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Feng H, Wu T, Chin J, Ding R, Long C, Wang G, Yan D, Ma X, Yue R. Tangzu granule alleviate neuroinflammation in diabetic peripheral neuropathy by suppressing pyroptosis through P2X7R /NLRP3 signaling pathway. JOURNAL OF ETHNOPHARMACOLOGY 2024; 337:118792. [PMID: 39251151 DOI: 10.1016/j.jep.2024.118792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 09/01/2024] [Accepted: 09/04/2024] [Indexed: 09/11/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus, mainly manifested as paresthesia. Tangzu granule (TZG) is derived from famous traditional Chinese medicine decoctions and optimized by long-term temporary practice. TZG has good efficacy in improving numbness, pain and pruritus of the lower extremities of DPN patients. However, the overall regulatory mechanisms underlying its effects on DPN remain unclear. AIM OF THE STUDY This study aims to explore the potential mechanism of TZG for treating DPN. MATERIALS AND METHODS Sprague-Dawley (SD) rats were used to establish an in vivo model of DPN with streptozotocin (STZ) injection and high-fat diet (HFD) feeding. Additionally, sciatic glial RSC96 cells were induced with high glucose in vitro. SD rats in intervention group received TZG treatment for 12 weeks. After 12 weeks of treatment, sciatic nerve function was evaluated by intelligent hot plate meter and neuro electrophysiology detector. The morphological changes of sciatic nerve cells were observed by hematoxylin-eosin staining and transmission electron microscope. IL-1β, IL-18 inflammatory cytokines, pyroptosis and P2X7R/NLRP3 signaling pathway were observed by Western blotting, immunofluorescence staining and ELISA. RESULTS TZG improved nerve conduction velocity and sciatic neuropathy rational structural changes in DPN rats. It also inhibited RSC96 inflammatory response and cell death that induced by high glucose. This may be related to TZG inhibiting P2X7R, decreasing the activation of NLRP3 inflammasomes, down-regulating the levels of pyroptosis proteins such as caspase-1, cleaved caspase-1, gasdermin D (GSDMD), and GSDMD-N, and inhibiting the release of interleuki (IL)-18 and IL-1β inflammatory cytokines. CONCLUSIONS TZG inhibited pyroptosis through P2X7R/NLRP3 signaling pathway, alleviated neuroinflammation, and showed protective effect in the treatment of DPN.
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Affiliation(s)
- Haoyue Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Tingchao Wu
- Chengdu Second People׳s Hospital, Chengdu, Sichuan, China.
| | - Jiawei Chin
- School of Integrative Medicine, Mae Fah Luang University, Chiangrai, Thailand.
| | - Rui Ding
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Caiyi Long
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Gang Wang
- Zigong First People's Hospital, Zigong, Sichuan, China.
| | - Dawei Yan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Xitao Ma
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Rensong Yue
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
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Tian L, Yang M, Tu S, Chang K, Jiang H, Jiang Y, Ding L, Weng Z, Wang Y, Tan X, Zong C, Chen B, Dou X, Wang X, Qi X. Xiaoke Bitong capsule alleviates inflammatory impairment via inhibition of the TNF signaling pathway to against diabetic peripheral neuropathy. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 132:155867. [PMID: 39047415 DOI: 10.1016/j.phymed.2024.155867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 07/05/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Xiaoke Bitong capsule (XBC) is a crude herbal compound believed to tonify qi, improve blood circulation, and alleviate blood stasis. It has been used as an herbal formula for the prevention and treatment of diabetic peripheral neuropathy (DPN) under the guidance of traditional Chinese medicine (TCM). However, the pharmacological mechanisms by which XBC ameliorates DPN remain poorly understood. The interaction between pro-inflammatory factors and the activation of tumor necrosis factor (TNF) plays a critical role in the underlying mechanisms of DPN. XBC may protect against DPN through the regulation of the TNF pathway. PURPOSE Many studies show the association between DPN and nerve dysfunction, however, treatment options are limited. To identify specific therapeutic targets and active components of XBC that contribute to its anti-DPN effects, our study aimed to investigate the potential mechanism of action of XBC during the progression of DPN using a system pharmacology approach. METHODS An approach involving UPLC-Q-TOF/MS and network pharmacology was used to analyze the compositions, potential targets, and active pathways of XBC. Further, models of streptozocin (STZ) induced mouse and glucose induced RSC96 cells were established to explore the therapeutic effects of XBC. High glucose induced RSC96 cells were pretreated with small interfering RNA (siRNA) to identify potential therapeutic targets of DPN. RESULTS Seventy-one active compositions of XBC and five potential targets, including mitogen-activated protein kinase 8 (MAPK), interleukin-6 (IL-6), poly-ADP-ribose polymerase-1 (PARP1), vascular endothelial growth factor A (VEGFA), and transcription factor p65 (NF-κB), were considered as the potential regulators of DPN. In addition, the results revealed that the TNF signaling pathway was closely related to DPN. Moreover, DPN contributed to the decreased expressions of PI3K and AKT, increased TNF-α and IL-1β in RSC96 cells, which were both reversed by XBC or TNF-α siRNA. CONCLUSION XBC could protect against DPN by inhibiting the release of pro-inflammatory cytokines and regulating the activation of the TNF signaling pathway, further accelerating neurogenesis, and alleviating peripheral nerve lesions. Therefore, this study highlights the therapeutic value of XBC for DPN.
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Affiliation(s)
- Lulu Tian
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR China
| | - Meiqi Yang
- Liaoning University of Traditional Chinese Medicine Xinglin College, Shenyang, Liaoning, PR China
| | - Shanjie Tu
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR China
| | - Kaixin Chang
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR China
| | - Huanyu Jiang
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR China
| | - Yuwei Jiang
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR China
| | - Lu Ding
- College of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin, PR China
| | - Zhiwei Weng
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR China
| | - Yueqiang Wang
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR China
| | - Xiaolong Tan
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR China
| | - Chunxiao Zong
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR China
| | - Buyang Chen
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR China
| | - Xiaobing Dou
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, PR China.
| | - Xiuge Wang
- College of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin, PR China.
| | - Xuchen Qi
- Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China; Department of Neurosurgery, Shaoxing People's Hospital, Shaoxing, Zhejiang, PR China.
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Cheng J, Dong Y, Wu J, Shao C, Tang YC, Dong ZQ. RNA-seq revealed the protective effect of Huangqi Guizhi Wuwu Decoction against cisplatin induced PC12 cell injury. Int J Neurosci 2024:1-11. [PMID: 39155776 DOI: 10.1080/00207454.2024.2392123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/05/2024] [Accepted: 08/09/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy not only affects the tolerability of chemotherapy, but also causes intolerable and prolonged neuropathic pain in cancer patients. Currently, duloxetine is the only drug used to treat chemotherapy-induced peripheral neuropathy. However, the clinical use of this drug still faces several challenges. Therefore, we focused on traditional Chinese medicine to find an effective and safe alternative medicine. Huangqi Guizhi Wuwu Decoction is a traditional Chinese medicine that has been clinically used for treating nerve pain for thousands of years. This study aimed to investigate the neuroprotective effect of Huangqi Guizhi Wuwu Decoction on cisplatin-induced nerve injury in PC12 cells and to elucidate its potential mechanism of action. METHODS Huangqi Guizhi Wuwu Decoction-containing serum and blank serum were prepared from a rat model. The protective effects of Huangqi Guizhi Wuwu Decoction on cisplatin (10 µmol/L)-induced PC12 cell injury were assessed by a Cell Counting Kit-8 assay. RNA expression in Huangqi Guizhi Wuwu Decoction-protected PC12 cells was analyzed using RNA-seq, and subsequently, differentially expressed genes were further analyzed using Gene Ontology and Gene Set Enrichment Analysis. RESULTS The Cell Counting Kit-8 results showed that pretreatment of PC12 cells with Huangqi Guizhi Wuwu Decoction-containing serum (5%, 10%, 15%) significantly increased cells' viability to 10 µmol/L cisplatin-induced cell death. RNA-seq analysis revealed 843 differentially expressed genes in the chemotherapy-induced peripheral neuropathy group and 249 in the Huangqi Guizhi Wuwu Decoction group. The gene set enrichment analysis results in this study suggest that Huangqi Guizhi Wuwu Decoction may treat chemotherapy-induced peripheral neuropathy by enhancing axon guidance. CONCLUSIONS This study provides valuable evidence for using Huangqi Guizhi Wuwu Decoction in treating chemotherapy-induced peripheral neuropathy, partially achieved by improving axon guidance pathways.
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Affiliation(s)
- Jie Cheng
- Department of Clinical Pharmacy Laboratory, The First Affiliated Hospital of Baotou Medical College, Baotou, China
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai, PR China
| | - Yuan Dong
- Department of Clinical Pharmacy Laboratory, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Jing Wu
- Department of Clinical Pharmacy Laboratory, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Chen Shao
- Department of Clinical Pharmacy Laboratory, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Yu-Chen Tang
- Department of Clinical Pharmacy Laboratory, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Zhi-Qiang Dong
- Department of Clinical Pharmacy Laboratory, The First Affiliated Hospital of Baotou Medical College, Baotou, China
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Yang XR, Zhang XY, Xia YJ, Fu J, Lian XX, Liang XR, He YQ, Li ZH. Study on the Efficacy and Safety of the Huangqi Guizhi Wuwu Decoction in the Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy: Meta-Analysis of 32 Randomized Controlled Trials. J Pain Res 2024; 17:2605-2628. [PMID: 39139997 PMCID: PMC11319928 DOI: 10.2147/jpr.s466658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/30/2024] [Indexed: 08/15/2024] Open
Abstract
Purpose Chemotherapy-induced peripheral neuropathy (CIPN) still lacks efficient therapeutic drugs. This study aimed to systematically evaluate the effects of Huangqi Guizhi Wuwu Decoction (HGWD) alone or combined with positive drugs on CIPN prevention and treatment. Methods The PubMed, Embase, Web of Science, Cochrane, China National Knowledge Infrastructure (CNKI), Wan Fang Data, China Science and Technology Journal (VIP) and Chinese Biomedical (CBM) databases were searched for randomized controlled trials (RCTs) of HGWD for CIPN prevention and treatment. The search time ranged from database establishment to October 17, 2023. The Cochrane risk-of-bias assessment tool was used for quality assessment, Review Manager 5.3 and STATA 12.0 were used for meta-analysis, and GRADEprofiler was used for evidence level assessment. Results A total of 32 RCTs involving 1987 patients were included. The meta-analysis results revealed the following: 1. In terms of the total CIPN incidence, that in the HGWD group was lower than that in the blank control group. The incidence in both the HGWD and HGWD+positive drug groups was lower than that in the monotherapy-positive drug group. 2. In terms of the incidence of severe CIPN, that in the HGWD group was lower than that in the blank control and positive drug groups. There was no statistically significant difference between the HGWD+positive drug and positive drug groups. Sensitivity analysis revealed that the results of severe incidence in the HGWD group was lower than that in the positive drug group were unstable 3. HGWD did not increase the number of chemotherapy-related adverse events. Conclusion HGWD can safely and effectively prevent CIPN, reduce symptoms, improve quality of life and reduce the impact of chemotherapy drugs on sensory nerve conduction. However, more high-quality RCTs are needed to compare the efficacy of HGWD with that of positive control drugs in preventing severe CIPN.
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Affiliation(s)
- Xin-Rong Yang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Xin-Yi Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yi-Jia Xia
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Jin Fu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Xiao-Xuan Lian
- Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Xin-Ru Liang
- Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Ying-Qi He
- Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Zhuo-Hong Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
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Bao J, Song Y, Hang M, Xu H, Li Q, Wang P, Chen T, Xia M, Shi Q, Wang Y, Wang X, Liang Q. Huangqi Guizhi Wuwu Decoction suppresses inflammation and bone destruction in collagen-induced arthritis mice. CHINESE HERBAL MEDICINES 2024; 16:274-281. [PMID: 38706818 PMCID: PMC11064554 DOI: 10.1016/j.chmed.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/02/2023] [Accepted: 10/13/2023] [Indexed: 05/07/2024] Open
Abstract
Objective Rheumatoid arthritis (RA) is a chronic inflammatory and destructive arthritis, characterized by inflammatory infiltration and bone destruction. Huangqi Guizhi Wuwu Decoction (HGWD) is traditional Chinese medicine, which has been applied in the treatment of RA in clinical. The aim of this study was to investigate the therapeutic effect of HGWD on collagen-induced arthritis (CIA) mouse model. Methods DBA/1J female mice were used to establish the collagen-induced arthritis (CIA) model. HGWD was administered intragastrically once a day for four weeks starting on the 22nd day after the first immunization. The body weight, hind paw thickness and clinical score were measured every five days. Gait analysis, histopathological staining, enzyme-linked immunosorbent assay (ELISA), ultrasound imaging and micro-computed tomography imaging were performed to determine the effects of HGWD treatment on inflammation and bone structure in this model. Moreover, Real-time PCR and Western blot analysis were used to detect inflammatory factors mRNA and protein levels after HGWD intervention in RAW 264.7 cells. Results HGWD attenuated symptoms of arthritis, suppressed inflammatory synovium area and the serum levels of inflammatory factors, inhibited joint space enlargement in the knee and ankle joints, reduced numbers of osteoclasts, protected bone destruction, as well as improved motor function. HGWD decreased the expression of mRNA for inflammatory factors and the protein expression levels of p-NF-кB and IL-17. Conclusion These results suggested that HGWD suppresses inflammation, attenuates bone erosion and maintains motor function in collagen-induced arthritis mice.
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Affiliation(s)
- Jiamin Bao
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yongjia Song
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Minghui Hang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Hao Xu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Qiang Li
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Pengyu Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Tao Chen
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Mengxiong Xia
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Qi Shi
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yongjun Wang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xiaoyun Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Qianqian Liang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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PING J, HAO H, WU Z, ZOU M, LI Z, CHENG G. Long-term efficacy and safety of Huangqi ()-based Traditional Chinese Medicine in diabetic peripheral neuropathy: a Meta-analysis of randomized controlled trials. J TRADIT CHIN MED 2024; 44:229-242. [PMID: 38504529 PMCID: PMC10927399 DOI: 10.19852/j.cnki.jtcm.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/20/2023] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To assess the long-term effectiveness of Huangqi (Radix Astragali Mongolici, HQ)-based Traditional Chinese Medicine (TCM) in the treatment of diabetic peripheral neuropathy (DPN). METHODS Nine databases were searched to retrieve available randomized controlled trials that compared HQ-based TCM and Western Medicines in the treatment of DPN. The methodological quality of the included studies was assessed using the Cochrane bias risk tool, and RevMan 5.4 was used for data analysis. The effect estimates of interest were risk ratio (RR), mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI). RESULTS The results from 48 available studies assessing 3759 patients demonstrated that cases administered HQ-based TCM [RR = 1.30, 95% CI (1.21, 1.40), P < 0.000 01] or HQ-based TCM combined with Western Medicines [RR = 1.25, 95% CI (1.19, 1.31), P < 0.000 01] exhibited higher total efficacy rates than individuals who received Western Medicine alone. The results showed that the HQ-based TCM group had decreased Toronto Clinical Scoring System scores [MD =-1.50, 95% CI (-1.83, -1.17), P < 0.000 01], and reduced serum interleukin 6 [SMD = -0.57, 95% CI (-0.87, -0.27), P = 0.0002] and tumor necrosis factors-α levels [SMD = -0.60, 95% CI (-0.95, -0.25), P = 0.0009]. In addition, both HQ-based TCM and HQ-based TCM combined with Western Medicine increased nerve conduction velocity and decreased glycaemia compared with Western Medicine alone. In terms of blood lipids, oxidative stress and adverse drug reactions, there were no significant differences between the HQ-based TCM groups and the Western Medicine control group. CONCLUSION The current Meta-analysis revealed that HQ-based TCM yields higher efficacy and safety than Western Medicine alone for the treatment of DPN, although further well-designed RCTs are required to validate these findings.
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Affiliation(s)
- Jing PING
- 1 School of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110000, China
| | - Hongzheng HAO
- 2 Department of Endocrinology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110000, China
| | - Zhenqi WU
- 3 Department of Research Administration, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110000, China
| | - Meijuan ZOU
- 4 School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110000, China
| | - Zuojing LI
- 4 School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110000, China
| | - Gang CHENG
- 4 School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110000, China
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Huang HY, Lin YP, Wei H, Fu Y, Zhou YH, Fang ZH, Qiu XT, Wang M, Li QB, Li SS, Wang SD, Dai F, Liu ZJ, Zhao L, Wen JX, Wu LY, Zeng HY, Zhang JM, Lu QY, He L, Song W, Sun L, Luo LL, He JL, Xie WW, Liang QS, Huang Y, Zhu SL, Long JE, Gao ZJ, Wen ZH, Li CJ, Ouyang WW, Li G, Wu MH, Li AX, Huang JZ, Paul SK, Tang XY, Fan GJ. Effect and Safety of Herbal Medicine Foot Baths in Patients with Diabetic Peripheral Neuropathy: A Multicenter Double-Blind Randomized Controlled Trial. Chin J Integr Med 2024; 30:195-202. [PMID: 38374490 DOI: 10.1007/s11655-024-3900-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To evaluate the effect and safety of foot baths with Tangbi Waixi Decoction (TW) in treating patients with diabetic peripheral neuropathy (DPN). METHODS It is a multicenter double-blinded randomized controlled trial. Participants with DPN were recruited between November 18, 2016 and May 30, 2018 from 8 hospitals in China. All patients received basic treatments for glycemic management. Patients received foot baths with TW herbal granules either 66.9 g (intervention group) or 6.69 g (control group) for 30 min once a day for 2 weeks and followed by a 2-week rest, as a therapeutic course. If the Toronto Clinical Scoring System total score (TCSS-TS) ⩾6 points, the patients received a total of 3 therapeutic courses (for 12 weeks) and were followed up for 12 weeks. The primary outcome was change in TCSS-TS score at 12 and 24 weeks. Secondary outcomes included changes in bilateral motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of the median and common peroneal nerve. Safety was also assessed. RESULTS Totally 632 patients were enrolled, and 317 and 315 were randomized to the intervention and control groups, respectively. After the 12-week intervention, patients in both groups showed significant declines in TCSSTS scores, and significant increases in MNCV and SNCV of the median and common peroneal nerves compared with pre-treatment (P<0.05). The reduction of TCSS-TS score at 12 weeks and the increase of SNCV of median nerve at 24 weeks in the control group were greater than those in the intervention group (P<0.05). The number of adverse events did not differ significantly between groups (P>0.05), and no serious adverse event was related with treatment. CONCLUSION Treatment of TW foot baths was safe and significantly benefitted patients with DPN. A low dose of TW appeared to be more effective than a high dose. (Registry No. ChiCTR-IOR-16009331).
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Affiliation(s)
- Hao-Yue Huang
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Yu-Ping Lin
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Hua Wei
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Yu Fu
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, China
| | - Yue-Hong Zhou
- Department of Endocrinology, Liuyang Hospital of Chinese Medicine, Changsha, 410000, China
| | - Zhao-Hui Fang
- Department of Endocrinology, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230000, China
| | - Xiao-Tang Qiu
- Department of Endocrinology, Hainan Provincial Hospital of Traditional Chinese Medicine, Haikou, 570100, China
| | - Mei Wang
- Department of Endocrinology, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, 110000, China
| | - Qing-Bo Li
- Department of Geriatric, Luoyang No.1 Hospital of Traditional Chinese Medicine, Luoyang, Henan Province, 471000, China
| | - Shan-Shan Li
- Department of Endocrinology, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, 550000, China
| | - Shi-Dong Wang
- Department of Endocrinology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, 100000, China
| | - Fang Dai
- Department of Endocrinology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, 550000, China
| | - Zhen-Jie Liu
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Ling Zhao
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Jian-Xuan Wen
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Li-Yan Wu
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Hui-Yan Zeng
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Jin-Ming Zhang
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Qi-Yun Lu
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Liu He
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Wei Song
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Lu Sun
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Lu-Lu Luo
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Jia-Li He
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Wen-Wen Xie
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Qing-Shun Liang
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Yuan Huang
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Sheng-Ling Zhu
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Jie-Er Long
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Zhi-Juan Gao
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Ze-Huai Wen
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Chun-Ji Li
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Wen-Wei Ouyang
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Geng Li
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Ming-Hui Wu
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - An-Xiang Li
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China
| | - Jin-Zhu Huang
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Sanjoy K Paul
- Melbourne EpiCentre, The University of Melbourne and Melbourne Health, Melbourne, 3013, Australia
| | - Xian-Yu Tang
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China.
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China.
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China.
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China.
| | - Guan-Jie Fan
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China.
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China.
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China.
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China.
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Zhang K, Peng P, Huang J, Chen M, Liu F, Zhu C, Lu Q, Wang M, Lin C. Integrating plasma metabolomics and gut microbiome to reveal the mechanisms of Huangqi Guizhi Wuwu Decoction intervene diabetic peripheral neuropathy. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117301. [PMID: 37820997 DOI: 10.1016/j.jep.2023.117301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/01/2023] [Accepted: 10/07/2023] [Indexed: 10/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Huangqi Guizhi Wuwu Decoction (HGWD) is a classic traditional Chinese herbal formula from "Synopsis of Golden Chamber," which is used to treat blood stagnation and has been used for alleviating diabetic peripheral neuropathy (DPN) in the clinic. However, the mechanisms of HGWD intervention DPN are still to be discovered. AIM OF THE STUDY This study aims to explore the mechanism of HGWD intervention DPN by integrating plasma metabolomics and gut microbiome. MATERIALS AND METHODS BKS Cg-m+/+Leprdb/J (db/db) mice with DPN were at 16 weeks of age. The indices of DPN phenotypes in db/db mice, pathomorphology of the sciatic nerve, intraepithelial nerve fibers (IENF) of the foot pad, levels of blood lipids and oxidative stress, and inflammatory reaction were used to appraise the HGWD efficacy. Finally, the pharmacological mechanisms of HGWD intervening DPN were explored by metabolomics and 16S rRNA gene sequencing. RESULTS HGWD reversed DPN phenotypes in db/db mice, improved peripheral nerve structure, ameliorated the level of blood lipids and nerve growth factor in plasma, enhanced antioxidant capacity, and alleviated inflammatory responses. Plasma metabolomics disclosed that HGWD remarkably regulated the unusual levels of thirty-seven metabolites involved in sphingolipid metabolism, biosynthesis of unsaturated fatty acids, arachidonic acid metabolism, and amino acid biosynthesis pathways. The gut microbiome showed that nine bacteria were highly correlated with the efficacy of HGWD in DPN. Integrating analysis of microbiome and metabolomics demonstrated that the interaction of four bacteria with four metabolic pathways might be the significant mechanism of HGWD intervention in DPN. CONCLUSIONS The mediation of gut microbiota and plasma metabolism may be the potential mechanism of HGWD ameliorating DPN in db/db mice. The interaction of Lactobacillus, Alloprevotella, Bacteroides, and Desulfovibio with four metabolic pathways might be the critical mechanism for HGWD treating DPN.
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Affiliation(s)
- Kaihui Zhang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Peng Peng
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Jinhao Huang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Ming Chen
- Guangzhou BaiYunShan PanGaoShou Pharmaceutical Company Limited, Guangzhou, 511400, PR China
| | - Fangle Liu
- The First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510405, PR China
| | - Chenchen Zhu
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Qifu Lu
- Guangzhou BaiYunShan PanGaoShou Pharmaceutical Company Limited, Guangzhou, 511400, PR China.
| | - Meiqi Wang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China.
| | - Chaozhan Lin
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China.
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9
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Fan Z, Guan J, Li L, Cui Y, Tang X, Lin X, Shen G, Feng B, Zhu H. Characterization of chemical constituents in Huangqi Guizhi Wuwu decoction using ultra-high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. J Sep Sci 2023; 46:e2300337. [PMID: 37654058 DOI: 10.1002/jssc.202300337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023]
Abstract
Huangqi Guizhi Wuwu decoction (HGWWD) is a classic traditional Chinese medicine prescription for the treatment of ischemic stroke, etc. However, the material basis of its efficacy remains unclear, seriously affecting drug development and clinical applications. In the present study, an ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry method was developed to separate and identify the chemical components of HGWWD. A total of 81 compounds were identified and tentatively characterized. Eight compounds were accurately identified by comparing the retention time and mass spectrometry data with those of reference substances, the remaining compounds were characterized by comparing the mass spectrometry data and reference information. Based on the results of compound attribution, 35 compounds were from Astragali Radix, six compounds were from Cinnamomi Ramulus, 23 compounds were from Paeoniae Radix Alba, eight compounds were from Zingiberis Rhizoma Recens and nine compounds were from Jujubae Fructus. The results showed that monoterpenoids, flavonoids, organic acids, triterpenes, amino acids, gingerols, alkaloids, and glycosides were the main chemical components of HGWWD. This analytical method is suitable for characterizing the chemical constituents of HGWWD, and the results provide important information for elucidating its pharmacodynamic material basis and mechanism of action.
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Affiliation(s)
- Zhuoyu Fan
- School of Pharmacy, Jilin Medical University, Jilin City, P. R. China
- School of Pharmacy, Yanbian University, Yanji, P. R. China
| | - Jiao Guan
- School of Pharmacy, Jilin Medical University, Jilin City, P. R. China
| | - Lele Li
- School of Pharmacy, Jilin Medical University, Jilin City, P. R. China
| | - Yue Cui
- School of Pharmacy, Jilin Medical University, Jilin City, P. R. China
| | - Xinmiao Tang
- School of Pharmacy, Jilin Medical University, Jilin City, P. R. China
- School of Pharmacy, Yanbian University, Yanji, P. R. China
| | - Xiaoying Lin
- School of Pharmacy, Jilin Medical University, Jilin City, P. R. China
| | - Guanghai Shen
- School of Pharmacy, Yanbian University, Yanji, P. R. China
| | - Bo Feng
- School of Pharmacy, Jilin Medical University, Jilin City, P. R. China
| | - Heyun Zhu
- School of Pharmacy, Jilin Medical University, Jilin City, P. R. China
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10
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Ou Z, Zhao M, Xu Y, Wu Y, Qin L, Fang L, Xu H, Chen J. Huangqi Guizhi Wuwu decoction promotes M2 microglia polarization and synaptic plasticity via Sirt1/NF-κB/NLRP3 pathway in MCAO rats. Aging (Albany NY) 2023; 15:10031-10056. [PMID: 37650573 PMCID: PMC10599726 DOI: 10.18632/aging.204989] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/24/2023] [Indexed: 09/01/2023]
Abstract
Huangqi Guizhi Wuwu decoction (HGWD) has been demonstrated to ameliorate cerebral ischemia-reperfusion injury in clinical application. Nevertheless, the exact mechanisms of HGWD have not been conclusively elucidated. This study aimed to investigate the potential role and mechanism of HGWD on neurological deficits in a rat model of middle cerebral artery occlusion (MCAO). Our results showed that HGWD significantly alleviated neurological deficits in MCAO rats, evidenced by high mNSS score, reduced cerebral infarction area, and improved brain pathological injury. Besides, HGWD reduced the levels of TNF-α, IL-1β, IL-6, SOD, MDA and GSH in the brain tissue. Further study suggested that HGWD promoted microglia polarization towards M2 by inhibiting M1 activation (Iba1+/CD16+, iNOS) and enhancing M2 activation (Iba1+/CD206+, Arg-1). Additionally, HGWD increased dendritic spine density and enhanced levels of synapse marker proteins (PSD95, Synapsin I). HGWD also up-regulated Sirt1 expression while inhibited p-NF-κB, NLRP3, ASC, and cleaved caspase-1 level in the hippocampus of MCAO rats. Sirt1 specific inhibitor EX527 notably weakened the neuroprotective efficacy of HGWD against cerebral ischemia, and significantly abolished its modulation on microglia polarization and synaptic plasticity in vivo. Collectively, our findings suggested that HGWD ameliorated neuronal injury in ischemic stroke by modulating M2 microglia polarization and synaptic plasticity, at least partially, via regulating Sirt1/NF-κB/NLRP3 pathway, further supporting HGWD as a potential therapy for neuroprotection after ischemic stroke.
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Affiliation(s)
- Zhijie Ou
- Department of Neurology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu 215500, Jiangsu, China
| | - Min Zhao
- School of Chinese Medicine and School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu, China
| | - Ying Xu
- School of Chinese Medicine and School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu, China
| | - Yan Wu
- Department of Neurology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu 215500, Jiangsu, China
| | - Lina Qin
- Department of Neurology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu 215500, Jiangsu, China
| | - Li Fang
- Department of Neurology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu 215500, Jiangsu, China
| | - Hong Xu
- Department of Neurology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu 215500, Jiangsu, China
| | - Juping Chen
- Department of Neurology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu 215500, Jiangsu, China
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Jo HG, Baek E, Lee D. Comparative Efficacy of East Asian Herbal Formulae Containing Astragali Radix-Cinnamomi Ramulus Herb-Pair against Diabetic Peripheral Neuropathy and Mechanism Prediction: A Bayesian Network Meta-Analysis Integrated with Network Pharmacology. Pharmaceutics 2023; 15:pharmaceutics15051361. [PMID: 37242603 DOI: 10.3390/pharmaceutics15051361] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
The Astragali Radix-Cinnamomi Ramulus herb-pair (ACP) has been widely used in the treatment of diabetic peripheral neuropathy (DPN) as part of East Asian herbal medicine (EAHM). Eligible randomized controlled trials (RCTs) were identified by searching 10 databases. The outcomes investigated were response rate, sensory nerve conduction velocity (SNCV), and motor nerve conduction velocity (MNCV) in four regions of the body. The compounds in the ACP and their targets of action, disease targets, common targets, and other relevant information were filtered using network pharmacology. Forty-eight RCTs, with 4308 participants, and 16 different interventions were identified. Significant differences were observed in the response rate, MNCV, and SNCV, as all EAHM interventions were superior to conventional medicine or lifestyle modification. The EAHM formula containing the ACP ranked highest in more than half of the assessed outcomes. Furthermore, major compounds, such as quercetin, kaempferol, isorhamnetin, formononetin, and beta-sitosterol, were found to suppress the symptoms of DPN. The results of this study suggest that EAHM may increase therapeutic efficacy in DPN management, and EAHM formulations containing the ACP may be more suitable for improving treatment response rates to NCV and DPN therapy.
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Affiliation(s)
- Hee-Geun Jo
- Department of Herbal Pharmacology, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam 13120, Republic of Korea
- Naturalis Inc., 6 Daewangpangyo-ro, Bundang-gu, Seongnam 13549, Republic of Korea
| | - Eunhye Baek
- RexSoft Inc., 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Donghun Lee
- Department of Herbal Pharmacology, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam 13120, Republic of Korea
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Xie Y, Li L, Xie L, Jiang J, Yao T, Mao G, Wang S, Lin A, Ge J, Wu D. Beneficial effects and safety of traditional Chinese medicine for chronic inflammatory demyelinating polyradiculoneuropathy: A case report and literature review. Front Neurol 2023; 14:1126444. [PMID: 37090970 PMCID: PMC10115958 DOI: 10.3389/fneur.2023.1126444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/09/2023] [Indexed: 04/08/2023] Open
Abstract
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated neuropathy. First-line treatments for CIDP include corticosteroids, intravenous immunoglobulin, and plasma exchange. However, the application is always limited by high costs, effectiveness, and adverse events. This study investigated a new potentially effective and safe therapeutic treatment to alleviate CIDP symptoms and improve the quality of life. In the present case, a 47-year-old rural woman presented with weakness and numbness of progressive extremities. She was diagnosed with CIDP based on abnormal cerebrospinal fluid and electromyography. The patient was treated with intravenous dexamethasone for 1 week and with Huangqi-Guizhi-Wuwu and Bu-Yang-Huan-Wu decoctions for 90 days. Surprisingly, after the treatment, the weakness and numbness were eliminated, and the quality of life improved. The varying INCAT, MRC, and BI scores also reflected the treatment effects. After 8 months of discharge, the symptoms did not relapse during the follow-up. We also searched “traditional Chinese medicine (TCM)” and “CIDP” in PubMed, EMBASE, the Web of Science, the Cochrane Library, the Chinese National Knowledge Infrastructure Databases, Wanfang Data, and the Chongqing Chinese Science and Technology Periodical Database. Finally, only ten studies were included in the literature review. Three studies were randomized controlled trials, and seven were case reports or case series. There were 419 CIDP patients, but all study sites were in China. Nine TCM formulas involving 44 herbs were reported, with Huang Qi (Astragalus membranaceus) being the most important herb. In conclusion, the case and literature demonstrated that TCM treatment might be a more effective, low-cost, and safe option for treating CIDP. Although these preliminary findings are promising, a larger sample size and higher-quality randomized clinical trials are urgently required to confirm our findings.
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Affiliation(s)
- Yao Xie
- Department of Neurology, Hunan Hospital of Integrated Traditional Chinese and Western Medicine, Changsha, China
| | - Lesang Li
- Ophthalmology Department, Hunan Want Want Hospital, Changsha, China
| | - Le Xie
- Department of Neurology, Hunan Hospital of Integrated Traditional Chinese and Western Medicine, Changsha, China
| | - Junlin Jiang
- Department of Neurology, Hunan Hospital of Integrated Traditional Chinese and Western Medicine, Changsha, China
| | - Ting Yao
- Department of Neurology, Hunan Hospital of Integrated Traditional Chinese and Western Medicine, Changsha, China
| | - Guo Mao
- Office of Academic Research, Hunan Hospital of Integrated Traditional Chinese and Western Medicine, Changsha, China
| | - Shiliang Wang
- Department of Neurology, Hunan Hospital of Integrated Traditional Chinese and Western Medicine, Changsha, China
| | - Anchao Lin
- Department of Neurology, Hunan Hospital of Integrated Traditional Chinese and Western Medicine, Changsha, China
| | - Jinwen Ge
- Department of Neurology, Hunan Hospital of Integrated Traditional Chinese and Western Medicine, Changsha, China
| | - Dahua Wu
- Department of Neurology, Hunan Hospital of Integrated Traditional Chinese and Western Medicine, Changsha, China
- *Correspondence: Dahua Wu
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13
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Chai Y, Zhao F, Ye P, Ma F, Wang J, Zhang P, Li Q, Wang J, Wang W, Li Q, Xu B. A Prospective, Randomized, Placebo-Controlled Study Assessing the Efficacy of Chinese Herbal Medicine (Huangqi Guizhi Wuwu Decoction) in the Treatment of Albumin-Bound Paclitaxel-Induced Peripheral Neuropathy. J Clin Med 2023; 12:jcm12020505. [PMID: 36675434 PMCID: PMC9863646 DOI: 10.3390/jcm12020505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
Objective: This study aimed to evaluate the efficacy and safety of Huangqi Guizhi Wuwu decoction (HGWD), which is composed of five crude drugs (Astragali Radix, Cinnamomi Ramulus, Paeoniae Radix Alba, Zingiberis Rhizoma Recens, and Jujubae Fructus), in the treatment of albumin-bound paclitaxel (nab-PTX)-induced peripheral neuropathy (PN) in Chinese patients with breast cancer (BC). Methods: This trial was conducted at the National Cancer Center in China from January 2020 to June 2022. The eligible participants were assigned randomly in a 1:1 ratio to an HGWD group or a control group. The outcome measure was EORTC QLQ-CIPN20 questionnaire. Results: 92 patients diagnosed with BC were enrolled and randomized to either HGWD group (n = 46) or control group (n = 46). There were no significant differences in baseline characteristics between the two groups (p > 0.05). A statistical analysis of the sensory and motor functions of the EORTC QLQ-CIPN20 scores showed that patients in the HGWD group reported a larger decrease in CIPN sensory scores than those in the control group (p < 0.001). The EORTC QLQ-CIPN20 autonomic scores showed no statistical significance between the two groups (p > 0.05). Conclusions: HGWD packs could significantly improve patients’ nab-PTX-induced PN, increase the tolerance for nab-PTX-containing chemotherapy, and further improve the quality of life of patients with BC.
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Affiliation(s)
- Yue Chai
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Fang Zhao
- Nursing Department of the Cancer Hospital, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Peizhi Ye
- Chinese Medicine Department of the Cancer Hospital, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Fei Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jiayu Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Pin Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Qing Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jiani Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wenna Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Qiao Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Correspondence: (Q.L.); (B.X.)
| | - Binghe Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Correspondence: (Q.L.); (B.X.)
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Chen T, Shi Y, Shi W. Huangqi Guizhi Wuwu decoction in peripheral neurotoxicity treatment using network pharmacology and molecular docking. Medicine (Baltimore) 2022; 101:e31281. [PMID: 36281162 PMCID: PMC9592446 DOI: 10.1097/md.0000000000031281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
In this study, we predicted the core active compounds of Huangqi Guizhi Wuwu decoction in treatment of oxaliplatin-induced peripheral neuropathy and the related potential mechanism. Corresponding database was used to complete the interaction (PPI) network of key targets and the enrichment analysis of corresponding genmes. Molecular docking of key targets and key compounds was carried out using relevant software. The 60 chemical components corresponding to the oral absorption of Huangqi Guizhi Wuwu decoction correspond to 157 unique targets, and the 233 chemical components corresponding to percutaneous absorption in vitro correspond to 155 unique targets. There were 1074 unique targets for chemotherapy-induced peripheral neuropathy. Finally, three common key targets (SLC6A2, SLC6A3, and SLC6A4) and two key compounds (6-Gingerol and nuciferin) were screened according to the above three target datasets. The results showed that The PPI network of common key targets involved 23 associated proteins. In the related GO enrichment results, there were 33 items related to biological processes, 13 items related to cell composition, 21 items related to molecular function, and four KEGG pathway enrichments. L1000 kinase and GPCR perturbation analysis showed that the associated protein had an effect on the expression of multiple groups of kinase genes. HPA revealed that the enrichment of three common key targets was tissue-specific. The docking results showed that the 6 groups were structurally stable. The oral and topical use of Huangqi Guizhi Wuwu decoction can prevent and control peripheral neurotoxicity. The prevention and control effects may be related to its participation in the regulation of neurotransmitter transport, sympathetic activity, and transport. The histological parts of the mechanism are mainly distributed in the adrenal gland, placenta, brain, intestine, and lung, the blood is not specific. According to the prediction results of molecular docking, 6-Gingerol and nuciferin can closely bind to three common key targets.
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Affiliation(s)
- Tingting Chen
- School of the First Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yabo Shi
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenchuan Shi
- Technology Transfer Center, Nanjing University of Chinese Medicine, Nanjing, China
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15
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Lee S, Wong AR, Yang AWH, Hung A. Interaction of compounds derived from the Chinese medicinal formula Huangqi Guizhi Wuwu Tang with stroke-related numbness and weakness targets: An in-silico docking and molecular dynamics study. Comput Biol Med 2022; 146:105568. [DOI: 10.1016/j.compbiomed.2022.105568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/15/2022] [Accepted: 04/25/2022] [Indexed: 11/03/2022]
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16
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Discovery of Traditional Chinese Medicine Prescription Patterns Containing Herbal Dosage Based on Multilevel Top-K Weighted Association Rules. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:5466011. [PMID: 35665295 PMCID: PMC9159864 DOI: 10.1155/2022/5466011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 11/17/2022]
Abstract
In traditional Chinese medicine (TCM), drug dosage is an important part of the prescription. Different doses of the same drug can have varying curative effects. Doctors must determine the drug combination and dosage in clinical practice based on the patient's symptoms and treatment efficacy. Existing studies on the prescription pattern of TCM on the treatment of osteoporosis only analyze the frequency that a certain drug combination is used, without considering the treatment efficacy or drug dosage. As a result, we searched for and recorded existing literature on randomized controlled trials of TCM treatment of osteoporosis, calculated weights based on the treatment efficacy of the prescriptions used in the randomized controlled trials, and created the TCM weighted transaction database. Then, a new multilevel Top-K weighted association rule algorithm is proposed to obtain effective prescription patterns that include drug dosages, which can assist doctors in clinical practice in choosing a combination of drugs to form a prescription with good curative effects.
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17
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Lee S, Hung A, Li H, Yang AWH. Mechanisms of Action of a Herbal Formula Huangqi Guizhi Wuwu Tang for the Management of Post-Stroke Related Numbness and Weakness: A Computational Molecular Docking Study. J Evid Based Integr Med 2022; 27:2515690X221082989. [PMID: 35369720 PMCID: PMC8984862 DOI: 10.1177/2515690x221082989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Stroke-related numbness and weakness (SRNW) are resultant symptoms of post-stroke sufferers. Existing research has supported the use of Huangqi Guizhi Wuwu Tang (HGWT) particularly for SRNW; however, their mechanisms of action have not been fully elucidated. Therefore, this study aimed to investigate the mechanisms of action of HGWT components targeting SRNW-related proteins through a computational molecular docking approach. Target proteins associated with SRNW were identified through DrugBank database and Open Targets database. Chemical compounds from each herb of HGWT were identified from the Traditional Chinese Medicine Systems Pharmacology and Analysis Platform (TCMSP). Autodock Vina was utilized and the cut-off criterion applied for protein-ligand complexes was a binding affinity score of ≤ -9.5 kcal/mol; selected protein-ligand complexes were identified using 3D and 2D structural analyses. The protein targets PDE5A and ESR1 have highlighted interactions with compounds (BS040, DZ006, DZ058, DZ118, and HQ066) which are the key molecules in the management of SRNW. PDE5A have bioactivity with the amino acid residues (Val230, Asn252, Gln133 and Thr166) throughout PDE5A-cGMP-PKG pathways which involved reduction in myofilament responsiveness. ESR1 were predicted to be critical active with site residue (Leu346, Glu419 and Leu387) and its proteoglycans pathway involving CD44v3/CD44 that activates rho-associated protein kinase 1 (ROCK1) and ankyrin increasing vascular smooth muscle. In conclusion, HGWT may provide therapeutic benefits through strong interactions between herbal compounds and target proteins of PDE5A and ESR1. Further experimental studies are needed to unequivocally support this result which can be valuable to increase the quality of life of post-stroke patients. Keywords Herbal medicine, Complementary and alternative medicine, Natural product, Post-stroke, Computational analysis.
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Affiliation(s)
- Sanghyun Lee
- School of Health and Biomedical Sciences, 5376RMIT University, Bundoora, Victoria 3083, Australia
| | - Andrew Hung
- Science, 5376RMIT University, Melbourne, Victoria 3000, Australia
| | - Hong Li
- Science, 5376RMIT University, Melbourne, Victoria 3000, Australia.,Syndrome Laboratory of Integrated Chinese and Western Medicine, School of Traditional Chinese Medicine, 70570Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Angela Wei Hong Yang
- School of Health and Biomedical Sciences, 5376RMIT University, Bundoora, Victoria 3083, Australia
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18
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Liu YW, Chen YJ, Chen YH, Tsai MY. Therapeutic Efficacy of Traditional Chinese Medicine Syndrome-Based Formulae to Neuropathic Pain Caused by Chemotherapy. Integr Cancer Ther 2022; 21:15347354221121095. [PMID: 36154520 PMCID: PMC9515521 DOI: 10.1177/15347354221121095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: Chemotherapy-induced neuropathic pain (CINP) is a troublesome complication of
anti-cancer treatment. The aim of this retrospective study was to
investigate the effectiveness of classic Chinese herbal formulae (CHF) Huang
Qi Gui Zhi Wu Wu Tang (HQGZWWT) and Dang Gui Si Ni Tang (DGSNT) in the
treatment of CINP. Materials and Methods: Douleur Neuropathique 4 (DN4) and Functional Assessment of Cancer
Therapy-General (FACT-G) questionnaires were rated at baseline and after
3-monthly CHF treatment. Results: By searching through our medical records of all the CIPN patients from 2018
to 2019, we identified and enrolled 37 patients with Deficiency-Cold
syndrome in the study, for whom the treatment of neuropathic pain by regular
pharmacotherapies had failed or intolerable. At the third month evaluation
with the DN4 questionnaire, 13 patients had symptomatic remission, 15
patients remained stable, and 9 patients had no response to CHF. The 3-month
mean DN4 score was significantly higher than that at the baseline
(P < .001). After CHF treatment, significant
differences in quality of life were noted in the physical, social,
emotional, and functional well-being subscales, and in the total score, of
the FACT-G (P < .001). No adverse events or instances of
disease progression were observed. Conclusions: The results of our small study are the first in the literature to show the
clinical effectiveness of CHF for CINP. Combination of HQGZWWT and DGSNT is
well tolerated and may offer the possibility to ameliorate CINP more than
conventional care can. It merits further investigation.
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Affiliation(s)
- Yan-Wen Liu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ying-Jung Chen
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Hao Chen
- Division of Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Yen Tsai
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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19
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Shi Y, Liu L, Sun X, Jiao J. Efficacy and safety of acupuncture combined Chinese herbal medicine for diabetic peripheral neuropathy: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e28086. [PMID: 34918663 PMCID: PMC8677943 DOI: 10.1097/md.0000000000028086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Acupuncture combined with Chinese herbal medicine has been widely utilized for pain management in patients with diabetic peripheral neuropathy (DPN). However, its results are still inconsistent, and no systematic review has specifically addressed this issue. Thus, this systematic review will comprehensively and systematically investigate the effectiveness and safety of acupuncture combined with Chinese herbal medicine for pain relief in DPN. METHODS Randomized controlled trials on acupuncture combined with Chinese herbal medicine treatment of DPN published before September of 2021 will be searched in 9 databases including Medline, Web of Science, PubMed, Cochrane Library, Excerpta Medica Database, Sinomed, China National Knowledge Infrastructure, WanFang, and China Science and Technology Journal Database. The methodological assessment performed using the risk of bias assessment tool of Cochrane, and the level of evidence quality for the main results will be evaluated by a recommended grading, evaluation, formulation, and evaluation system approach. Bayesian network meta-analysis will be conducted using STATA V.14.0 and WinBUGS V.1.4.3. RESULTS This study will provide a high-quality comprehensive evaluation of the safety of acupuncture combined with Chinese herbal medicine for treating DPN. CONCLUSION This systematic review will evaluate the efficacy and safety of Chinese herbal medicine combined with acupuncture in the treatment of DPN, and provide the latest evidence for clinical application. ETHICS AND DISSEMINATION The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.Registration number: INPLASY2021100004.
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Affiliation(s)
- Yong Shi
- School of Special Education, Changchun University, 6543 Weixing Road, Changchun, China
| | - Le Liu
- Traditional Chinese Medicine College of Changchun University of Chinese Medicine, Changchun, China
| | - Xuefeng Sun
- Nursing College of Changchun University of Chinese Medicine, Changchun, China
| | - Jundong Jiao
- Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, China
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20
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Oral Administration of East Asian Herbal Medicine for Peripheral Neuropathy: A Systematic Review and Meta-Analysis with Association Rule Analysis to Identify Core Herb Combinations. Pharmaceuticals (Basel) 2021; 14:ph14111202. [PMID: 34832984 PMCID: PMC8622183 DOI: 10.3390/ph14111202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/11/2021] [Accepted: 11/18/2021] [Indexed: 01/04/2023] Open
Abstract
This review aimed to comprehensively assess the efficacy and safety of oral East Asian herbal medicine (EAHM) for overall peripheral neuropathy (PN). In addition, an Apriori algorithm-based association rule analysis was performed to identify the core herb combination, thereby further generating useful hypotheses for subsequent drug discovery. A total of 10 databases were searched electronically from inception to July 2021. Randomized clinical trials (RCTs) comparing EAHM with conventional analgesic medication or usual care for managing PN were included. The RCT quality was appraised using RoB 2.0, and the random effects model was used to calculate the effect sizes of the included RCTs. The overall quality of evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation. By analyzing the constituent herb data, the potential association rules of core herb combinations were explored. A total of 67 RCTs involving 5753 patients were included in this systematic review. In a meta-analysis, EAHM monotherapy and combined EAHM and western medicine therapy demonstrated substantially improved sensory nerve conduction velocity, motor nerve conduction velocity, and response rate. Moreover, EAHM significantly improved the incidence rate, pain intensity, Toronto clinical scoring system, and Michigan diabetic neuropathy score. The evidence grade was moderate to low due to the substantial heterogeneity among the studies. Nine association rules were identified by performing the association rule analysis on the extraction data of 156 EAHM herbs. Therefore, the constituents of the herb combinations with consistent association rules were Astragali Radix, Cinnamomi Ramulus, and Spatholobi Calulis. This meta-analysis supports the hypothesis that EAHM monotherapy and combined therapy may be beneficial for PN patients, and follow-up research should be conducted to confirm the precise action target of the core herb.
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21
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Mai W, Wei A, Lin X, Wang F, Ye J, Chen P. Efficacy and safety of traditional Chinese medicine injection with mecobalamin in treating diabetic peripheral neuropathy: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e23702. [PMID: 33429738 PMCID: PMC7793311 DOI: 10.1097/md.0000000000023702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Diabetic peripheral neuropathy is a common complication of diabetes and the main cause of disability. At present, there is no specific therapeutic regimen. Mecobalamin is often used as a neurotrophic drug, and its long-term effects are not satisfactory when used alone. Clinical practice indicates that traditional Chinese medicine injection with mecobalamin has a therapeutic advantage in treating diabetic peripheral neuropathy while it lacks evidence-based medicine. In this scheme, the efficacy and safety of traditional Chinese medicine injection with mecobalamin in treating diabetic peripheral neuropathy has been studied. METHODS Computers were used to search the English database (PubMed, the Cochrane Library, Embase, Web of Science), and Chinese database (CNKI, Wanfang, CBMDISC, VIP). Besides, manual searching was conducted to search for Baidu Scholar, CHICTR, Google Scholar. During the establishment of the database to November 2020, a randomized controlled trial on traditional Chinese medicine injection with mecobalamin in treating diabetic peripheral neuropathy was conducted. There were 2 researchers independently conducting data extraction and quality evaluation of literature on the included studies, RevMan5.3 was performed for meta-analysis on the included literature. RESULTS In this study, the efficacy and safety of traditional Chinese medicine injection with mecobalamin in treating diabetic peripheral neuropathy was evaluated by the total effective rate, motor nerve conduction velocity, sensory nerve conduction velocity, adverse reactions, and glucose metabolism level. CONCLUSION This study can provide an evidence-based basis on the clinical applications of traditional Chinese medicine injection with mecobalamin in the treatment of diabetic peripheral neuropathy. ETHICS AND DISSEMINATION The study does not involve patient privacy or rights and does not require approval from an ethics committee. The results may be published in peer-reviewed journals or disseminated at relevant conferences. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/KPW5E.
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Affiliation(s)
- Weihua Mai
- Department of Endocrinology, Foshan Hospital of Traditional Chinese Medicine
| | - Aisheng Wei
- Department of Endocrinology, Foshan Hospital of Traditional Chinese Medicine
| | - Xiaoxuan Lin
- Department of Medicine, Zhangcha Hospital, Foshan, Guangdong Province, China
| | - Funeng Wang
- Department of Endocrinology, Foshan Hospital of Traditional Chinese Medicine
| | - Jianhong Ye
- Department of Endocrinology, Foshan Hospital of Traditional Chinese Medicine
| | - Ping Chen
- Department of Endocrinology, Foshan Hospital of Traditional Chinese Medicine
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22
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Wang L, Fan Y, Xin P, Zhao Y, Deng H, Jia B. The efficacy and safety of Huangqi Guizhi Wuwu decoction for rheumatoid arthritis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22011. [PMID: 32899051 PMCID: PMC7478548 DOI: 10.1097/md.0000000000022011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis has the characteristics of slow progression, long course, and repeated attacks. At present, western medicine commonly used in clinical practice not only reduces pain and improves symptoms, but also has more adverse reactions, affecting the health, and life of patients. In ancient China, Huangqi Guizhi Wuwu decoction was used by doctors to treat rheumatoid arthritis, with remarkable effect. In recent years, many clinical studies have also shown that Huangqi Guizhi Wuwu decoction has reliable effect in treating rheumatoid arthritis, but there is no evidence of evidence-based medicine. Therefore, this study aims to systematically evaluate the clinical efficacy and safety of Huangqi Guizhi Wuwu decoction in the treatment of rheumatoid arthritis. METHODS Using computer to retrieve PubMed, The Cochrance Library, Embase, Web of Science, CNKI, VIP and Wanfang database, in addition manually retrieve Google academic and Baidu academic to collect all randomized controlled trials for Huangqi Guizhi Wuwu decoction in the treatment of rheumatoid arthritis, including relevant academic journal and conference papers, dissertations, from the establishment of the database to July 2020. After 2 evaluators independently screened the literature, extracted the data, and evaluated the risk of bias included in the study, RevMan5.3 software was used to analyze the data. RESULTS This research evaluate the efficacy and safety of Huangqi Guizhi Wuwu decoction in treating Rheumatoid arthritis from the aspects of clinical efficacy rate, visual analog scale (VAS), swollen joint count (SJC), morning stiffness time, Rrythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), and adverse reaction incidence. CONCLUSION This study will provide reliable evidence for the clinical application of Huangqi Guizhi Wuwu decoction in the treatment of rheumatoid arthritis. ETHICS AND DISSEMINATION The private information from individuals will not publish. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/RZY3V.
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Affiliation(s)
- Lei Wang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Yihua Fan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
| | - Ping Xin
- Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Yuetong Zhao
- Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Huaihan Deng
- Pengzhou Hospital of Traditional Chinese Medicine, Pengzhou, Sichuan Province, China
| | - Bo Jia
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
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23
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Sawangjit R, Thongphui S, Chaichompu W, Phumart P. Efficacy and Safety of Mecobalamin on Peripheral Neuropathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Altern Complement Med 2020; 26:1117-1129. [PMID: 32716261 DOI: 10.1089/acm.2020.0068] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Objectives: To assess the efficacy and safety of mecobalamin on peripheral neuropathy. Background: Mecobalamin is an active form of vitamin B12 that has been suggested to be beneficial in improving nerve conduction and neuropathic pain symptoms. Although it is already widely used in Asia for the treatment of peripheral neuropathies, its efficacy remains unclear. Methods: Relevant electronic databases were systematically searched for randomized controlled trials investigating the efficacy and safety of mecobalamin on peripheral neuropathy, from inception through December 2019. Study selection, data extraction, and quality assessment were performed independently by two reviewers. The clinical therapeutic efficacy, pain score, neuropathic symptom score, nerve conduction velocities (NCVs), and adverse events of mecobalamin were assessed and were pooled by using a random-effects model. Heterogeneity was assessed by I2 and chi-squared tests. Results: Fifteen studies with 1707 peripheral neuropathy patients caused by diabetic peripheral neuropathy and herpetic neuropathy were included. Based on Cochrane's risk of bias criteria, most of the included studies (11/15, 73%) were rated high risk of bias, whereas 20% and 7% were rated some concerns and low risk of bias, respectively. In terms of the proportion of patients achieving clinical therapeutic efficacy, mecobalamin alone (risk ratio [RR] = 1.17; 95% confidence interval [CI] 1.03-1.33) and mecobalamin in combination (RR = 1.32; 95% CI 1.21-1.45) are more effective than active control. For NCV outcomes, only mecobalamin combination treatment was effective. Neither mecobalamin alone nor mecobalamin in combination is effective on the pain score and neuropathic symptom outcomes. No serious adverse events associated with mecobalamin were reported during the treatment periods. Conclusion: Our findings indicate that mecobalamin in combination may be effective in improving clinical therapeutic efficacy and NCV outcomes for peripheral neuropathy patients, but the evidence is not clear for mecobalamin alone. More high-quality studies are required to confirm this finding.
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Affiliation(s)
- Ratree Sawangjit
- Clinical Trials and Evidence-Based Syntheses Research Unit (CTEBs RU), Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Suntana Thongphui
- Clinical Trials and Evidence-Based Syntheses Research Unit (CTEBs RU), Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Wanida Chaichompu
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Panumart Phumart
- Clinical Trials and Evidence-Based Syntheses Research Unit (CTEBs RU), Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
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24
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Zhao J, Li Y, Xin L, Sun M, Yu C, Shi G, Bao T, Liu J, Ni Y, Lu R, Wu Y, Fang Z. Clinical Features and Rules of Chinese Herbal Medicine in Diabetic Peripheral Neuropathy Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2020; 2020:5795264. [PMID: 32724325 PMCID: PMC7382735 DOI: 10.1155/2020/5795264] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/27/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To analyse the clinical features of diabetic peripheral neuropathy (DPN) and employ data mining technology to explore the rules of Chinese herbal medicine (CHM) therapy. METHODS The clinical data of 216 patients with DPN and qi-yin deficiency syndrome were obtained, and the clinical features of the patients were assessed by cluster analysis. Relevant information was entered into the clinical diagnosis and treatment collection system, and data mining techniques were used to analyse the drug frequency, core CHM, CHM pair, and so on. RESULTS In this study, glycated haemoglobin (HbA1c) and homocysteine (HCY) were closely related to the pathogenesis of DPN. Overall, 162 patients had typical DPN syndrome characteristics, and we analysed 216 prescriptions, including 182 CHM. The frequencies of prescription of Astragalus membranaceus, Ligusticum wallichii, Poria cocos, and Radix Rehmanniae were greater than 45%. A Bayesian network analysis diagram showed that the 9 most common core CHM included Astragalus membranaceus, Ligusticum wallichii, Poria cocos, atractylodes rhizome, and Salvia miltiorrhiza Bge. According to the association rules of CHM, Radix Ophiopogon is used for Codonopsis pilosula; Astragalus membranaceus and atractylodes rhizome for Rehmannia are also frequently used. Astragalus membranaceus and Cinnamomi Ramulus or Ligusticum wallichii and Moutan bark were highly related to a decreased Michigan Diabetic Neuropathy Score. CONCLUSION HbA1c and HCY are related risk factors for DPN. Numbness is a typical syndrome characteristic. Astragalus membranaceus is a monarch CHM and is used most frequently.
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Affiliation(s)
- Jindong Zhao
- Department of Endocrine Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - Yan Li
- Department of Infectious Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - Ling Xin
- Department of Information, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - Min Sun
- School of Life Sciences, Anhui University, Hefei 230039, China
| | - Chanjuan Yu
- Department of Endocrine Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - Guobin Shi
- Department of Endocrine Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - Taotao Bao
- Department of Endocrine Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - Jian Liu
- Department of Endocrine Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - Yingqun Ni
- Department of Endocrine Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - RuiMin Lu
- Department of Endocrine Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - Yuanyuan Wu
- Department of Endocrine Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - Zhaohui Fang
- Department of Endocrine Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
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25
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Chen G, Ye Y, Cheng M, Tao Y, Zhang K, Huang Q, Deng J, Yao D, Lu C, Huang Y. Quercetin Combined With Human Umbilical Cord Mesenchymal Stem Cells Regulated Tumour Necrosis Factor-α/Interferon-γ-Stimulated Peripheral Blood Mononuclear Cells via Activation of Toll-Like Receptor 3 Signalling. Front Pharmacol 2020; 11:499. [PMID: 32390844 PMCID: PMC7194129 DOI: 10.3389/fphar.2020.00499] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 03/30/2020] [Indexed: 12/22/2022] Open
Abstract
The beneficial effect of quercetin in rheumatic diseases is unclear. Studies have already confirmed that human umbilical cord mesenchymal stem cells (hUCMSCs) alleviate some symptoms of rheumatoid arthritis (RA) by their immunosuppressive capacities. This study explored whether there are additive effects of quercetin and hUCMSCs on peripheral blood mononuclear cells (PBMCs) under simulated rheumatic conditions. hUCMSCs were pretreated with quercetin (10 μM) before coculture with TNF-α/IFN-γ-stimulated PBMCs at a ratio of 1:1 for 3 days. PBMC proliferation was inhibited, and the proportion of Th17 cells was shifted. These effects may be related to the effect of quercetin on functional molecules in hUCMSCs, including nitric oxide (NO), indoleamine 2,3-dioxygenase (IDO), interleukin 6 (IL-6) and Toll-like receptor-3 (TLR-3) and the Akt/IκB pathways. These results suggest that quercetin effectively promoted the immunoregulatory effect of hUCMSCs by inhibiting the Akt/IκB pathway, activating the Toll-like receptor-3 pathway, and regulating downstream cytokines.
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Affiliation(s)
- Guiling Chen
- Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of National Institute of Stem Cell Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Yang Ye
- Department of Shanghai Zhangjiang Biobank, National Engineering Centre for Biochip at Shanghai, Shanghai, China
| | - Ming Cheng
- Department of Shanghai Zhangjiang Biobank, National Engineering Centre for Biochip at Shanghai, Shanghai, China
| | - Yi Tao
- Department of Shanghai Zhangjiang Biobank, National Engineering Centre for Biochip at Shanghai, Shanghai, China
| | - Kejun Zhang
- Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of National Institute of Stem Cell Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Qiong Huang
- Department of Shanghai Zhangjiang Biobank, National Engineering Centre for Biochip at Shanghai, Shanghai, China
| | - Jingwen Deng
- Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China.,Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Danni Yao
- Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China.,Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Chuanjian Lu
- Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China.,Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yu Huang
- Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of National Institute of Stem Cell Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
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26
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Cheng H, Lu T, Wang J, Xia Y, Chai X, Zhang M, Yao Y, Zhou N, Zhou S, Chen X, Su W, Liu C, Yi W, Chen Y, Yao L. HuangqiGuizhiWuwu Decoction Prevents Vascular Dysfunction in Diabetes via Inhibition of Endothelial Arginase 1. Front Physiol 2020; 11:201. [PMID: 32269530 PMCID: PMC7109290 DOI: 10.3389/fphys.2020.00201] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 02/21/2020] [Indexed: 12/12/2022] Open
Abstract
Hyperglycemia induces vascular endothelial dysfunction, which contributes to the development of vascular complication of diabetes. A classic prescription of traditional medicine, HuangqiGuizhiWuwu Decoction (HGWWD) has been used for the treatment of various cardiovascular and cerebrovascular diseases, which all are related with vascular pathology. The present study investigated the effect of HGWWD treatment in streptozocin (STZ)-induced vascular dysfunction in mouse models. In vivo studies were performed using wild type mice as well as arginase 1 knockout specific in endothelial cells (EC-A1-/-) of control mice, diabetes mice and diabetes mice treated with HGWWD (60 g crude drugs/kg/d) for 2 weeks. For in vitro studies, aortic tissues were treated with mice serum containing HGWWD with or without adenoviral arginase 1 (Ad-A1) transduction in high glucose (HG) medium. We found that HGWWD treatment restored STZ-induced impaired mean velocity and pulsatility index of mouse left femoral arteries, aortic pulse wave velocity and vascular endothelial relaxation accompanied by elevated NO production in the aorta and plasma, as well as reduced endothelial arginase activity and aortic arginase 1 expression. The protective effect of HGWWD is reversed by an inhibitor of nitric oxide synthesis. Meanwhile, the preventive effect of serum containing HGWWD in endothelial vascular dysfunction is completely blocked by Ad-A1 transduction in HG incubated aortas. HGWWD treatment further improved endothelial vascular dysfunction in STZ induced EC-A1-/- mice. This study demonstrates that HGWWD improved STZ-induced vascular dysfunction through arginase 1 - NO signaling, specifically targeting endothelial arginase 1.
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Affiliation(s)
- Hong Cheng
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tian Lu
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingya Wang
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yucen Xia
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaoshu Chai
- Department of Oncology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Minyi Zhang
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yutong Yao
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Na Zhou
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Sisi Zhou
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinyi Chen
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weiwei Su
- Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Cunzhi Liu
- Acupuncture Research Center, Beijing University of Chinese Medicine, Beijing, China
| | - Wei Yi
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yongjun Chen
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lin Yao
- School of Pharmaceutical Sciences, South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
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27
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Liang L, Wei X, Feng M, Zhu L, Yu J, Yang G, Yin X, Zhou S, Li K, Yang M, Wang X. Huangqi Guizhi Wuwu Decoction for treating cervical radiculopathy: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99:e19137. [PMID: 32049834 PMCID: PMC7035008 DOI: 10.1097/md.0000000000019137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Huangqi Guizhi Wuwu Decoction (HGWD) is a common prescription for the treatment of cervical radiculopathy (CR). And the effectiveness and safety of HGWD for CR were assessed in this study. METHODS Seven databases were searched. Randomized controlled trials involving HGWD alone or HGWD combined with conventional treatment were enrolled. The authors in pairs independently assessed the risk of bias and extracted the data. RESULTS Eight studies involving 783 participants with CR were included. Meta-analysis revealed that the efficacy of HGWD for CR was significantly superior compared with control treatment (risk ratio = 1.12, 95% confidence interval [CI]:1.06-1.19, Z = 3.71; P = .0002). Compare with control group, there is an increase in visual analog scale (mean difference [MD] = 0.99; 95% CI: 0.83-1.14; Z = 12.57; P < .00001). There was also an improvement of neck disability index (MD = 9.2; 95% CI: 8.28-10.11; Z = 19.75; P < .00001). Adverse events were not mentioned in the 8 trials. CONCLUSION HGWD alone or HGWD plus other treatment may be helpful to patients with CR. However, the methodological quality of the randomized controlled trials was generally low. Larger and better-designed randomized controlled trials are recommended.
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Affiliation(s)
- Long Liang
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
| | - Xu Wei
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
| | - Minshan Feng
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
| | - Liguo Zhu
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
| | - Jie Yu
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
| | - Gongbo Yang
- Department of Traumatology and Orthopedics, Xiyuan Hospital of Chinese Academy of Chinese Medical Sciences, Haidian District, Beijing
| | - Xunlu Yin
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
| | - Shuaiqi Zhou
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
| | - Kaiming Li
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District
| | - Mao Yang
- First Affiliated Hospital of Anhui University of Chinese Medicine, Shushan District, Anhui, China
| | - Xingyu Wang
- First Affiliated Hospital of Anhui University of Chinese Medicine, Shushan District, Anhui, China
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28
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Zheng Y, Yang F, Han L, Gou X, Lian F, Liu W, Zhao L, Pang B, Zhao X, Tong X. Efficacy of Chinese Herbal Medicine in the Treatment of Moderate-Severe Painful Diabetic Peripheral Neuropathy: A Retrospective Study. J Diabetes Res 2019; 2019:4035861. [PMID: 31950063 PMCID: PMC6948321 DOI: 10.1155/2019/4035861] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/12/2019] [Accepted: 11/29/2019] [Indexed: 02/07/2023] Open
Abstract
Painful diabetic peripheral neuropathy (pDPN) is a debilitating complication of diabetes. The aim of this retrospective study was to investigate the effectiveness of a Chinese herbal medicine regimen-the modified Huangqi Guizhi Wuwu Decoction (HGWD)-in the treatment of moderate-severe pDPN. The primary objective was to estimate the improvement in neuropathic pain severity. The secondary objective was to assess the response of common symptoms to the treatment. The change in patients' blood glucose level during the whole treatment was also evaluated. By searching through our medical records of all the diabetic patients from January 2006 to January 2012, we identified and enrolled 30 moderate and severe pDPN patients in the study, for whom the treatment of neuropathic pain by regular pharmacotherapies had failed. The modified HGWD treatment was administered orally twice a day for 6 months. The numerical rating scale (NRS) level at month 6 was 2.57 ± 2.30, significantly improved compared with the baseline level of 6.03 ± 1.83 (P < 0.05). The amelioration of 3 common symptoms, namely, limb pain, limb numbness, and insomnia, was evident, and the major response of common symptoms at month 6 including limb pain, insomnia, and limb coldness was significantly increased compared with the results at month 3 (P < 0.05). Moreover, 2-hour postprandial blood glucose (2hPG) level decreased from 10.77 ± 1.29 mmol/L at baseline to 9.66 ± 0.60 mmol/L at month 6 (P < 0.05). No serious adverse events occurred throughout the treatment period. The modified HGWD was effective in the treatment of moderate and severe pDPN and can thus be offered as a new alternative treatment option for pDPN patients who failed to respond to regular pharmaceutical therapies.
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Affiliation(s)
- Yujiao Zheng
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
- Graduate School, Beijing University of Chinese Medicine, China
| | - Fan Yang
- Rehabilitation Hospital Affiliated to National Research Center for Rehabilitation Technical Aids, China
| | - Lin Han
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Xiaowen Gou
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
- Graduate School, Beijing University of Chinese Medicine, China
| | - Fengmei Lian
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Wenke Liu
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Linhua Zhao
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Bing Pang
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Xiyan Zhao
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Xiaolin Tong
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
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29
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Guan J, Wang L, Jin J, Chang S, Xiao X, Feng B, Zhu H. Simultaneous determination of calycosin-7-O-β-D-glucoside, cinnamic acid, paeoniflorin and albiflorin in rat plasma by UHPLC-MS/MS and its application to a pharmacokinetic study of Huangqi Guizhi Wuwu Decoction. J Pharm Biomed Anal 2019; 170:1-7. [DOI: 10.1016/j.jpba.2019.03.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/05/2019] [Accepted: 03/12/2019] [Indexed: 01/21/2023]
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30
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Huo J, Liu LS, Jian WY, Zeng JP, Duan JG, Lu XJ, Yin S. Stationary Treatment Compared with Individualized Chinese Medicine for Type 2 Diabetes Patients with Microvascular Complications: Study Protocol for a Randomized Controlled Trial. Chin J Integr Med 2018; 24:728-733. [PMID: 29915910 DOI: 10.1007/s11655-018-2987-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Microvascular complications in type 2 diabetes (T2DM), including diabatic retinopathy (DR), diabetic kidney disease (DKD), diabetic peripheral neuropathy (DPN) are the leading causes of visual loss, end-stage renal disease or amputation, while the current therapies are still unsatisfactory. Chinese medicine (CM) has been widely used for treating diabetic mellitus. However, most of the previous studies focused on the single complication. The role of CM treatment in T2DM patients with 2 or multiple microvascular complications is not clear. OBJECTIVE To appraise the curative effect of CM in T2DM patients with 2 or multiple microvascular complications, and to compare the effects of stationary treatment and individualized treatment in T2DM patients with microvascular complications. METHODS This trial will be an 8-center, randomized, controlled study with 8 parallel groups. A total of 432 patients will be randomized to 8 groups: DR study group (32 cases) and a corresponding control group (32 cases), DR+DKD study group (64 cases) and a corresponding control group (64 cases), DR+DPN study group (64 cases) and a corresponding control group (64 cases), DR+DKD+DPN study group (56 cases) and a corresponding control group (56 cases). The control group will receive stationary treatment, and the study group will receive individualized treatment based on CM syndrome differentiation in addition to stationary treatment. The study duration will be 50 weeks, comprising a 2-week run-in period, 24 weeks of intervention, and 24 weeks of follow-up. The outcomes will assess efficacy of treatment, improvement in CM symptoms, safety assessments, adherence to the treatment, and adverse events. CONCLUSION This study will provide evidence of evidence-based medicine for CM treatment in two or multiple microvascular complications caused by T2DM. (Registration No. ChiCTR-IPR-15007072).
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Affiliation(s)
- Jian Huo
- College of Ophthalmology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Li-Sha Liu
- Good Clinical Practice Center, the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Wen-Yuan Jian
- College of Ophthalmology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Jie-Ping Zeng
- Good Clinical Practice Center, the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Jun-Guo Duan
- College of Ophthalmology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
| | - Xue-Jing Lu
- College of Ophthalmology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Shuo Yin
- College of Ophthalmology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
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