Preparation Technology of Wuwei Xiaoke Granules

[Objectives]To optimize the extraction and preparation technology of Wuwei Xiaoke granules.[Methods]Taking the extraction rate of extract as the scoring standard,the water extraction technology was optimized by orthogonal test.The influence of the proportion of pharmaceutical excipients on the molding conditions of Wuwei Xiaoke granules was investigated using granule molding rate,solubility,moisture,granularity,water-soluble extract and microorganism examination as evaluation indicators,and the optimal molding technology was optimized.[Results]The extraction technology was soaking in water for 0.5 h and heat extraction twice for 1 h each time:adding 10 times the amount of water in the first time,and adding 8 times the amount of water in the second time.The best molding technology was:extract density 1.13-1.16(55-60℃),extract:soluble starch=1:2,and 0.15%stevioside.[Conclusions]The water extraction technology and granule molding technology optimized by orthogonal test are reliable and stable,with good granular characteristics,easy oral administration and good solubility,which can maximize the comprehensive quality of Wuwei Xiaoke granules,and provide an effective reference for the preparation and production of Wuwei Xiaoke granules.

Analysis of new therapeutic strategies for diabetes mellitus based on traditional Chinese medicine'xiaoke'formulae

Objective:To develop new therapeutic strategies for diabetes mellitus(DM)by analyzing the mechanisms of action of traditional Chinese medicine(TCM)'xiaoke'formulae(TCM prescriptions for remedying xiaoke).Methods:We characterized 291 xiaoke formulae,including the herbs contained,chemical composition,constituents'targets,and corresponding genes.Xiaoke-related genes were retrieved based on the relationships of constituents'targets and xiaoke formulae,and a threshold of over 95.88%occurrence of each constituent target in the 291 TCM formulae served as a definition for xiaoke-related genes.Upon comparison with DM-related genes in the DisGeNET database,the genes differing in expression between cases administered TCM and synthetic drugs were explored using a TCM grammar system.Results:The results showed that xiaoke formulae and 14 exclusively xiaoke-related genes were significantly associated with multiple biological processes closely related to DM and diabetic complications(P<.01).Moreover,intervention in the expression of these xiaoke-related genes would affect DM-related genes directly or indirectly.Conclusion:The 14 xiaoke-related genes APEX1,EHMT2,TSHR,CBX1,FEN1,GMNN,JUN,KMT2A,MAPT,POLl,USP1,PIN1,POLB,and POLK can serve as candidate genes for antidiabetic drug design.Compared with DM-related genes in DisGeNET,intervention in the expression of 14 xiaoke-related genes by TCM formulae has the potential to not only lower blood glucose,but also reduce the occurrence of some side effects and inhibit the development of diabetic complications.These findings will contribute to the discovery of new strategies for treating DM.

Effect of Huangqi Xiaoke Recipe combined with alprostadil on qi and yin deficiency type diabetic nephropathy and its effect on vascular endothelium and oxidative stress

Objective: To observe the clinical efficacy of Huangqi Xiaoke Decoction combined with alprostadil on qi and yin deficiency type diabetic nephropathy (DN) and its effect on vascular endothelium and oxidative stress. Methods: A total of 72 patients with qi and yin deficiency type DN who were admitted to the diabetes specialist ward and outpatient department of Baoan District Hospital of Shenzhen from January 2017 to July 2018 were enrolled. The patients were divided into the control group and the observation group according to the random number method. 36 cases in each group. Both groups were treated with conventional treatments such as hypoglycemic, hypotensive, lipid-lowering and anti-platelet aggregation. The control group was treated with alprostadil on the basis of conventional treatment. The observation group was given orally on the basis of the control group. Both groups were treated once a day for a total of 4 weeks. Compare the clinical syndrome scores and clinical efficacy of the two groups before and after treatment;fasting blood glucose (FPG), glycosylated hemoglobin (HbA1C), blood lipids (TC, TG, LDL, HDL), serum creatinine (SCr), blood urea nitrogen (BUN Endothelin-1 (ET-1), nitric oxide (NO), von Willebrand factor (vWF);glutathione peroxidase (GSH-Px), superoxide disproportionation The level of enzyme (SOD), malondialdehyde (MDA). Results:The total effective rate of TCM syndromes in observation group was 94.44%, which was significantly different from 72.22% in the control group. The scores of TCM syndromes in the observation group were significantly lower than those in the control group;Compared with the control group, the HDL-C of the observation group did not change much, there was no statistical difference;FBG, HbA1C, SCr, BUN, TC, TG, LDL-C, ET-1, vWF, MDA Significantly decreased, NO, GSH-Px, SOD increased significantly, with significant difference. Conclusion: Huangqi Xiaoke Decoction combined with alprostadil in the treatment of qi and yin deficiency type DN has significant curative effect, which can not only lower blood sugar, regulate blood lipids, improve renal function and clinical symptoms, but also inhibit oxidative stress and protect endothelial function.

Xiaoke Decoction in treatment of type Ⅱ diabetes:A Meta-analysis

Objective:To systematically evaluate the clinical effect of Xiaoke Decoction in the treatment of type 2 diabetes.Methods:Chinese databases such as CNKI,Wanfang,Weipu Chinese Biomedical Journal Database,and Chinese Medical Biological Literature Database,Pub Med,Cochrane Library,Embase,and Web of Science were searched for English language literature from their inception until November 2019.A Meta-analysis was performed using Rev Man 5.3 and Stata 12.0.Results:Thirty-eight studies were included in this study,with a total of 3757 patients.It was found that adding Xiaoke Decoction could improve total efficiency.The Xiaoke Decoction groups surpassed the western medicine groups regarding improvement in total efficiency(OR = 3.49;95% CI:2.78–4.39,P < 0.00001).Adding Xiaoke Decoction could lower the fasting plasma glucose(FPG) level.The Xiaoke Decoction groups surpassed the western medicine groups regarding reduction in FPG levels(MD =-1.14;95% CI:-1.36 to 0.92,P < 0.00001).Adding Xiaoke Decoction could lower the 2 h postprandial blood glucose(2 h PG) level.The Xiaoke Decoction groups surpassed the western medicine groups regarding reduction in 2 h PG(MD =-1.40;95% CI:-1.61 to 1.19,P < 0.00001).Adding Xiaoke Decoction could lower glycated hemoglobin(Hb A1 c).The Xiaoke Decoction groups surpassed the western medicine groups regarding reduction in Hb A1 c(MD =-0.77;95% CI:-0.95 to 0.58,P < 0.00001).It was found that adding Xiaoke Decoction could lower the traditional Chinese medicine(TCM) syndrome score.The TCM syndrome scores among patients in the Xiaoke Decoction group were lower than those among patients in the control group after treatment(MD =-4.90;95% CI:-7.22 to 2.57,P < 0.0001).At the same time,we conducted a subgroup and sensitivity analysis of age and intervention duration on the heterogeneity of total efficiency,FPG,2 h PG,Hb Alc,and TCM syndrome score outcome indicators.For detecting publication bias,an egger test was conducted.Conclusion:Compared with western medicine alone,Xiaoke Decoction has more advantages for the treatment of type 2 diabetes with respect to total efficiency,FPG,2 h PG,Hb Alc,and TCM syndrome score.

Jiangtang Xiaoke granule attenuates glucose metabolism disorder via regulating endoplasmic reticulum stress in the liver of type 2 diabetes mellitus mice

OBJECTIVE:To observe the effect of Jiangtang Xiaoke(JTXK) granule on endoplasmic reticulum(ER)stress in high fat diet(HFD)-induced type 2 diabetes mellitus(T2 DM) KK-Ay mice.METHODS:KK-Ay mice were fed with HFD to induce the T2 DM model,while normal control C57 BL/6 J mice were given standard feed.Fasting blood glucose(FBG) in all mice was measured weekly and oral glucose tolerance tests(OGTTs) were performed at 4 and 10 weeks after start of treatment to determine glucose metabolism.Serum fasting insulin(FINS) and insulin sensitivity index(ISI) were measured to determine insulin sensitivity.m RNA expressions of eukaryotic initiation factor-2 alpha(e IF2α),glucose regulated protein 78(GRP78),activating transcription factor 4(ATF4),and C/EBP homology protein(CHOP) were assessed by reverse transcription polymerase chain reaction and the protein expressions of p-e IF2α,GRP78,and CHOP were assessed by Western blotting.RESULTS:JTXK granule significantly reduced FBG and free fatty acid levels and improved OGTT at the120 min of the 10-week treatment in T2 DM KK-Ay mice.FINS and Hb Alc levels were reduced and insulin sensitivities were increased in KK-Ay diabetic mice,which were improved with the treatment of JTXK granule,especially at the 7 and 3.5 g/kg doses.JTXK granule at the 3.5 g/kg dose was most effective in reducing both gene and protein expressions of e IF2α,GRP78,and CHOP.CONCLUSION:ER stress response is increased in T2 DM KK-Ay mice.Treatment with JTXK granule attenuates glucose disorders,improves insulin sensitivity,and reduces serum FFA in T2 DM KK-Ay mice.The mechanisms may be attributed to regulation of the signaling ER stress pathway via decreasing e IF2α phosphorylation and suppressing e IF2α-ATF4-CHOP activation.

Effect of Xiaoke Granule(消渴冲剂) on Blood Sugar and Blood Rheological Property in Experimental Diabetic Animals

Objective:To study the pharmacological effect of Xiaoke Granule(XKG,消渴冲剂)on blood sugar and blood rheological property in the diabetic animals.Methods:Alloxan induced diabetic mice or rats were grouped randomly.The effects of XKG on blood sugar,appetite,capacity of drinking,glucose tolerance,blood lipid and blood rheological property were observed and compared among groups.Results:XKG showed a trend in reducing the appetite and capacity of drinking,increasing the body weight,and significantly inhibiting the increase of blood sugar coused by ectogenic glucose in mice,and could improve the blood lipid and blood rheological property in rats.Conclusion:XKG is effective in reducing serum total cholesterol,lowering the blood viscosity,improving the blood rheological property of alloxan induced diabetic animals.Therefore,it might effective in treating and preventing the occurrence of diabetes mellitus and the complications of blood stasis.