Salviae miltiorrhizae and ligustrazine hydrochloride injection combined with mecobalamin for treating diabetic peripheral neuropathy: A protocol for systematic review and meta-analysis

Safety and effectiveness of Salvia miltiorrhiza and ligustrazine injection for acute cerebral infarction in Chinese population: a PRISMA-compliant meta-analysis

Background

Salvia miltiorrhiza and ligustrazine injection (SML) is a type of traditional Chinese medicine injection, which has been considered a promising adjunctive therapy treatment for acute cerebral infarction (ACI). Although there have been positive reports on the treatment of SML, there is still controversy over its exact efficacy and safety in ACI patients. In this study, a systematic review was conducted on randomized controlled trials (RCTs) of SML for the treatment of ACI to evaluate its clinical efficacy and safety.

Method

From the establishment of the database until May 2023, all randomized controlled trials related to SML and ACI were collected from the Cochrane Library, Web of Science, Embase, Medline, PubMed, CSJD, Wanfang database, CBM and CNKI. This systematic review and meta-analysis were strictly conducted in accordance with the PRISMA statement. The reported outcomes including overall response (ORR), National Institutes of Health Stroke Scale (NIHSS), hemorrheology indexes, activity of daily living (ADL) and adverse events were in detail investigated.

Results

An analysis was conducted on the relevant data of 3869 ACI patients from 38 trials. The results indicated that the combination of conventional treatment and SML can significantly improve the ORR of patients (RR = 1.23, 95% CI = 1.20-1.27, P < 0.00001), neurological status (NIHSS, MD = -4.35, 95% CI = -5.15-3.54, P < 0.00001) and ADL (Barthel Index score, MD = 10.27, 95% CI = 7.75-12.79, P < 0.00001) compared with regular treatment alone. After the combined therapy, the hemorheology of ACI patients also significantly improved (P < 0.05). There is no significant difference in the frequency of adverse events between the two groups (RR = 1.49, 95% CI = 0.91-2.46, P = 0.11).

Conclusion

The evidence from the meta-analysis suggested that the combination of conventional therapy and SML is safer and more effective than conventional therapy alone in treating ACI. However, due to the limitations of this analysis, such as regional bias and publication bias, the above conclusions need to be further verified by prospective, high-quality and multicenter clinical trials.

Physicochemical and Antioxidative Properties of Protein Hydrolysates from Residual Goat Placenta Extract by Two Different Methods

Protein hydrolysates from the goat placenta provide multiple benefits, such as immune system enhancement, antioxidant activities, and reductions in uric acid levels. Despite these benefits, their industrial applications have been underexplored. This study aimed to prepare extract protein hydrolysates (GPERPs) from residual goat placenta extract (GPER) and assess their functional properties, focusing on how different drying methods influence these properties. The essential amino acid contents were 30.94% for the GPER and 34.11% for the GPERPs. Moreover, all the essential amino acids were present, and the amino acid score (AAS) for each exceeded 1.0 in the GPERPs. The foaming properties of the spray-dried GPERPs (95.56 ± 5.89%) were significantly greater than those of the freeze-dried GPERPs (49.13 ± 4.17%) at pH values of 4.0~10.0. The emulsion stability (ES) of the spray-dried GPERPs (453.44 ± 8.13 min) was notably greater than that of the freeze-dried GPERPs (245.58 ± 7.12 min). Furthermore, the water retention capacity (WRC) of the freeze-dried GPERPs (201.49 ± 6.12%) was significantly greater than that of the spray-dried GPERPs (103.35 ± 7.13%), except at pH 10.0 (101.44 ± 8.13%). Similarly, at pH values of 6.0, 8.0, and 10.0, the oil retention capacity (ORC) of the freeze-dried GPERPs (715.58 ± 12.15%) was significantly greater than that of the spray-dried GPERPs (560.56 ± 11.15%), although the opposite trend was noted under acidic conditions. In terms of the antioxidant activity, the ability of the goat placenta extract residual protein hydrolysates (GPERPs) to scavenge DPPH radicals and superoxide anion radicals increased with the increasing peptide powder concentration, and the maximum scavenging rates of the DPPH radicals (39.5 ± 0.56%) and superoxide anions (81.2 ± 0.54%) in the freeze-dried peptide powder were greater than those in the spray-dried peptide powder. These findings contribute to the understanding of the physicochemical and antioxidant properties of GPERPs under various drying methods and provide fundamental data for the development of functional foods based on GPERPs.

The efficacy and safety of mecobalamin combined with Chinese medicine injections in the treatment of diabetic peripheral neuropathy: A systematic review and Bayesian network meta-analysis of randomized controlled trials

Background: In recent years, people pay more and more attention to diabetic peripheral neuropathy (DPN). As a neurotrophic agent, mecobalamin is able to repaire nerves, which has already become a consensus among experts. However, it has been found that mecobalamin has poor effect to increase nerve conduction velocity, which is an important indicator. Clinical data have shown that Chinese medicine injection, combined with mecobalamin injection, can significantly improve nerve conduction velocity of the limbs. Nevertheless, several kinds of Chinese medicine injections have been used to treat DPN. The effect of these Chinese medicine injections for DPN are various. Therefore, it is necessary to evaluate the effectiveness of Chinese medicine injections combined with mecobalamin in the treatment of DPN.

Methods: All relevant articles published before 12 March 2022 were searched in eight electronic databases. Randomized controlled trials (RCTs) on Chinese medicine injections plus Mecobalamin for DPN were identified according to inclusion criteria, and were assessed using the revised Cochrane risk of bias tool (ROB2.0). R software and stata15 was used to create the ranking probabilities and network meta-analysis.

Results: A total of 80 RCTs involving 6,980 patients were included. The results showed that mecobalamin plus Dengzhanxixin injection (ME + DZXX) ranked first in overall response rate [RR = 1.64, 95% CI (1.26, 2.21)] and median motor nerve conduction velocity [MD = 9.46, 95% CI (5.67, 13.28)]. Then, mecobalamin plus Kudiezi Injection (ME + KDZ) had the best effect in median sensory nerve conduction velocity [MD = 10.41, 95% CI (−13.31, −7.52)], and mecobalamin plus Honghua injection (ME + HH) ranked highest in common peroneal motor nerve conduction velocity [MD = 6.8, 95% CI (4.13, 9.49)] and common peroneal sensory nerve conduction velocity [MD = −6.25, 95% CI (−8.85, −3.65)].

Conclusion: This study determined the efficacy of different Chinese medicine injections combined with mecobalamin. DZXX may be the best adjunctive Chinese medicine injection for DPN patients. However, due to potential risk of bias and limited RCTs, our results need to be treated with reservations.

Effects of Infrared Combined with Methylcobalamin on the Vibratory Sensory Threshold and Nerve Conduction Velocity of the Lower Extremity in Patients with Diabetic Foot Treatment

Objective

To investigate the effect of infrared combined with methylcobalamin on the vibratory sensory threshold and lower limb nerve conduction velocity of patients with diabetic foot.

Methods

One hundred and six patients with diabetic foot in our hospital from February 2018 to December 2020 were enrolled and divided into the study and control groups. The patients in the control group were given methylcobalamin, and the patients in the research group were treated with infrared light on the basis of the control group. The therapeutic effect, vibration sensory threshold, lower limb nerve conduction velocity, and related biochemical index levels before and after treatment in the two groups were counted.

Result

The total effective rate of the study group (94.34%) was significantly higher than that of the control group (81.13%). The left/right lower limb vibration sensation threshold decreased in both groups after treatment, and the study group was lower than that of the control group (P < 0.05). The conduction velocity of the left/right common peroneal nerve and tibial nerve increased in both groups after treatment, and the study group was larger than that of the control group (P < 0.05). The bFGF, VEGF, and APN increased in both groups after treatment. VEGF and APN increased and IL-6 and TNF-α decreased in both groups after treatment, and the study group was better than the control group (P < 0.05).

Conclusion

Infrared and methylcobalamin combined treatment of diabetic foot can effectively improve lower extremity nerve conduction velocity and vibration sensory threshold, regulate serum bFGF and VEGF levels, reduce the degree of inflammatory response, and help improve the overall treatment effect.