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 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.

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.

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 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.

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.

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)

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。

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。

基于足三阴经筋理论的小针刀松解疗法联合桃红四物汤治疗早中期股骨头坏死研究

目的 研究在足三阴经筋理论指导下的闭合性小针刀松解疗法联合桃红四物汤治疗早中期股骨头坏死的临床效果。方法 选取2020年6月至2023年6月在该院就诊的72例早中期股骨头坏死患者作为研究对象,对其临床资料进行回顾性分析。根据治疗方案不同将患者分为2组,其中38例接受足三阴经筋理论指导下的闭合性小针刀松解疗法联合桃红四物汤治疗(观察组),另34例接受常规闭合性松解术治疗(对照组)。比较2组治疗效果,以及治疗前后髋关节功能、疼痛程度及生活质量评分。结果 观察组患者整体疗效优于对照组,差异有统计学意义(P<0.05)。治疗后3、6个月时,观察组患者Harris髋关节功能评分高于对照组,视觉模拟评分法评分低于对照组,差异均有统计学意义(P<0.05)。治疗后6个月时,观察组患者生理功能、躯体疼痛、活力、情感职能、社会功能、生理职能、精神健康及总体健康等简明健康状况调查问卷评分显著高于对照组,全血黏度高切、低切及血浆黏度水平均低于对照组,差异均有统计学意义(P<0.05)。结论 基于足三阴经筋理论指导下的小针刀松解术联合桃红四物汤治疗早中期股骨头坏死患者效果显著,有助于改善患者血液流变学,减轻躯体疼痛,提高患者生活质量。

中药坐浴温度对混合痔外剥内扎术后患者舒适度及并发症的影响

目的观察中药坐浴不同温度对混合痔外剥内扎术后患者舒适度和并发症的影响。方法将90例混合痔外剥内扎术后患者随机分为38℃组29例、42℃组31例、45℃组30例,所有患者从术后第1天起,每日在排便后或换药前坐浴1次,10 min/次,疗程均为7 d。观察比较舒适度、舒适状况量表(GCQ)评分、创面水肿评分、疼痛视觉模拟评分法(VAS)评分及创面愈合时间情况。结果①试验期间,各组均未出现脱落或剔除病例,90例患者全部完成试验。②术后第1、3、5、7天组内比较,各组坐浴后舒适度显著提高(P<0.05)。③组间术后第1天比较,GCQ总分及各个子项评分差异均无统计学意义(P>0.05)。组间术后第7天比较,环境评分差异无统计学意义(P>0.05);42℃组生理、心理评分显著高于38℃组和45℃组(P<0.05)。④组间术后第1、3、5天比较,创面水肿评分差异无统计学意义(P>0.05);术后第7天比较,45℃组创面水肿评分显著高于38℃组及42℃组(P<0.05)。⑤在疼痛VAS评分、创面愈合时间方面,各组间比较差异均无统计学意义(P>0.05)。结论混合痔外剥内扎术后使用中药坐浴能够提高患者舒适度,且坐浴温度为42℃时更显著,较高温度(45℃)无益于缓解创面水肿等术后并发症。

穴位贴敷联合中药足浴治疗老年原发性高血压睡眠障碍临床疗效

目的观察穴位贴敷联合中药浴足治疗老年原发性高血压睡眠障碍患者的临床疗效。方法选择2022年1月至2023年1月收治的82例老年原发性高血压睡眠障碍患者为研究对象,对照组41例予西医常规干预措施,治疗组41例在对照组的基础上加用穴位贴敷联合中药浴足治疗干预。2组均治疗3周后统计疗效,比较2组治疗前后匹兹堡睡眠质量指数(PSQI)(包括睡眠障碍、日间功能、入睡时间、睡眠效率、睡眠时间、睡眠质量及安眠药物)评分、血压水平(包括收缩压和舒张压)及简易精神状态量表(MMSE)评分变化情况。结果治疗组总有效率97.56%(40/41),对照组总有效率78.05%(32/41),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后PSQI睡眠障碍、日间功能、入睡时间、睡眠效率、睡眠时间、睡眠质量及安眠药物评分均降低(P<0.05),且治疗组治疗后PSQI各项评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后收缩压及舒张压均降低(P<0.05),且治疗组治疗后收缩压及舒张压均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后MMSE评分均升高(P<0.05),且治疗组治疗后MMSE评分高于对照组(P<0.05)。结论穴位贴敷联合中药浴足治疗老年原发性高血压睡眠障碍临床疗效确切,可有效改善患者睡眠障碍情况,降低血压,提高认知功能。

疏经通督推拿结合中药熏洗对中风偏瘫患者肢体肿胀的疗效

目的:分析疏经通督推拿结合中药熏洗对中风偏瘫患者肢体肿胀的疗效。方法:选取2021年7月—2023年7月南宁市第二人民医院中医科收治的80例中风偏瘫肢体肿胀患者,按病案号随机分为观察组和对照组,各40例。对照组给予中药熏洗治疗,观察组在对照组的基础上联合疏经通督推拿治疗,观察两组治疗前后手足肿胀程度、足背血流动力学、偏瘫手精细动作运动协调能力与感觉功能、手足功能、临床疗效、患肢运动功能、日常生活能力。结果:干预后,两组手肿胀程度、足肿胀程度均低于干预前,血管内径、血流量和峰值流速均高于干预前,且观察组手肿胀程度、足肿胀程度均低于对照组,血管内径、血流量和峰值流速均高于对照组,差异有统计学意义(P<0.05)。干预后,两组运动协调能力评分、感觉功能评分、Broetz手功能评分、Maryland足功能评分、患肢运动功能评分、改良Barthel指数(MBI)评分均高于干预前,且观察组均高于对照组,差异有统计学意义(P<0.05)。观察组总优良率高于对照组,差异有统计学意义(P<0.05)。结论:疏经通督推拿结合中药熏洗治疗能够减轻中风偏瘫患者手足肿胀程度,改善患者足背血流动力学,调节偏瘫手精细动作运动协调能力、感觉功能与手足功能,改善患肢运动功能,提升患者日常生活能力。

手足综合征的中西医防治概况

手足综合征是肿瘤患者接受化疗或分子靶向治疗后出现的特异性皮肤毒性反应,以手足皮肤红肿、疼痛、脱屑、溃疡,伴麻木、疼痛等感觉异常为特点。手足综合征的中医疗法以口服汤药、中药浸洗为主,辅以针灸等非药物手段;西医疗法则以药物对症处理为主,如控制炎症、改善血供,同时配合健康宣教、剂量控制等综合措施。研究发现,中西医防治手足综合征存在相似的作用机制,中西医联合治疗手足综合征有望成为一种可靠选择。参考文献69篇。

中医导引术联合中西医结合疗法对2型糖尿病足溃疡康复的影响

目的评估中医导引术联合中西医结合治疗对2型糖尿病足溃疡康复的疗效。方法回顾性分析2017年1月至2021年4月在首都医科大学附属北京中医医院接受治疗的71例2型糖尿病足溃疡患者资料。患者按治疗方法分导引组(36例)和对照组(35例),其中导引组接受导引术结合中西医结合疗法,对照组仅接受中西医结合疗法,比较两组患者的疗效和相关临床指标。结果对照组治疗后心功能分级、降钙素原(procalcitonin,PCT)和C反应蛋白(C-reactive protein,CRP)指标和治疗前的差异有统计学意义(P<0.05),而导引组的踝肱指数(ankle brachial index,ABI)、经皮氧分压(transcutanous oxygen pressure,TcPO2)、疼痛评分、跛行距离、心功能分级、PCT和CRP等指标和治疗前比较差异有统计学意义(P<0.05)。两组患者治疗后ABI、TcPO2、疼痛评分、跛行距离、心功能分级和CRP指标的差异有统计学意义(P<0.05)。导引组患者出现不良事件25次,发生率1.15%,无跌倒损伤、骨折及膝、踝关节损伤等情况出现。结论导引术结合中西医结合疗法对2型糖尿病足溃疡康复具有积极的影响,在促进创面愈合、改善疼痛、缓解炎症、改善心脏功能方面显出益处。