固醇教育计划（NCEP）最近强调饮食疗法是对无多种危险因素或低密度脂蛋白胆固醇浓度极高的低风险患者的一线主要干预措施。年龄小于或等于45岁且无其他危险因素且低密度脂蛋白胆固醇浓度中度升高（4.1 - 5.7 mmol/l）的男性和绝经前女性在近期发生冠状动脉事件的风险相对较低，因此适合饮食疗法联合辅助性车前草疗法。车前草耐受性良好，仅有轻微的短暂不良反应（腹胀、过多气体、肠胃胀气），且依从性良好记录（大于或等于90%）。对于轻度至中度高胆固醇血症的低风险患者，它将是饮食干预的有用辅助手段。需要进一步研究来评估车前草对女性的影响及其长期使用的疗效。
