Meta-analysis of Xiaoxianxiong Decoction in the treatment of gastroesophageal reflux disease

Objective:To evaluate the clinical efficacy of Xiaoxianxiong Decoction in the treatment of gastroesophageal reflux disease.Methods:CNKI,Wan Fang,VIP,Sino Med,Cochrane Library and Pub were searched by computer Randomized controlled trials(RCTS)of Xiaoxianxiong Decoction in the treatment of gastroesophageal reflux disease(GERD)from the establishment of Med and other Chinese and English databases to December 2021.Literatures was screened and extracted according to the exclusion criteria,Cochranev5.1.0 bias risk assessment tool and modified Jadad scale were used to evaluate the quality of the included literatures,and Rev Man5.3 software was used for Meta-analysis.Results:(1)Eleven articles were included,including 873 patients;(2)Meta-analysis showed that the total effective rate of Xiaoxiangxiong Decoction in treating GERD was higher than that of the control group[P=0.89,I2=0%,OR=3.48,95%CI(2.29,5.30),Z=5.84,P<0.00001].Compared with other conventional western medicine therapies,acid reflux symptoms were significantly improved[WMD=-0.30,95%CI[-0.59,-0.01],Z=2.06,P=0.04(subgroup 1);WMD=-0.17,95%CI[-0.44,0.11],Z=1.18,P=0.24(subgroup 2);WMD=-0.17,95%CI[-0.44,0.11],Z=1.18,P=0.24(subgroup 2).WMD=-0.14,95%CI[-0.37,0.08],Z=1.23,P=0.22(subgroup3)];The recurrence rate was lower[OR=0.13,95%CI[0.05,0.37],Z=3.89,P<0.0001];There was no significant difference in the improvement of heartburn and retrosternal pain symptoms between the experimental group and the control group(P>0.05).Conclusion:Compared with other conventional western medicine therapies,Xiaoxianxiong Decoction has a higher total effective rate and lower recurrence rate in the treatment of Gastroesophageal reflux disease,and has certain advantages in alleviating acid reflux symptoms,but has no obvious advantages in improving heartburn and retrosternal pain symptoms.

System pharmacology-based dissection of the potential effective material basis and mechanism of Xiaoxianxiong decoction for type 2 diabetes mellitus

Background:Xiaoxianxiong decoction is a classic formula in traditional Chinese medicine used to treat type 2 diabetes mellitus and proven to be effective.But the material basis and underlying mechanisms remain unclear.The aim of the present study was to elucidate the potential effective material basis of Xiaoxianxiong decoction and molecular mechanism treating type 2 diabetes mellitus.Methods:The absorbed bioactive components were identified based on serum pharmacochemistry.Network analysis were performed to obtain effect targets for docking verification with the absorbed prototypes to determine the potential effective material basis.On the above basis,network pharmacology was conducted to explore the molecular mechanism.Results:76 compounds were identified of Xiaoxianxiong decoction and 61 absorbed bioactive compounds were investigated.Serine/threonine kinase 1 and ALB were key targets acquired by network analysis for molecular docking.Subsequently,5 compounds were considered as the potential effective material basis,namely berberine,berberrubine,lariciresinol and gingerenone A,jatrorrhizine.Further,the mechanism mainly lies in the insulin signaling pathway,HIF-1 signaling pathway,PI3K-Akt signaling pathway,FoxO signaling pathway,AGE-RAGE signaling pathway in diabetic complications,phospholipase D signaling pathway to regulate blood glucose levels on target tissues as well as organs and exhibit anti-inflammatory,promote cell differentiation and cell growth,maintain oxygen homeostasis and affect the enzymes along with key metabolites.Conclusion:This integrated research strategy to investigate the treatment of Xiaoxianxiong decoction on type 2 diabetes mellitus provides valuable insights for further study and clinical practice of Xiaoxianxiong decoction.