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 searc...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 HQbased 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<0.00001]or HQ-based TCM combined with Western Medicines[RR=1.25,95%CI(1.19,1.31),P<0.00001]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<0.00001],and reduced serum interleukin 6[SMD=-0.57,95%CI(-0.87,-0.27),P=0.0002]and tumor necrosis factors-αlevels[SMD=-0.60,95%CI(-0.95,-0.25),P=0.0009].In addition,both HQ-based TCM and HQbased 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.展开更多
Background:To explore the action mechanism of Huangqi(Radix Astragali)and Shanzhuyu(Fructus Corni)in the treatment of diabetic nephropathy based on network pharmacology,aiming to provide a basis for clinical applicati...Background:To explore the action mechanism of Huangqi(Radix Astragali)and Shanzhuyu(Fructus Corni)in the treatment of diabetic nephropathy based on network pharmacology,aiming to provide a basis for clinical application.Methods:The main active components of Huangqi and Shanzhuyu were discerned through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),Traditional Chinese Medicine Integrated Database(TCMID).The targets related to diabetic nephropathy(DN)were obtained using Genecards,Therapeutic Target Database(TTD),and National Center for Biotechnology Information(NCBI)Gene.Subsequently,protein-protein interaction(PPI)networks were constructed with Cytoscape 3.7.2 and the STRING database.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analyses were performed to analyze the intersection of targets via Database for Annotation,Visualization,and Integrated Discovery(DAVID)6.8.Built on the above analysis,we made a“Chinese medicine-chemical composition-target gene-disease”network.Results:Twenty-one active components were predicted from the Huangqi and Shanzhuyu herb pair,such as jaranol,mandenol and sitosterol.These components were applied to 41 targets mainly involved in many biological processes such as the PI3K-Akt signaling pathway,vascular endothelial growth factor(VEGF)signaling pathway,regulation of sodium ion transport and steroid-binding.Conclusion:This study proposes the network pharmacology method and identifies the potent combination therapeutic mechanism of Huangqi and Shanzhuyu for diabetic nephropathy(DN)through multiple targets and routes,this strategy will lay a good foundation for further in-depth study of the mechanism of action.展开更多
文摘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 HQbased 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<0.00001]or HQ-based TCM combined with Western Medicines[RR=1.25,95%CI(1.19,1.31),P<0.00001]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<0.00001],and reduced serum interleukin 6[SMD=-0.57,95%CI(-0.87,-0.27),P=0.0002]and tumor necrosis factors-αlevels[SMD=-0.60,95%CI(-0.95,-0.25),P=0.0009].In addition,both HQ-based TCM and HQbased 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.
文摘Background:To explore the action mechanism of Huangqi(Radix Astragali)and Shanzhuyu(Fructus Corni)in the treatment of diabetic nephropathy based on network pharmacology,aiming to provide a basis for clinical application.Methods:The main active components of Huangqi and Shanzhuyu were discerned through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),Traditional Chinese Medicine Integrated Database(TCMID).The targets related to diabetic nephropathy(DN)were obtained using Genecards,Therapeutic Target Database(TTD),and National Center for Biotechnology Information(NCBI)Gene.Subsequently,protein-protein interaction(PPI)networks were constructed with Cytoscape 3.7.2 and the STRING database.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analyses were performed to analyze the intersection of targets via Database for Annotation,Visualization,and Integrated Discovery(DAVID)6.8.Built on the above analysis,we made a“Chinese medicine-chemical composition-target gene-disease”network.Results:Twenty-one active components were predicted from the Huangqi and Shanzhuyu herb pair,such as jaranol,mandenol and sitosterol.These components were applied to 41 targets mainly involved in many biological processes such as the PI3K-Akt signaling pathway,vascular endothelial growth factor(VEGF)signaling pathway,regulation of sodium ion transport and steroid-binding.Conclusion:This study proposes the network pharmacology method and identifies the potent combination therapeutic mechanism of Huangqi and Shanzhuyu for diabetic nephropathy(DN)through multiple targets and routes,this strategy will lay a good foundation for further in-depth study of the mechanism of action.
