A Review on the Traditional Chinese Medicinal Herbs and Formulae with Hypolipidemic Effect

Table 2

A summary of antihyperlipidemic effects of representative Chinese herbal medicines.

Chinese herbal medicines	Sources	Possible bioactive compounds	Effects mentioned in TCMs [54, 94]	Possible hypolipidemic mechanisms
Alismatis Rhizoma; (Zexie)	Dried rhizome of Alisma orientale (Sam.) Juzep.	Alisol-triterpenes [59]	(i) Promoting urination to drain dampness; (ii) Discharging heat; (iii) Resolving turbidity and lowering lipid	(i) Decreasing the liver synthesis of cholesterol [57]; (ii) Lessening lipid peroxidation and activating antioxidant enzymes [58]
Coptidis Rhizoma; (Huanglian/Goldthread)	Dried rhizome of Coptis chinensis Franch. or C. deltoidea C. Y. Cheng et Hsiao.	Alkaloids [64], esp. berberine [66, 67]	(i) Clearing heat and drying dampness; (ii) Discharging fire and removing toxin	(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]
Crataegi Fructus (Shanzha/Hawthorn)	Dried ripe fruit of Crataegus pinnatifida Bge. and C. pinnatifida Bge. var. major N. E. Br.	Polyphenols [70] and triterpenic acids for example oleanolic acid and ursolic acid [71]	(i) Promoting digestion and invigorating the stomach; (ii) Resolving turgidity and lowering lipid; (iii) Moving 𝑄𝑖 and dissipating blood stasis	(i) Activating PPAR𝛼 [69]; (ii) Inhibiting intestinal ACAT activity in human colon carcinoma cell line Caco-2 [71]
Ginseng Radix et Rhizoma (Renshen/Asian ginseng)	Dried root of Panax ginseng C. A. Mey.	(i) Saponins [78, 79]; (ii) Acidic polysaccharides [81]; (iii) Phenolic extract [83]	(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	(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]
Notoginseng Radix et Rhizoma (Sanqi)	Rhizome and root of Panax notoginseng (Burk.) F. H. Chen	Sanqi saponins [95]	(i) Dissipating stasis and stanching bleeding; (ii) Dispelling swelling and relieving pain	(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]
Oryzae cum Monasco Semen (Red yeast rice/Hongqu)	Washed and cooked rice fermented with Monascus purpureus Went	Monacolins, esp. monacolin K [104, 110]	(i) Strengthening “spleen” to improve food digestion; (ii) Promoting blood circulation to dissipate blood stasis	Containing a family of monacolins that resemble HMG-CoA reductase inhibitors [104]
Puerariae Lobatae Radix (Gegen/Kudzu root)	Dried root of Pueraria  lobata (Willd.) Ohwi	Puerarin [113]	(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	(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]
Rhei Radix et Rhizoma (Dahuang)	Root and rhizome of Rheum palmatum L., R. tanguticum Maxim or R. officinale Baill.	Rhein [123–125]	(i) Relaxing the bowels; (ii) Cooling the blood and removing toxin; (iii) Expelling stasis to unblock the meridian	(i) Inhibitory effect on HMG-CoA reductase [123]; (ii) Having LXR antagonism and regulation of uncoupling protein-1 expression in brown adipose tissues [125]
Salviae Miltiorrhizae Radix (Danshen)	Dried root of Salvia  miltiorrhiza Bunge.	(i) Danshensu; (ii) Rosmarinic acid; (iii) Salvianolic acid A and B [133]	(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	(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]