紅麴加上益生菌對降血脂作用之評估

李建瑩 魏正宗 施宏哲
中山學大學附設醫院
隨著人口的老化，在台灣慢性疾病已成為老年人死亡的主要原因，而高血脂症是導致動脈粥狀硬化重要的因素。
人體的膽固醇，約三分之二由肝臟製造，而三分之一則來自食物。紅麴是由紅麴菌與米發酵而成，先前有研究指出紅麴菌的二次代謝產物monacolin (K, J, M, X and dihydromonacolin L) 是HMG-CoA reductase 的抑制劑，可以抑制膽固醇(cholesterol) 的合成，其中monacolin K (lovastatin) 已是廣泛被使用的臨床用藥。乳酸菌降膽固醇的可能機制有多種方式，而Lactobacillus casei在抗膽固醇血症的特性比Lactobacillus acidophilus佳。Lactobacillus casei在生長時可藉由產生bile acid hydrolase將膽酸去結合(deconjugate) 。
此研究在比較主成分為藥品級的紅麴「壽美降脂一號」＋Lactobacillus casei與「壽美降脂一號」＋安慰劑調節血脂之功效。本研究為為期12週之隨機雙盲控制試驗，評估降血脂功效及其安全性，經過4週的飲食控制，收集60位高血脂病人，經隨機分配到紅麴「壽美降脂一號」＋Lactobacillus casei與「壽美降脂一號」＋安慰劑組。病人於第0、4、8週回診，主要指標是用藥8週後血漿中低密度脂蛋白膽固醇(LDL-C)和基礎值比較的平均改變百分比。次要指標是血中總膽固醇值(total cholesterol)、三酸甘油脂(TG)用藥前後的平均改變百分比。
關鍵字：紅麴、益生菌、高血脂

The Cholesterol-Lowering Effect of Red Yeast Rice Plus Probiotic

Chien-Ying Lee, Cheng-Chung Wei, Hung-Che Shih
Chung Shan Medical University Hospital
As the population aging, chronic illness has become a major cause of death in elders in Taiwan. Hypercholesterolemia is an important factor that could lead to atherosclerosis. 
The production of Cholesterol, 2/3 was from liver, 1/3 was from food. Red yeast rice is the product of yeast(Monascus purpureus) grown on rice Red, It’s secondary metabolite monacolin (K, J, M, X and dihydromonacolin L) is HMG-CoA reductase inhibitor, can inhibit the synthesis of cholesterol, monacolin K was widely used in clinical.The Cholesterol-Lowering mechanism of Lactobacillus has many different waies, and the Cholesterol-Lowering Effect of Lactobacillus casei was greater than Lactobacillus acidophilus. When Lactobacillus casei growing, bile acid was deconjugate by bile acid hydrolase.
We want to compare the cholesterol-lowering effect of Red yeast rice plus probiotic and red yeast rice plus placebo. The 12-week efficacy and safety of the study was a part of the double-blinded, control study. After at least 4-week washout /diet control period, sixty patients with primary dyslipidemia were randomized at Week 0 to a 8-week active treatment then shifted to the second 4-week washout /diet control period. Lipid parameters and safety assessments were done at Week 0, 4 and 8. The primary endpoint was the mean percent change of LDL-cholesterol from baseline (Week 0)to the end of active treatment (Week 8).
關鍵字：Red yeast rice, Probiotic, Hyperlipidemia