The effectiveness and safety of a danshen-containing Chinese herbal medicine for diabetic retinopathy: A randomized, double-blind, placebo-controlled multicenter clinical trial

Lian, Fengmei; Wu, Li-e; Tian, Jiaxing; Jin, Ming; Zhou, Shuiping; Zhao, Min; Wei, Lidong; Zheng, Yanlin; Wang, Yuliang; Zhang, Mingchang; Qin, Wei; Wu, Zhifeng; Yuan, Chun‐Su; Tong, Xiaolin

doi:10.1016/j.jep.2015.01.048

Cited by 65 publications

(65 citation statements)

References 20 publications

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“…One eligible RCT for treating DR focused on the Compound Danshen Dripping Pill (CDDP) . Radix Salviae Miltiorrhizae, borneol and Radix Notoginseng have been found to improve effectively fluorescence fundus angiography (FFA) and funduscopic examination of patients with DR.…”

Section: Resultsmentioning

confidence: 99%

Evidence and potential mechanisms of traditional Chinese medicine for the treatment of type 2 diabetes: A systematic review and meta‐analysis

Tian

Jin

Bao

et al. 2019

Diabetes Obesity Metabolism

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Traditional Chinese medicine (TCM) has recorded knowledge of diabetes for over 2000 years. Because a considerable number of TCM studies exhibit design defects, such as limited intervention duration, small sample sizes and inconsistent efficacy evaluations, the role of TCM in the treatment of diabetes cannot be fully elucidated. In this review, we evaluate randomized controlled trials of prediabetes, diabetes and diabetic complications published in the past decade. We found that TCM could significantly improve glucose control and clinical indices in patients with diabetes and effectively delay the progression of diabetes. We also summarize potential pharmacological mechanisms underlying the efficacy of TCM medication/herbs and their active ingredients for treating diabetes. More rigorously designed experiments and long-term evaluation of TCM for diabetes will allow for more effective diabetes management. K E Y W O R D S diabetes, diabetic complications, pharmacological mechanisms, prediabetes, randomized controlled trials, traditional Chinese medicine 1 | INTRODUCTION The overall population of patients with diabetes has reached approximately 415 million and is estimated to rise further to nearly 642 million by 2040. 1 Vast amounts of medical resources are spent on diabetes, and the total global health expenditure because of diabetes was estimated to be $673 billion in 2015; however, a decrease in the incidence of diabetes has not been observed. 1,2 About 5 million deaths are attributed to diabetes each year, and patients with an extended duration of complications lose their ability to work, thereby causing heavy social and economic burdens. Therefore, it is urgent to develop effective strategies to prevent the global health threat of diabetes. Traditional Chinese medicine (TCM) has focused on the treatment of diabetes for thousands of years. The "whole view" and "multi-targets" approaches of TCM provide unique advantages in controlling complex diseases such as diabetes. 3 TCM focuses on individualized treatments that are based on the differentiation of syndromes, control of balance and various routes of administration. 4,5 In recent years, large-scale clinical trials have confirmed that TCM has made progress in controlling blood glucose levels. Additionally, the application of modern science and technology has helped to uncover some of the therapeutic mechanisms underlying TCM's potency. Studies have been conducted to *Jiaxing Tian, De Jin and Fengmei Lian contributed equally to this study. Fengmei Lian and Xiaolin Tong are co-corresponding authors.

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Section: Resultsmentioning

confidence: 99%

Evidence and potential mechanisms of traditional Chinese medicine for the treatment of type 2 diabetes: A systematic review and meta‐analysis

Tian

Jin

Bao

et al. 2019

Diabetes Obesity Metabolism

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“…S. miltiorrhiza has also shown a significant anti-diabetic effect in animal studies; for instance, it decreases FBG and increases the insulin sensitivity index (31,32). It is effective for preventing and treating diabetic complications such as myocardial malfunction (33,34) and diabetic retinopathy (35). A. sinensis is also one of the most frequently used herbs for diabetes in China (36) due to evidence of its anti-diabetic properties (37).…”

Section: Discussionmentioning

confidence: 99%

Herbal acupuncture for type 2 diabetes: A meta-analysis

Lee

Nam

Lee

2017

Experimental and Therapeutic Medicine

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Herbal acupuncture (HA) is a modern adjunctive technique in which natural herbs or biologic substances are injected into acupuncture points. The objective of this systematic review was to evaluate evidence of the effectiveness of HA for type 2 diabetes mellitus (T2DM). Three databases were searched. The included randomized controlled trials (RCTs) evaluated HA in controls and patients with T2DM and reported at least one of the following: Fasting blood glucose (FBG), postprandial (PP2hr) glucose and glycated hemoglobin (HbA1c). In a meta-analysis of seven RCTs (n=598 patients), HA significantly reduced levels of FBG, PP2hr glucose and HbA1c (P<0.0001, P=0.0005 and P=0.004, respectively). There was no significant effect of HA on total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, or triglyceride level. High degrees of heterogeneity were present for all analyses except HDL-cholesterol and LDL-cholesterol. HA might have a beneficial effect on FBG, PP2hr glucose and HbA1c levels in patients with T2DM; however, because of several limitations, the results are inconclusive. Therefore, additional rigorous RCTs are warranted to overcome the limitations of previous studies.

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“…In fact, Danshen has also been shown to elicit beneficial effects in clinical trials. Two separate clinical studies – one conducted as a randomized, double‐blind, placebo‐controlled multicentre clinical trial and the other as a randomized, double‐dummy, double‐blind study, established the therapeutic effects and safety of Danshen in patients of diabetic retinopathy and concluded that it can effectively be used for the treatment of this diabetic complication in humans …”

Section: Chinese Herbs As Potential Antidiabetic Retinopathy Therapymentioning

confidence: 99%

“…Two separate clinical studiesone conducted as a randomized, double-blind, placebo-controlled multicentre clinical trial and the other as a randomized, double-dummy, double-blind study, established the therapeutic effects and safety of Danshen in patients of diabetic retinopathy and concluded that it can effectively be used for the treatment of this diabetic complication in humans. [37,38] Rosmarinic acid, another phytoconstituent of S. miltiorrhiza, inhibits retinal neovascularization by causing cell cycle arrest at G 2 and M phase. [39] A recent study done to explore the antidiabetic retinopathy potential of S. miltiorrhiza described the effectiveness of this plant extract to remove haemostasis in retina, caused during diabetic retinopathy due to the thickening of capillary basement membrane which alters the membrane permeability and thus reduces the removal of free radicals formed by the dense mitochondrial population of the highly aerobic retinal tissue.…”

Section: Salvia Miltiorrhizamentioning

confidence: 99%

Chinese herbal drugs for the treatment of diabetic retinopathy

Behl

Kotwani

2017

Journal of Pharmacy and Pharmacology

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Objectives To explore the various pharmacological actions and the molecular mechanisms behind them by which Chinese herbs tend to lower the risk of developing microvascular diabetic complications in retina and prevent its further progression. Key findings Several Chinese herbs, indeed, elicit potent anti-inflammatory, antioxidant, anti-angiogenic, anti-apoptotic, peroxisome proliferator-activated receptor-gamma receptor agonistic, platelet-activating factor antagonistic, aldose reductase inhibitory and various other beneficial pharmacological activities, required to counteract the pathological conditions prevalent in retina during diabetes. Summary Chinese herbs can potentially be used for the treatment/prevention of diabetic retinopathy owing to the virtue of numerous properties by which they alleviate several hyperglycaemia-induced pathological occurrences in retina. This would provide a natural and safe therapy for diabetic retinopathy, which currently is clinically limited to destructive techniques like laser photocoagulation and vitrectomy.

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The effectiveness and safety of a danshen-containing Chinese herbal medicine for diabetic retinopathy: A randomized, double-blind, placebo-controlled multicenter clinical trial

Cited by 65 publications

References 20 publications

Evidence and potential mechanisms of traditional Chinese medicine for the treatment of type 2 diabetes: A systematic review and meta‐analysis

Evidence and potential mechanisms of traditional Chinese medicine for the treatment of type 2 diabetes: A systematic review and meta‐analysis

Herbal acupuncture for type 2 diabetes: A meta-analysis

Chinese herbal drugs for the treatment of diabetic retinopathy

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