Advances in the treatment of diabetic peripheral neuropathy by modulating gut microbiota with traditional Chinese medicine

Diabetic peripheral neuropathy(DPN)is one of the strongest risk factors for diabetic foot ulcers(neuropathic ulcerations)and the existing ulcers may further deteriorate due to the damage to sensory neurons.Moreover,the resulting numbness in the limbs causes difficulty in discovering these ulcerations in a short time.DPN is associated with gut microbiota dysbiosis.Traditional Chinese medicine(TCM)compounds such as Shenqi Dihuang Decoction,Huangkui Capsules and Qidi Tangshen Granules can reduce the clinical symptoms of diabetic nephropathy by modulating gut microbiota.The current review discusses whether TCM compounds can reduce the risk of DPN by improving gut microbiota.

Research progress in the treatment of diabetic foot with traditional Chinese medicine

Diabetic foot is one of the chronic complications of diabetes,which is serious and expensive to treat.As an effective method for treating diabetic foot,Chinese medicine plays an important role in improving the clinical symptoms and reducing the suffering of diabetic foot patients.The methods of traditional Chinese medicine to treat diabetic foot include internal treatment method,external treatment method and comprehensive therapy.This article reviews the research results of traditional Chinese medicine treatment of diabetic foot in order to provide reference for the treatment of diabetic foot.

The effect of foot bath of Chinese medicine combined with acupoint injection for diabetic peripheral neuropathy:a meta analysis

Objective:The aim of this systematic review was to assess the effect of foot bath of Chinese medicine combined with acupoint injection(FBCMCAI)on patients with diabetic peripheral neuropathy(DPN).Methods:Databases such as Cochrane Library,Pubmed,Web Of Science,China Biology Medicine(CBM),CNKI,VIP and WANFANG DATA were electronically searched to collect the randomized controlled trials(RCTs)(up to October 2016).According to the inclusion and exclusion criteria,literature about effects of FBCMCAI in the treatment of DPN were screened and data were extracted.Literature quality evaluation was appliced by Cochrane Reviewer Handbook 5.1.0.A random or a fixed effects model was used to analyze outcomes by RevMan 5.3 software.Subgroup analysis,sensitivity analysis,and orientation description were performed if necessary.Results:11 randomized controlled trials with a total of 927 patients were included.Meta analysis results revealed that the efficacy of FBCMCAI for DPN was significantly superior to the control treatment(OR=5.07,95%CI:3.23-7.94,Z=7.08,P<0.00001).Besides,there was an increase in motor conduction velocity of peroneal nerve(SMD=1.08,95%CI:0.66-1.48,Z=5.30,P<0.00001),motor conduction velocity of tibial nerve(SMD=1.08,95%CI:0.58-1.58,Z=4.22,P<0.0001)and motor conduction velocity of median nerve(SMD=0.46,95%CI:0.23-0.68,Z=3.96,P<0.0001)in FBCMCAI groups.For another,there was also an increase in sensory motor conduction velocity of the motor nerve(SMD=0.80,95%CI:0.54-1.05,Z=6.06,P<0.00001)and sensory motor conduction velocity of median nerve(SMD=0.66,95%CI:0.38-0.93,Z=4.73,P<0.00001)in the FBCMCAI groups.Symptoms score was significantly reduced after FBCMCAI treatment(WMD=-4.21,95%CI[-4.95,-3.48],Z=11.25,P<0.00001).Conclusion:FBCMCAI may have significant therapeutic efficacy for the treatment of DPN.Diabetic neurologic symptoms and nerve conduction velocities can be improved under FBCMCAI treatment.In-depth research and high quality randomized controlled trials on the efficacy of FBCMCAI are necessary.

Advances in traditional Chinese medicine as adjuvant therapy for diabetic foot

Diabetes mellitus(DM)is a complex disease that often causes multiple systemic complications that have become a major international public health problem.Diabetic foot(DF)is one of the severe and frequent chronic complications of DM due to vascular lesions and neuropathy.DF ulcers(DFU)affect approximately 15%of people with DM and are the leading cause of death and disability.The prevalence and recurrence of DF are worrisome,and morbidity and mortality are also on the rise,which poses a substantial socioeconomic burden.Treating DF is difficult for clinicians and requires multidisciplinary cooperation,combining local and systemic therapy to reduce amputation and case-fatality rates.Traditional Chinese Medicine(TCM)has received extensive attention due to noticeable therapeutic effects and few adverse reactions.In recent years,research on DF treatment by TCM has been increasing,and further progress has been made.TCM includes oral medication,injectable preparations,and adjuvant therapy.This article reviews the relevant research on TCM-related adjuvant therapy for DF.We describe current progress in TCM in terms of external application,acupuncture,massage,acupoint injection,foot bath,fumigation,and moxibustion,as well as the mechanisms involved.

Quantitative and Qualitative Investigation of Traditional Chinese Medicine Nursing Protocols for Type 2 Diabetes Mellitus

Objective:To analyze the implementation status of traditional Chinese medicine(TCM)nursing protocols for type 2 diabetes mellitus.Methods:Totally 420 hospitalized patients with type 2 diabetes mellitus were given TCM nursing protocols by syndrome differentiation.A quantitative and qualitative investigation was conducted to patients who received TCM nursing and nurses who performed TCM nursing techniques.Results:According to the self-evaluation outcomes of patients,TCM nursing protocols were effective to relieve polydipsia,polyuria,fatigue and other symptoms.Patients exhibited a high level of compliance with nursing techniques such as auricular point pressing,acupoint massage,Chinese herbal foot-bath and moxibustion.The interview showed that patients could benefit from the TCM nursing protocols,and nurses considered that application of TCM nursing protocols could enhance their awareness of TCM knowledge and practice skills.Conclusion:The application of TCM nursing protocols is effective to relieve clinical symptoms of type 2 diabetes mellitus.It can also improve the knowledge level and practice skills of nurses in TCM hospitals.

Evaluation on Common Hand, Foot and Mouth Disease Treated by Integrative Traditional Chinese Medicine and Western Medicine

Objective To evaluate the efifcacy and safety of traditional Chinese medicine (TCM) combined with Western medicine in the treatment of patients with common hand, foot and mouth disease (HFMD) by conducting a prospective, controlled, and randomized trial. Methods A total of 452 patients with common HFMD were randomly assigned to receive Western medicine alone (n=220) or combined with TCM (Reduning or Xiyanping injections) (n=232). The primary outcome was the incidence rate of rash/herpes disappearance within 5 days, while secondary outcomes included the incidence rate for fever, cough, lethargy, agitation, and vomiting clearance within 5 days. Results The rash/herpes disappearance rate was 45.5% (100/220) in Western medicine therapy group, and 67.2% (156/232) in TCM and Western medicine combined therapy group, with significant difference (P<0.001). Moreover, TCM remarkably increased the incidence rate of secondary disappearance, which was 56.4%in Western medicine therapy group and 71.4%in TCM and Western medicine combined therapy group (P=0.001). No drug-related adverse events were observed. Conclusions It’s suggested that the integrative TCM and Western medicine therapy achieved a better therapeutic efficacy. TCM may become an important complementary therapy on relieving the symptoms of HFMD.

The effects of Buyang Huanwu decoction combined with Western medicine in diabetic foot treatment:a systematic review and meta-analysis

Objective:Systematically evaluate the effect of Buyang Huanwu decoction(BHD)combined with Western medicine(WM)in treating diabetic foot(DF).Methods:Randomized controlled trials that examined the effects of BHD on DF were collected from various databases,including CBM,PubMed,EMBASE,Web of Science,CNKI,Wanfang,and Weipu.Two researchers evaluated the quality of the literature and extracted relevant data,which was then analyzed using RevMan 5.3 for meta-analysis.The analysis was carried out in accordance with the 2020 PRISMA checklist.Results:The study analyzed 19 articles involving 1284 patients.According to the meta-analysis,BHD combined with WM improved clinical efficacy and reduced traditional Chinese medicine syndrome scores,glycosylated hemoglobin,and fibrinogen levels in DF patients.Although the BHD combined with WM showed a trend towards reducing wound area,the difference was not significant.Additionally,the incidence of adverse reactions did not show a significant decrease with BHD combined with WM.Conclusion:The findings of the study indicated that the use of BHD combined with WM yielded better therapeutic outcomes than WM alone,supporting the recommendation of using BHD with WM for DF treatment.This approach is suggested for further clinical application and promotion.

Effect and Safety of Herbal Medicine Foot Baths in Patients with Diabetic Peripheral Neuropathy:A Multicenter Double-Blind Randomized Controlled Trial

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.Chi CTR-IOR-16009331)

More studies are necessary to establish the effectiveness of Jinhuang powder in the treatment of diabetic foot

Diabetes mellitus is a common global public health problem that can cause serious illness and premature death.Diabetic foot ulcer,one of the complications of diabetes,is a major cause of morbidity and mortality and is associated with many other devastating complications.Previous study found that a group of traditional Chinese medicine(TCM)can be used for treating diabetic foot ulcers.More and more attention is being paid to the use of Chinese medicine to heal diabetic feet.Under the guidance of relevant theories of traditional Chinese medicine,more studies are needed to reveal the key active components and related signal pathways of TCM in the treatment of diabetic foot ulcer.One clinical study explored the treatment of diabetic foot with infection combined moist exposed burn ointment with Jinhuang powder.However,large-scale multi-center,double blind,randomized,placebo-controlled clinical trials and animal studies are necessary to establish the effectiveness of Jinhuang powder in the treatment of diabetic foot.

中药熏洗坐浴护理与情志护理对肛肠术后患者疼痛程度的影响

目的分析中药熏洗坐浴护理+情志护理应用于肛肠术后患者中的护理效果。方法选取2022年1月至2023年12月厦门市中医院收治的170例肛肠术后患者,采用随机数字表法分为两组,各85例,对照组实施高锰酸钾坐浴+常规护理,观察组实施中药熏洗坐浴护理+情志护理,对比两组术后恢复情况、心理负面情绪评分、血清炎性指标、生活质量评分、护理满意度情况。结果观察组水肿、疼痛、渗出物消失时间和创面愈合时间比对照组短(P<0.05),VAS、SAS及SDS评分低于对照组(P<0.05),观察组干预后血清炎性指标均低于对照组(P<0.05),观察组干预后生活质量评分高于对照组(P<0.05)。结论肛肠术后患者中应用中药熏洗坐浴护理+情志护理,可以为患者提供更好的护理服务,减轻患者术后疼痛,改善患者心理负面情绪,控制术后炎症反应,促进患者创面尽快恢复,进一步提升患者生活质量。

Safety and effectiveness of Traditional Chinese Medicinal herbs for diabetic foot:a systematic review and Meta-analysis

OBJECTIVE: To evaluate the safety and effectiveness of traditional Chinese medicinal herbs(TCMHs) as an adjunctive treatment for diabetic foot(DF).METHODS: The sources used were Pub Med(1966 to August 2015), the Cochrane Library(1988 to August 2015), the Excerpta Medica Database(1974 to August 2015), Wiley(1807 to August 2015), Ovid(1988 to August 2015), Clinical Trials.gov(1993 to August 2015), the Cochrane Central Register of Controlled Trials(1966 to August 2015), China Science and Technology Journal Database(1994 to August2015), Chi CTR(2007 to August 2015), Sino Med(1978 to August 2015), the China National Knowledge Infrastructure(1984 to August 2015), Wanfang Data Knowledge Service Platform(1998 to August 2015), and the Traditional Chinese Medical Literature Analysis and Retrieval System(TCMLARS)(1984 to August 2015). Studies were identified and selected, and the data were extracted by two independent reviewers. The Cochrane Risk of Bias tool was used to assess the quality of studies. Revman 5.2 software was used for data synthesis and analysis.RESULTS: Sixteen studies were included based on the selection criteria. Of these, seven studies had low bias risk and one had high bias risk. In the overall analysis, TCMHs resulted in a significantly higher total effective rate(OR 5.08; 95% CI 3.50 to7.36; P < 0.000 01), cure rate(OR 2.12; 95% CI1.63 to 2.77; P < 0.000 01), and shorter time to ulcer healing(SMD-0.64; 95% CI-0.89 to-0.40;P < 0.000 01) when compared with non-TCMHs treated DF. The analysis also revealed that significantly fewer amputations occurred in TCMHs patients(OR 0.36; 95% CI 0.20 to 0.65; P = 0.0007).Sensitivity analysis indicated that the findings of the Meta-analysis were robust to study quality,and the funnel plot of the Egger test showed no publication bias.CONCLUSION: TCMHs intervention appears to be more effective for DF, with a similar safety profile,when compared with non-TCMHs treatments, although this result requires further verification with more well-designed studies.

Recent Advances in TCM Treatment of Diabetic Gangrene

Diabetic gangrene (DG) is a severe complication of diabetes.Clinically, it is characterized by pain in the distal end of the extremities, infection, ulceration, gangrene, and even dactylolysis (of the fingers and toes). DG has become the most important reason for amputation for non-traumatic patients.About half of patients receiving amputation are DG patients each year. In recent years TCM doctors have made a great deal of clinical trials on DG and achieved significant curative effects. Following is a brief summary of the literature concerned.

龙胆汤联合足浴治疗脑卒中后失眠临床观察

目的研究龙胆汤内服联合足浴在脑卒中后失眠老年患者中的临床疗效。方法选取66例脑卒中后失眠患者,随机分为对照组和观察组,每组33例。对照组采用艾司唑仑片口服治疗,观察组采用龙胆汤内服联合足浴治疗。疗程均为4周,比较2组患者的临床疗效。结果治疗后观察组总有效率为93.94%(31/33),明显高于对照组的66.67%(22/33),差异有统计学意义(P<0.01)。结论采用龙胆汤内服联合足浴治疗脑卒中后失眠,可有效改善患者睡眠质量,且无明显不良反应,值得临床推广。

中药足浴联合西药降糖治疗糖尿病周围神经病变临床观察

目的观察中药足浴联合西药降糖治疗糖尿病周围神经病变的临床效果。方法回顾性选取2021年9月—2023年5月江西省宜丰县人民医院收治的糖尿病周围神经病变患者62例,分为西医降糖药常规治疗联合中药足浴治疗组(联合治疗组)、西医降糖药常规治疗组(常规治疗组)两组,各31例。比较两组中医证候积分,凉温感觉阈值,血糖、血脂水平,震动感觉阈值(VPT),疼痛觉阈值,间歇性跛行距离分级。结果联合治疗组患者的疼痛感、麻木感、烧灼感、异样感积分及中医证候总积分,凉感觉阈值、温感觉阈值,空腹血糖、餐后2 h血糖、胆固醇、三酰甘油水平,足背VPT、第一足趾VPT、疼痛觉阈值均低于常规治疗组(P<0.05)。联合治疗组患者的间歇性跛行距离分级1级比率高于常规治疗组,2级、3级、4级比率均低于常规治疗组(P<0.05)。联合治疗组患者的总缓解率96.77%(30/31)高于常规治疗组的70.97%(22/31)(P<0.05)。结论糖尿病周围神经病变应用西医降糖药常规治疗联合中药足浴治疗的临床效果较西医降糖药常规治疗好。

ADVANCES IN TCM TREATMENT OF DIABETIC ACROMELIC GANGRENE

Diabetic acromelic gangrene is a kind of ischemic necrosis developed in extremities of the diabetic patients. It occurs frequently in the lower extremities, hence known as 'diabetic foot'. According to the reports in China, the incidence rate is about 0.9-1.7% in the diabetic patients, and ac-

足全息疗法治疗失眠的临床应用

足全息疗法,属于生物全息疗法,也是微针疗法的一种,该疗法具有一定历史源流,随着时代的发展与进步,其理论基础不断完善,中医学和现代医学均有其作用机制的相关阐述。足全息疗法适用于多种临床疑难病症,尤其是神经系统疾病。失眠作为一种精神心理疾病,严重困扰并影响人们的生活与工作,有研究证实足全息疗法在改善睡眠方面疗效较好。因此,此文总结足全息疗法治疗失眠的理论基础及具体临床操作,为临床诊疗提供参考。

中药沐足及护理干预对糖尿病周围神经病变的影响

目的:探析中药沐足及护理干预对糖尿病周围神经病变(DPN)的影响。方法:在我院就诊的DPN患者中选取120例(时间:2022年1月—2022年12月),120例入选者均行综合治疗,以治疗原则为依据分组,对照组60例行常规护理,观察组60例行中药沐足+护理干预,分析组间治疗效果。结果:治疗后,观察组治疗总有效率较对照组高(P<0.05);观察组MCV、SCV等指标水平较对照组高(P<0.05),观察组满意度较对照组高(P<0.05)。结论:DPN患者接受中药沐足及护理干预能有效改善患者的疾病症状,足部神经传导功能改善,满意度提高,值得推荐。

中药足浴对结直肠癌术后疲劳综合征(气滞血瘀型)的影响

目的观察中药足浴对气滞血瘀型结直肠癌术后疲劳综合征(POFS)的影响,探讨中药足浴在加速康复外科治疗气滞血瘀型结直肠癌POFS的价值。方法纳入100例符合诊断标准的患者,随机分2组,各50例。对照组采取围手术期加速康复外科干预措施;试验组在对照组的基础上加用中药足浴,2组均干预14 d。比较干预前后2组患者中医证候积分、围手术期疲劳评定量表(ICFS)评分、视觉模拟评分量表(VAS)评分和血清白蛋白(ALB)水平。结果治疗后,2组患者中医证候积分、ICFS评分和VAS评分均明显改善(P<0.05),且观察组优于对照组(P<0.05);治疗后,试验组ALB水平优于治疗前,差异有统计学意义(P<0.05)。结论中药足浴有助于改善气滞血瘀型结直肠癌POFS,利于术后快速康复。

中医传统特色外治疗法在糖尿病周围神经病变患者中的应用进展研究

糖尿病周围神经病变(Diabetic Peripheral Neuropathy, DPN)广泛存在于糖尿病患者群体中,患者通常存在下肢麻木疼痛等感觉异常。DPN患者临床症状诸多,严重影响生活质量。临床针对DPN患者治疗方式多采用口服药物治疗为主,其临床应用效果具有一定局限性。中医传统特色外治法的出现为DPN治疗领域工作开展提供新思路,诸多特色外治疗法应用方式及功效均存在差异。该文主要从DPN发病机制及临床症状、中医对DPN的认识及中医传统特色外治疗法技术优势3个方面探究DPN及外治疗法临床应用意义,并从膏摩疗法、推拿疗法及针刺疗法3个维度探究外治法应用效果。以此为DPN患者治疗提供重要技术参考,满足DPN患者群体个性化治疗需求,凸显传统中医在治疗DPN领域中的价值。

中药足浴对原发性高血压患者降压效果的Meta分析

目的系统评价中药足浴对原发性高血压患者的降压效果及不良反应分析。方法检索中国知网(CNKI)、万方数据(Wanfang Data)、维普网(VIP)、PubMed等数据库,搜集中药足浴对原发性高血压患者的随机对照干预研究(RCT),检索时限为建库至2023年8月15日。按Cochrane系统评价方法,由2位评价者按照文献纳入条件独立筛选文献、提取数据,并采用Cochrane风险评估工具进行文献质量评价,采用RevMan5.3软件进行Meta分析。结果本研共纳入9个RCT,合计762例患者。经Meta分析结果显示:中药足浴可改善原发性高血压患者收缩压(MD=-7.13,95%CI-8.10~-6.17,P<0.00001)及舒张压(MD=-7.11,95%CI-10.04~-4.17,P<0.00001),其降压效果显著(OR=4.48,95%CI 2.30~8.72,P<0.00001),并且未见明显不良反应。结论现有证据表明,中药足浴治疗原发性高血压具有良好的有效性与安全性,可作为一种很好的辅助治疗措施。