BACKGROUND Diabetes is a metabolic disease with a high complication rate.Diabetic foot ulcers(DFUs)seriously affect the quality of life of patients.A total of 15%-20%of diabetic patients develop DFUs,which heal with d...BACKGROUND Diabetes is a metabolic disease with a high complication rate.Diabetic foot ulcers(DFUs)seriously affect the quality of life of patients.A total of 15%-20%of diabetic patients develop DFUs,which heal with difficulty over a long time and can result in amputation and disability.Traditional Chinese medicine has a unique effect in the treatment of skin ulcerative diseases.Ruyi Jinhuang powder(RHP)is one of the classic prescriptions in traditional Chinese medicine and is widely used in clinical practice.AIM To verify the ability of RHP to promote wound healing by electron microscopy analysis in animal models and hematoxylin-eosin(HE)staining.The effective components of RHP were extracted and identified by gas chromatography-mass spectrometry(GC-MS),and the obtained chemical components were analyzed by network pharmacology methods to predict its therapeutic mechanism.METHODS Sprague Dawley rats were injected with streptozotocin to establish the DFU model.HE staining was used to observe the wound tissue under an electron microscope.The chemical constituents of RHP were extracted first by supercritical fluid extraction and alcohol extraction,and then,GC-MS and ultra-performance liquid chromatography–MS were used to separately identify the chemical constituents.In addition,the"herb-component-target"link was established through the Traditional Chinese Medicine Systems Pharmacology database to obtain the target information,and the molecular docking of important components and key targets was performed in Discovery Studio software.Cytoscape software was used to visualize and analyze the relationship between the chemical composition,targets and Traditional Chinese Medicine network.RESULTS RHP promoted DFU healing in rats by affecting fibroblasts and nerve cells.A total of 89 chemical components were obtained by GC-MS.Network pharmacological analysis revealed that RHP was associated with 36 targets and 27 pathways in the treatment of DFU,of which the important components were luteolin,trans caryophyllene,ar-turmerone,palmitic acid,methyl palmitate,gallic acid,demethoxycurcumin,berberine,and rheic acid.The key targets were posttranscriptional silencing,topoisomerase II alpha,muscarinic acetylcholine receptor M2,interleukin 6,tumor necrosis factor and retinoic X receptor alpha,and the key pathways were the phosphoinositide 3-kinase-protein kinase B signaling pathway,neuroactive ligand–receptor interactions,and the forkhead box O signaling pathway.CONCLUSION Our results indicated that RHP may play a role in the treatment of DFU through these target pathways by affecting insulin resistance,altering the nervous system and immune system,participating in inflammatory responses and regulating cell proliferation,differentiation and apoptosis through other specific mechanisms.展开更多
Background:Traditional Chinese Medicines(TCM)had been indicated to benefit for the chronic non-infectious diseases,such as cancers,hypertension,primary dysmenorrheal,etc.Although randomized controlled trials(RCTs)had ...Background:Traditional Chinese Medicines(TCM)had been indicated to benefit for the chronic non-infectious diseases,such as cancers,hypertension,primary dysmenorrheal,etc.Although randomized controlled trials(RCTs)had been conducted,there was still the controversy on the efficacy of Jinhuang powder for diabetic foot ulcers(DFUs).Objective:This systematic review aimed to objectively evaluate the potential of Jinhuang powder for DFUs.Methods:Seven databases(CNKI,Chongqing VIP,Wanfang database,CBM,the Cochrane Library,PubMed and Web of Science)were searched to retrieve RCTs up to December,2016;and the relevant references of the eligible studies were screened.According to the eligible criteria,the literature was screened;data were extracted;and then the methodological quality was assessed.The meta-analysis,power analysis and trial sequential analysis(TSA)were performed by using Meta analyst software(version beta 3.13),Stata 12.0,Power and Precision statistical software package(Biostat)and TSA software(version0.9),respectively.Results:Finally,three RCTs with 198 participants were included.The results of meta-analysis showed that there were statistically significant differences between groups in(1)the cure rate(RR,1.25;95%CI.1.10to1.41;P=0.00)and(2)the wound healing time(SMD,-3.404;95%CI,-5.821 to -0.987;P=0.00).Three trials presented more than 80% power with 0.05α-errors in both outcomes and the power of two meta-analyses to pool different outcomes presented more than 95%.The TSA showed that the summary results were certain.Conclusion:The external application with Jinhuang powder was an effective and cost-effective therapy for DFUs.The power analysis and TSA showed that the efficacy of Jinhuang powder dressing for the treatment of DFUs is conclusive.展开更多
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...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.展开更多
基金Supported by National Natural Science Foundation of China,No.82074025Scientific Research Project of Heilongjiang Health Committee,No.2020-293Scientific and Technological Innovation Project for College Students of Heilongjiang University of Chinese Medicine,No.2021-13.
文摘BACKGROUND Diabetes is a metabolic disease with a high complication rate.Diabetic foot ulcers(DFUs)seriously affect the quality of life of patients.A total of 15%-20%of diabetic patients develop DFUs,which heal with difficulty over a long time and can result in amputation and disability.Traditional Chinese medicine has a unique effect in the treatment of skin ulcerative diseases.Ruyi Jinhuang powder(RHP)is one of the classic prescriptions in traditional Chinese medicine and is widely used in clinical practice.AIM To verify the ability of RHP to promote wound healing by electron microscopy analysis in animal models and hematoxylin-eosin(HE)staining.The effective components of RHP were extracted and identified by gas chromatography-mass spectrometry(GC-MS),and the obtained chemical components were analyzed by network pharmacology methods to predict its therapeutic mechanism.METHODS Sprague Dawley rats were injected with streptozotocin to establish the DFU model.HE staining was used to observe the wound tissue under an electron microscope.The chemical constituents of RHP were extracted first by supercritical fluid extraction and alcohol extraction,and then,GC-MS and ultra-performance liquid chromatography–MS were used to separately identify the chemical constituents.In addition,the"herb-component-target"link was established through the Traditional Chinese Medicine Systems Pharmacology database to obtain the target information,and the molecular docking of important components and key targets was performed in Discovery Studio software.Cytoscape software was used to visualize and analyze the relationship between the chemical composition,targets and Traditional Chinese Medicine network.RESULTS RHP promoted DFU healing in rats by affecting fibroblasts and nerve cells.A total of 89 chemical components were obtained by GC-MS.Network pharmacological analysis revealed that RHP was associated with 36 targets and 27 pathways in the treatment of DFU,of which the important components were luteolin,trans caryophyllene,ar-turmerone,palmitic acid,methyl palmitate,gallic acid,demethoxycurcumin,berberine,and rheic acid.The key targets were posttranscriptional silencing,topoisomerase II alpha,muscarinic acetylcholine receptor M2,interleukin 6,tumor necrosis factor and retinoic X receptor alpha,and the key pathways were the phosphoinositide 3-kinase-protein kinase B signaling pathway,neuroactive ligand–receptor interactions,and the forkhead box O signaling pathway.CONCLUSION Our results indicated that RHP may play a role in the treatment of DFU through these target pathways by affecting insulin resistance,altering the nervous system and immune system,participating in inflammatory responses and regulating cell proliferation,differentiation and apoptosis through other specific mechanisms.
文摘Background:Traditional Chinese Medicines(TCM)had been indicated to benefit for the chronic non-infectious diseases,such as cancers,hypertension,primary dysmenorrheal,etc.Although randomized controlled trials(RCTs)had been conducted,there was still the controversy on the efficacy of Jinhuang powder for diabetic foot ulcers(DFUs).Objective:This systematic review aimed to objectively evaluate the potential of Jinhuang powder for DFUs.Methods:Seven databases(CNKI,Chongqing VIP,Wanfang database,CBM,the Cochrane Library,PubMed and Web of Science)were searched to retrieve RCTs up to December,2016;and the relevant references of the eligible studies were screened.According to the eligible criteria,the literature was screened;data were extracted;and then the methodological quality was assessed.The meta-analysis,power analysis and trial sequential analysis(TSA)were performed by using Meta analyst software(version beta 3.13),Stata 12.0,Power and Precision statistical software package(Biostat)and TSA software(version0.9),respectively.Results:Finally,three RCTs with 198 participants were included.The results of meta-analysis showed that there were statistically significant differences between groups in(1)the cure rate(RR,1.25;95%CI.1.10to1.41;P=0.00)and(2)the wound healing time(SMD,-3.404;95%CI,-5.821 to -0.987;P=0.00).Three trials presented more than 80% power with 0.05α-errors in both outcomes and the power of two meta-analyses to pool different outcomes presented more than 95%.The TSA showed that the summary results were certain.Conclusion:The external application with Jinhuang powder was an effective and cost-effective therapy for DFUs.The power analysis and TSA showed that the efficacy of Jinhuang powder dressing for the treatment of DFUs is conclusive.
基金supported by the Taizhou philosophy and social science planning project,No. 19GHZ05the Taizhou Science and technology planning project,No. 1902ky85
文摘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.
