Huangqi Guizhi Wuwu Decoction for treating diabetic peripheral neuropathy: a meta-analysis of 16 randomized controlled trials

Pang, Bing; Zhao, Tianyu; Zhao, Linhua; Wan, Fang; Ye, Ru; Zhou, Qiang; Tian, Feng; Tong, Xiaolin

doi:10.4103/1673-5374.189202

Cited by 32 publications

(20 citation statements)

References 15 publications

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“…However, our present study shows that HGWWD has no effect on blood glucose in diabetic mice (Figures 1D,E), which is supported by several clinical studies (Liu, 2005;Bian, 2010;Lu and You, 2010;Pang et al, 2016). One study reported that HGWWD can reduce the glucose levels of diabetic patients (Chen, 2019), but the reasons for this discrepancy are unclear.…”

Section: Discussionsupporting

confidence: 80%

“…Recent clinical evidence-based studies have shown that HGWWD has a positive therapeutic effect on various cardiovascular and cerebrovascular diseases. For example, HGWWD can improve cerebral blood flow in stroke patients and alleviate the subjective symptoms of diabetic peripheral neuropathy (Baiqing, 2015;Pang et al, 2016). Similarly, a recent study reported that HGWWD effectively treated lower extremity macroangiopathy in diabetic patients (Hu et al, 2018).…”

Section: Introductionmentioning

confidence: 98%

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HuangqiGuizhiWuwu Decoction Prevents Vascular Dysfunction in Diabetes via Inhibition of Endothelial Arginase 1

et al. 2020

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Hyperglycemia induces vascular endothelial dysfunction, which contributes to the development of vascular complication of diabetes. A classic prescription of traditional medicine, HuangqiGuizhiWuwu Decoction (HGWWD) has been used for the treatment of various cardiovascular and cerebrovascular diseases, which all are related with vascular pathology. The present study investigated the effect of HGWWD treatment in streptozocin (STZ)-induced vascular dysfunction in mouse models. In vivo studies were performed using wild type mice as well as arginase 1 knockout specific in endothelial cells (EC-A1 −/−) of control mice, diabetes mice and diabetes mice treated with HGWWD (60 g crude drugs/kg/d) for 2 weeks. For in vitro studies, aortic tissues were treated with mice serum containing HGWWD with or without adenoviral arginase 1 (Ad-A1) transduction in high glucose (HG) medium. We found that HGWWD treatment restored STZ-induced impaired mean velocity and pulsatility index of mouse left femoral arteries, aortic pulse wave velocity and vascular endothelial relaxation accompanied by elevated NO production in the aorta and plasma, as well as reduced endothelial arginase activity and aortic arginase 1 expression. The protective effect of HGWWD is reversed by an inhibitor of nitric oxide synthesis. Meanwhile, the preventive effect of serum containing HGWWD in endothelial vascular dysfunction is completely blocked by Ad-A1 transduction in HG incubated aortas. HGWWD treatment further improved endothelial vascular dysfunction in STZ induced EC-A1 −/− mice. This study demonstrates that HGWWD improved STZ-induced vascular dysfunction through arginase 1-NO signaling, specifically targeting endothelial arginase 1.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 98%

HuangqiGuizhiWuwu Decoction Prevents Vascular Dysfunction in Diabetes via Inhibition of Endothelial Arginase 1

et al. 2020

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“…The AUC for MDNS scores was 0.906 [ 41 ], the MDNS is a good screening tool for diabetic neuropathy, Astragalus membranaceus , Cinnamomi Ramulus, and Ligusticum wallichii are included in the Huangqi Guizhi Wuwu decoction. Pang et al [ 42 ] and Liang et al [ 43 ] performed a systematic review and meta-analysis reporting that this decoction improves DPN symptoms and ameliorates nerve conduction velocities. However, their studies did not explicitly mention the MDNS.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Rules of Chinese Herbal Medicine in Diabetic Peripheral Neuropathy Patients

Zhao

Xin

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Objective. To analyse the clinical features of diabetic peripheral neuropathy (DPN) and employ data mining technology to explore the rules of Chinese herbal medicine (CHM) therapy. Methods. The clinical data of 216 patients with DPN and qi-yin deficiency syndrome were obtained, and the clinical features of the patients were assessed by cluster analysis. Relevant information was entered into the clinical diagnosis and treatment collection system, and data mining techniques were used to analyse the drug frequency, core CHM, CHM pair, and so on. Results. In this study, glycated haemoglobin (HbA1c) and homocysteine (HCY) were closely related to the pathogenesis of DPN. Overall, 162 patients had typical DPN syndrome characteristics, and we analysed 216 prescriptions, including 182 CHM. The frequencies of prescription of Astragalus membranaceus, Ligusticum wallichii, Poria cocos, and Radix Rehmanniae were greater than 45%. A Bayesian network analysis diagram showed that the 9 most common core CHM included Astragalus membranaceus, Ligusticum wallichii, Poria cocos, atractylodes rhizome, and Salvia miltiorrhiza Bge. According to the association rules of CHM, Radix Ophiopogon is used for Codonopsis pilosula; Astragalus membranaceus and atractylodes rhizome for Rehmannia are also frequently used. Astragalus membranaceus and Cinnamomi Ramulus or Ligusticum wallichii and Moutan bark were highly related to a decreased Michigan Diabetic Neuropathy Score. Conclusion. HbA1c and HCY are related risk factors for DPN. Numbness is a typical syndrome characteristic. Astragalus membranaceus is a monarch CHM and is used most frequently.

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“…Pang et al conducted a meta-analysis of sixteen randomized controlled trials with a total of 1,173 patients suffering diabetic peripheral neuropathy. The results revealed that Huangqi Guizhi Wuwu tang had significant therapeutic efficacy in treating peripheral diabetic neuropathy (Pang et al, 2016). Previous studies have shown that quercetin has various biological actions, such as antioxidative and anti-inflammatory effects (Chen et al, 2018), including inhibiting inflammatory cytokines, such as ROS, IFNg, TNF-a, and IL-2 (Meng et al, 2018).…”

Section: Introductionmentioning

confidence: 96%

Quercetin Combined With Human Umbilical Cord Mesenchymal Stem Cells Regulated Tumour Necrosis Factor-α/Interferon-γ-Stimulated Peripheral Blood Mononuclear Cells via Activation of Toll-Like Receptor 3 Signalling

Chen

Yang²,

Cheng³

et al. 2020

Front. Pharmacol.

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Huangqi Guizhi Wuwu Decoction for treating diabetic peripheral neuropathy: a meta-analysis of 16 randomized controlled trials

Cited by 32 publications

References 15 publications

HuangqiGuizhiWuwu Decoction Prevents Vascular Dysfunction in Diabetes via Inhibition of Endothelial Arginase 1

HuangqiGuizhiWuwu Decoction Prevents Vascular Dysfunction in Diabetes via Inhibition of Endothelial Arginase 1

Clinical Features and Rules of Chinese Herbal Medicine in Diabetic Peripheral Neuropathy Patients

Quercetin Combined With Human Umbilical Cord Mesenchymal Stem Cells Regulated Tumour Necrosis Factor-α/Interferon-γ-Stimulated Peripheral Blood Mononuclear Cells via Activation of Toll-Like Receptor 3 Signalling

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