This study systematically collected, analyzed, and evaluated randomized controlled trial(RCT) in the treatment of diabetic foot ulcer(DFU). The aim as provide references for future studies and to enhance the application of clinical evidence. The RCT of DFU treated with Chinese Patent Medicine was obtained and analyzed using the AI-Clinical Evidence Database of Chinese Patent Medicine(AICED-CPM). The analysis was supplemented with data from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, and Web of Science. A total of 275 RCTs meeting the requirements were retrieved, with only 7 of them having a sample size of 200 or more. These trials involved 66 different Chinese patent medicine including 25 oral medications, 24 Chinese herbal injections, and 17 external drugs. Among the 33 different intervention/control designs identified, the most common design was Chinese patent medicine + conventional treatment vs conventional treatment(86 cases, 31.27%). Out of the 275 articles included in the literature, 50 did not provide information on the specific course of treatment(18.18%). A total of 10 counting indicators(with a frequency of 426) and 36 measuring indicators(with a frequency of 962) were utilized. The methodological quality of the RCT for the treatment of DFU with Chinese patent medicine was found to be low, with deficiencies in blind methods, other bias factors, study registration, and sample size estimation. There were noticeable shortcomings in the reporting of allocation hiding and implementation bias(blind method application). More studies should prioritize trial registration, program design, and strict quality control during implementation to provide valuable data for clinical practice and serve as a reference for future investigations.
Objective To analyze clinical efficacy of moxibustion therapy in the treatment of diabetic peripheral neuropathy.Methods According to the random number method,120 patients with diabetic peripheral neuropathy were selected in our hospital from June 2015 to October 2016 and were divided into control group (n=60) and observation group (n=60).The control group was treated with Mecobalamin oral drug treatment,and the observation group was treated with moxibustion.The sensory and motor nerve conduction velocities were measured before and after the treatment by electromyography,and the SF-36 quality of life scale (BP) score,VAS score and the effective rate of the treatment were recorded.Results Before treatment,the motor and sensory nerve conduction velocity of two groups had no significant difference (P>0.05);After treatment,motor and sensory nerve conduction velocity of two groups were significantly improved,but above indicators of the observation group was significantly better than the control group (P<0.05).Before treatment,VAS score and BP score of two groups had no significant difference (P>0.05);After treatment,VAS score and BP score for both groups were improved,but the observation group improved more than the control group (P<0.05).The total effective rate of the observation group was 85%,which was higher than 68.33% of the control group (P<0.05).Conclusion Moxibustion therapy in the treatment of diabetic peripheral neuropathy highlights the advantages of Chinese medicine,it can reduce injury of peripheral nerve in diabetic patients,improve the clinical treatment effect and the quality of life of patients,so it has better application prospect.
[Objective]A Meta-analysis of the efficacy and safety of tonifying kidney and promoting blood circulation in the treatment of chronic kidney disease.[Methods]By searching CNKI,VIP,Wanfang Data,SinoMed,PubMed,Web of Science databases,the kidney tonifying and blood circulation method combined with conventional Western medicine treatment was used as the test group,and the conventional Western medicine treatment group was used as the control group,and the related words such as"kidney and blood circulation","chronic kidney disease"were used as the search terms,and the randomized controlled trials were used as the retrieval targets.Relevant studies meeting the inclusion criteria were evaluated by the"risk of bias assessment"tool recommended by Cochrane Reviewer's Handbook 5.0.1,and the data were analyzed by Revman 5.4.1 software.[Results]In the 18 articles included,taking the clinical efficiency,blood creatinine,urea nitrogen,uric acid,glomerular filtration rate,severity of adverse reactions as outcome indicators,it was concluded that the efficacy of the experimental group was higher than that of the control group,with statistical difference(P<0.05).[Conclusion]The method of tonifying kidney and activating blood circulation has curative effect on chronic kidney disease.
[Objective]To investigate the protective effect and possible mechanism of Ciwujia Injection(CWJI)on myocardial tissue of rats with heart failure after acute myocardial infarction(HF-AMI).[Methods]The rat model with HF-AMI was established by ligation of the anterior descending branch of the left coronary artery,and model group,Captopril(CPT,10 mg/kg)group,CWJI low-dose(CWJI-L,15 mg/kg),medium-dose(CWJI-M,30 mg/kg),high-dose(CWJI-H,60 mg/kg)group,and the Sham group were set up,with 16 rats in each group.After 4 weeks of continuous administration once a day in each group,the cardiac function[left ventricular ejection fraction(LVEF),left ventricular short axis shortening rate(LVFS),maximum rate of rise and fall of left indoor pressure(+dp/dtmax,-dp/dtmax)]was detected by Doppler ultrasound and physiological signal acquisition system.The level of cardiac troponin(cTnI),angiotensinⅡ(AngⅡ)and aldosterone(ALD)in serum were determined by enzyme-linked immunosorbent assay(ELISA).The left ventricular myocardial hypertrophy index(LVHI)was calculated.The myocardial histopathological changes,apoptosis and tissue fibrosis were observed by HE,TUNEL or Masson staining,the mitochondrial ultrastructure changes was observed by transmission electron microscopy.The activity of total superoxide dismutase(T-SOD),glutathione peroxidase(GSH-Px)and the content of malondialdehyde(MDA),reactive oxygen species(ROS)were detected by spectrophotometry.The mRNA expression of nuclear factor E2-related factor 2(Nrf2)and heme oxygenase 1(HO-1)were detected by RT-PCR.The protein expression of Nrf2 and HO-1 were detected by Western Blot.[Results]Compared with the model group,the LVEF,LVFS,+dp/dtmax,-dp/dtmax,the level of cTnI,AngⅡ,ALD in serum and LVHI in CPT group,CWJI-M,CWJI-H groups were significantly decreased(P<0.05).The myocardial histopathological changes,apoptosis and tissue fibrosis were significantly improved,and the apoptosis index(AI)and collagen volume fraction(CVF)were significantly decreased(P<0.05).The ultrastructural changes of myocardial cell mitochondria were significantly improved.The activity of T-SOD,GSH-Px in myocardial tissue were significantly increased,while the content of MDA,ROS were significantly decreased(P<0.05).The mRNA and protein expression of Nrf2,HO-1 were significantly increased(P<0.05).The above effects of CWJI were dose-dependent,and the effect of CWJI-H group on other indexes except LVFS was better than those of CPT group(P<0.05).[Conclusion]CWJI can alleviate myocardial tissue lesion,cell apoptosis,tissue fibrosis and mitochondrial ultrastructure lesion in rats with HF-AMI,and improve cardiac function,which may be related to activation of Nrf2/HO-1 signaling pathway and inhibition of oxidative stress.
[Objective]To explore the pharmacodynamic material basis and mechanism of Sophorae Tonkinensis Radix et Rhizoma against liver cancer based on ultra-high pressure liquid chromatography tandem four-stage rod time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS)technique,network pharmacology and molecular docking.[Methods]UPLC-Q-TOF/MS technique was used to quickly identify the chemical components of Sophorae Tonkinensis.Pharm Mapper and Swiss Target Prediction were used to collect and predict component targets,followed by the search of liver cancer-related targets with GeneCards and DrugBank.The intersection targets of components of Sophorae Tonkinensis and liver cancer were obtained using Venny 2.1.0.Cytoscape 3.7.2 was used to construct the"chemical component-target-disease"network,to screen potential active components of Sophorae Tonkinensis against liver cancer.Protein-protein interaction(PPI)network was constructed using STRING to uncover the core targets of Sophorae Tonkinensis against liver cancer.,which were subjected to Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis based on DAVID database.and the"chemical component-target-pathway"network was constructed.The binding activity of the active components to the target proteins of Sophorae Tonkinensis against liver cancer and core target proteins was verified by molecular docking technology.Verify the anti hepatoma effect of Trifolirhizin,Oxymatrine and Matrine by cell activity test.[Results]UPLC-Q-TOF/MS revealed 23 ingredients of Sophorae Tonkinensis and a total of 33 intersection targets of Sophorae Tonkinensis components and the disease were obtained,PPI,GO,and KEGG analyses showed that Sophorae Tonkinensis presumedly acted on cyclin D1(CCND1),serine/threonine kinase 1(AKT1),receptor tyrosine kinase 2(ERBB2),epidermal growth factor receptor(EGFR),estrogen receptor 1(ESR1),and other targets through active components such as matrine,oxymatrine,6,8-diprenylkaempferol,syringaresinol and shandougenine A,and regulated hypoxia-inducible factor(HIF-1),receptor for advanced glucation end products(AGE-RAGE),phosphatidylinositol 3-kinase and protein kinase B(PI3K/AKT),receptor tyrosine kinase(ErbB),and other signaling pathways to play the role of anti hepatoma.Molecular docking verified a good binding ability of the potential active ingredients of Sophorae Tonkinensis to the core targets.Cell activity test showed that Trifolirhizin,Oxymatrine and Matrine had different anti hepatoma effects.[Conclusion]This study preliminarily indicates that Sophorae Tonkinensis is effective in playing the role of anti hepatoma through multiple components,multiple targets,and multiple pathways.This study provides a reference for elucidating the pharmacodynamic material basis and mechanism research of Sophorae Tonkinensis against liver cancer.
