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This study aimed to provide a panorama of artificial intelligence (AI) in acupuncture by characterizing and visualizing the knowledge structure, hotspots and trends in global scientific publications. Publications were extracted from the Web of Science. Analyses on the number of publications, countries, institutions, authors, co-authorship, co-citation and co-occurrence were conducted. The USA had the highest volume of publications. Harvard University had the most publications among institutions. Dey P was the most productive author, while lczkowski KA was the most referenced author. The Journal of Alternative and Complementary Medicine was the most active journal. The primary topics in this field concerned the use of AI in various aspects of acupuncture. "Machine learning" and "deep learning" were speculated to be potential hotspots in acupuncture-related AI research. In conclusion, research on AI in acupuncture has advanced significantly over the last two decades. The USA and China both contribute significantly to this field. Current research efforts are concentrated on the application of AI in acupuncture. Our findings imply that the use of deep learning and machine learning in acupuncture will remain a focus of research in the coming years.
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Terapia por Acupuntura , Inteligência Artificial , Humanos , Aprendizado de Máquina , Bibliometria , ChinaRESUMO
The objective of this study was to evaluate the effect of replacing dicalcium phosphate (DCP) with mono-dicalcium phosphate (MDCP) to formulate low-phosphorus (P) diets on laying performance, egg quality, phosphorus-calcium metabolism, and bone metabolism of 69-78-week-old aged laying hens. Hy-Line Brown laying hens (n = 1,350, 69 weeks old) were randomly assigned to six treatments, each with five replicates of 45 hens. A corn-soybean meal-based diet was formulated to contain 0.12% non-phytate phosphorus (NPP), 3.81% calcium (Ca), and 1,470 FTU/kg phytase. The control group (CON) was supplemented with DCP inorganic phosphorus (Pi) at the NPP level of 0.20% (dietary NPP levels of 0.32%). Test groups (T1-T5) were supplemented with MDCP Pi at NPP levels of 0.07%, 0.11%, 0.15%, 0.18, and 0.20% (dietary NPP levels of 0.19, 0.23, 0.27, 0.30, and 0.32%, respectively). Calcium carbonate levels were adjusted to ensure all experimental diets contained the same Ca levels (3.81%). The feeding trial lasted 10 weeks, with hens increasing in age from 69 to 78 weeks. When supplemented with 1,470 FTU/kg phytase, extra DCP Pi or MDCP Pi did not affect (p > 0.05) laying performance (day laying rate, average egg weight, feed intake, feed-to-egg mass ratio, broken egg rate), egg quality (eggshell strength, albumen height, haugh units), or serum P, Ca, copper (Cu), iron (Fe), zinc (Zn), and manganese (Mn) levels. However, when laying hens were fed MDCP Pi (NPP levels of 0.07 to 0.20%), yolk color improved (p = 0.0148). The tibia breaking strength was significantly higher (p < 0.05) in the 0.18 and 0.20% NPP MDCP Pi groups than in the 0.20% NPP DCP Pi group. The breaking strength, Ca content, and P content of tibia in 0.11% and 0.15% NPP MDCP Pi hens were not significantly (p > 0.05) different from those in 0.20% NPP DCP Pi hens. Hens fed 0.07% NPP MDCP Pi had higher (p < 0.01) serum levels of osteoprotegerin (OPG), type-I collagen c-telopeptide (CTX-I), and tartrate-resistant acid phosphatase 5b (TRACP-5b) than those in all other groups. Serum levels of TRACP-5b and CTX-I in the 0.11% and 0.15% NPP MDCP Pi group were significantly lower than those in 0.18 and 0.20% NPP MDCP Pi groups and the 0.20% NPP DCP Pi group (p < 0.0001). Hens fed 0.07% and 0.11% NPP MDCP Pi had higher (p < 0.05) serum levels of parathyroid hormone (PTH) than those in all other groups. No differences were detected in serum calcitonin (CT), 1,25-dihydroxy-vitamin D3 (1,25-(OH)2D3), bone alkaline phosphatase (BAP), osteocalcin(OCN), and osteopontin (OPN) among all groups (p > 0.05). The expression of P transporters type IIa Na/Pi cotransporter (NaPi-IIa) in 0.11% and 0.15% NPP MDCP Pi hens were higher than those in 0.20% NPP MDCP Pi group and 0.20% NPP DCP Pi group (p < 0.05). The results indicated that both renal P reabsorption and bone resorption were involved in adapting to a low-P diet. In summary, when MDCP was used instead of DCP to supplement P, NPP levels could be reduced to 0.11% (dietary NPP level of 0.23%) without negative effects on laying performance and skeletal health of aged hens. In addition, MDCP was more beneficial than DCP for tibia quality. The results of the current study would provide references for the application of MDCP in low-P diets of aged laying hens.
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BACKGROUND: According to current studies, more than 20% of all patients diagnosed with COVID-19 globally have diabetes. Further, the mortality rate of these patients is 7.3%. Compared with non-diabetic COVID-19 patients, diabetic COVID-19 patients have higher rates of mortality and severe infection, suggesting that diabetes is associated with the severity of COVID-19 infection. This study aimed to analyse the relationship and susceptibility factors between COVID-19 and T2DM. METHODS: Using bioinformatics methods, potential targets for COVID-19 and T2DM were screened from GeneCards database. Potential targets of COVID-19 and T2DM were mapped to each other to identify overlapping targets, and a PPI network was constructed to extract the core target. The clusterProfiler package in R was used to analyse the function and pathway that core target involved. GO enrichment and KEGG pathway analysis were used to elucidate the correlation between COVID-19 and T2DM. RESULTS: A total of 277 potential pathogenic targets of COVID-19 were found, 282 potential targets were found for T2DM. Mapping of the potential COVID-19 and T2DM targets revealed 53 overlapping targets, with TNF as the core target. IL-17 signalling pathway was the most significant KEGG pathway involving TNF. CONCLUSIONS: The inflammatory cytokine, TNF, was identified as a core target between COVID-19 and T2DM, which induces inflammatory response mainly through the IL-17 signalling pathway, leading to aggravation of infection and increased difficulty in blood glucose control. This study provides a reference for further exploring the potential correlation and endogenous mechanisms between two seemingly independent and unrelated diseases-T2DM and COVID-19.
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COVID-19 , Diabetes Mellitus Tipo 2 , Medicamentos de Ervas Chinesas , Humanos , Diabetes Mellitus Tipo 2/genética , Interleucina-17 , Biologia Computacional , Citocinas , Simulação de Acoplamento MolecularRESUMO
Obesity is an important cause of diseases such as type 2 diabetes, non-alcoholic fatty liver and atherosclerosis. The use of ingredients extracted from traditional Chinese medicine for weight loss is now receiving more and more attention. Ginseng has been recorded since ancient times for the treatment of diabetes. The (20R)-Panaxadiol (PD) belongs to the ginseng diol type compounds, which are moderately bioavailable and may remain in the intestinal tract for a longer period of time. This study investigated the potential positive effect of PD in ob/ob mice and evaluated its effect against obesity. The ob/ob mice were administered PD for ten weeks. Our study showed that PD could improve obesity, glucose tolerance disorder, as well as gut dysbiosis. Panaxadiol decreased ob/ob mice's Firmicutes/Bacteroidetes (F/B). Furthermore, 16S rRNA gene sequencing of the fecal microbiota suggested that PD changed the composition of the gut microbiota in ob/ob mice and modulated specific bacteria such as lactobacillus, prevotellace and so on. Moreover, PD improved the intestinal wall integrity. In conclusion, our results suggest that (20R)-Panaxadiol, as an active ingredient of the traditional Chinese medicinal herb ginseng, may improve obesity to some extent via improving gut microbiota.
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Diabetes Mellitus Tipo 2 , Microbioma Gastrointestinal , Panax , Animais , Diabetes Mellitus Tipo 2/complicações , Dieta Hiperlipídica , Ginsenosídeos , Camundongos , Camundongos Endogâmicos C57BL , Obesidade/etiologia , RNA Ribossômico 16S/genéticaRESUMO
BACKGROUND: The aim of the EU-funded HERA (health and environment research agenda) project is to set priorities for the future European research agenda in the environment, climate and health nexus. We report results from a European researcher's perspective and identify research areas that have been inadequately investigated to date. METHODS: An online survey was completed by European researchers to assess, evaluate and visualise research gaps. These research gaps were identified for 21 predefined areas within 3 main categories: i) classical environment and health paradigm; ii) problem or sector-based research areas and approaches and iii) holistic research areas and concepts. All research gaps were then evaluated by expert groups with the pre-defined criteria and systematically summarized. For areas identified within the survey as under-reported, additional input was sought from a range of key selected experts. The EU project database Cordis was utilized to verify that these areas were under-researched. RESULTS: Between May and July 2019, 318 respondents from 38 countries reported 624 research gaps. The main areas for attention identified were: urban environments; chemicals; and climate change, (combined n = 313 gaps). Biodiversity loss and health; transport, mobility, sustainable solutions and health; energy transition and health; waste and the circular economy and health; ethics and philosophy and health were areas that were acknowledged as under-researched (combined n = 27 gaps). These under-researched areas were identified as having certain commonalities, they: i) mostly fell in the category "problem or sector based approaches"; ii) they are essential for developing and implementing solutions; and iii) require trans-disciplinary and cross-sectoral collaboration. CONCLUSIONS: Currently attention is given to topical and highly researched areas in environmental health. In contrast, this paper identifies key topics and approaches that are under-researched, yet, are critical for the implementation of the EU Green Deal, related strategies and action plans, and require further investigation and investment. The findings reveal the imperative to foster solutions-oriented, trans-disciplinary and participatory research and its implementation through changes in research funding and research structures.
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Mudança Climática , PrevisõesRESUMO
Background: Type 2 diabetes mellitus (T2DM) complicated with dyslipidaemia is associated with a high risk of cardiovascular diseases. The Jiangtang Tiaozhi (JTTZ) recipe is a Chinese herbal formula that has been used to regulate the blood glucose and lipid levels for many years. Interestingly, a previous study has demonstrated its efficacy; however, the associated mechanism remains unclear. We hypothesised that the therapeutic effect of the JTTZ on patients with T2DM may be mediated by the modulation of metabolites secreted by the gut microbiota. This study aims to examine this mechanism. Methods and analysis: This study is a randomised, positive drug parallel-controlled, open-label clinical trial in patients with T2DM and dyslipidaemia. A total of 96 patients will be recruited and randomly assigned to treatment with JTTZ or metformin for 12 weeks. The primary outcome will be the rates of effectively regulated blood glucose and lipid levels (measured with the levels of glycated haemoglobin, fasting plasma glucose, 2-h plasma glucose, triglyceride, and low-density lipoprotein cholesterol). The secondary outcomes will be the changes in body weight, body mass index, and waist circumference and Traditional Chinese Medicine symptom scores. In addition, 16S rRNA gene sequencing will be performed on the gut microbiota obtained from faeces, and metabolomics analysis will be performed based on blood and gut microbiota samples. Intention-to-treat, per-protocol analysis and safety analysis will be performed. Clinical trial registration number: https://clinicaltrials.gov/ct2/show/NCT04623567.
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PURPOSE: The purpose of this work is to (a) demonstrate the feasibility of delivering a spread-out Bragg peak (SOBP) proton beam in ultra-high dose rate (FLASH) using a proton therapy synchrocyclotron as a major step toward realizing an experimental platform for preclinical studies, and (b) evaluate the response of four models of ionization chambers in such a radiation field. METHODS: A clinical Mevion HYPERSCAN® synchrocyclotron was adjusted for ultra-high dose rate proton delivery. Protons with nominal energy of 230 MeV were delivered in pulses with temporal width ranging from 12.5 µs to 24 µs spanning from conventional to FLASH dose rates. A boron carbide absorber and a range modulator block were placed in the beam path for range modulation and creating an SOBP dose profile. The radiation field was defined by a brass aperture with 11 mm diameter. Two Faraday cups were used to determine the number of protons per pulse at various dose rates. The dosimetric response of two cylindrical (IBA CC04 and CC13) and two plane-parallel (IBA PPC05 and PTW Advanced Markus® ) ionization chambers were evaluated. The dose rate was measured using the plane-parallel ionization chambers. The integral depth dose (IDD) was measured with a PTW Bragg Peak® ionization chamber. The lateral beam profile was measured with EBT-XD radiochromic film. Monte Carlo simulation was performed in TOPAS as the secondary check for the measurements and as a tool for further optimization of the range modulators' design. RESULTS: Faraday cups measurement showed that the maximum protons per pulse is 39.9 pC at 24 µs pulse width. A good agreement between the measured and simulated IDD and lateral beam profiles was observed. The cylindrical ionization chambers showed very high ion recombination and deemed not suitable for absolute dosimetry at ultra-high dose rates. The average dose rate measured using the PPC05 ionization chamber was 163 Gy/s at the pristine Bragg peak and 126 Gy/s at 1 cm depth for the SOBP beam. The SOBP beam range and modulation were measured 24.4 mm and 19 mm, respectively. The pristine Bragg peak beam had 25.6 mm range. Simulation results showed that the IDD and profile flatness can be improved by the cavity diameter of the range modulator and the number of scanned spots, respectively. CONCLUSIONS: Feasibility of delivering protons in an SOBP pattern with >100 Gy/s average dose rate using a clinical synchrocyclotron was demonstrated. The dose heterogeneity can be improved through optimization of the range modulator and number of delivered spots. Plane-parallel chambers with smaller gap between electrodes are more suitable for FLASH dosimetry compared to the other ion chambers used in this work.
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Terapia com Prótons , Prótons , Ciclotrons , Método de Monte Carlo , Radiometria , Dosagem RadioterapêuticaRESUMO
BACKGROUND: Ulcerative colitis (UC) is a refractory intestinal disease prone to recurrent attacks, with a high rate of canceration, which seriously affects life treatment. Routine treatment has disadvantages such as long course of treatment, high cost, easy recurrence and limited effectiveness. Clinical practice shows that acupoint catgut embedding therapy has certain therapeutic advantages but lacks evidence of evidence-based medicine. The purpose of this study is to systematically study the effectiveness and safety of acupoint catgut embedding for ulcerative colitis. METHODS: Retrieve English database (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese database (CNKI, CDDB, CQVIP, CBM) by computer, and manually retrieve Baidu and Google Academy for randomized controlled trials (RCTs) of acupoint catgut embedding therapy for ulcerative colitis from the time of construction of database to September 2020. Two researchers independently extracted data and evaluated the quality of the literature included in the study, and used RevMan 5.3 software for meta-analysis of the included literature. RESULT: The study evaluated the effectiveness and safety of acupoint catgut embedding for ulcerative colitis through efficiency, symptom score, colonoscopy score, mucosal healing rate, recurrence rate, incidence of adverse reactions, etc. CONCLUSION:: This study will provide reliable evidence-based evidence for clinical application of acupoint catgut embedding therapy for ulcerative colitis. OSF REGISTRATION NUMBER: DOI 10.17605/ OSF.IO / 7T4QV.
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Terapia por Acupuntura/métodos , Colite Ulcerativa/terapia , Humanos , Metanálise como Assunto , Revisões Sistemáticas como AssuntoRESUMO
BACKGROUND: Catgut-embedding therapy combined with minimally invasive surgery has been used for treating slow transit constipation (STC) widely. However, the application effect of catgut-embedding therapy combined with minimally invasive surgery for STC are unclear. This study aims to evaluate the application effect of catgut-embedding therapy combined with minimally invasive surgery for STC. METHODS: Randomized controlled trials of catgut-embedding therapy combined with minimally invasive surgery in the treatment of STC will be searched in PubMed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WanFang, the Chongqing VIP Chinese Science and Technology Periodical Database, and China biomedical literature database from inception to July, 2020. And Baidu Scholar, Google Scholar, International Clinical Trials Registry Platform, and Chinese Clinical Trials Registry will be searched to obtain more relevant studies comprehensively. Two researchers will perform data extraction and risk of bias assessment independently. Statistical analysis will be conducted in RevMan 5.3. RESULTS: This study will summarize the present evidence by exploring the application effect of catgut-embedding therapy combined with minimally invasive surgery in the treatment of STC. CONCLUSIONS: The findings of the study will provide helpful evidence for the application effect of catgut-embedding therapy combined with minimally invasive surgery in the treatment of STC, facilitating clinical practice and further scientific studies. ETHICS AND DISSEMINATION: The private information from individuals will not publish. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/7HVZB.
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Categute , Constipação Intestinal/terapia , Medicina Tradicional Chinesa , Procedimentos Cirúrgicos Minimamente Invasivos , Terapia Combinada , Constipação Intestinal/fisiopatologia , Trânsito Gastrointestinal/fisiologia , Humanos , Metanálise como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como AssuntoRESUMO
Lactoferrin (LF) exerts a promoting bone health function. The effects of LF on bone formation at the metabolic level have been less explored. Urinary metabolic profiling of growing Sprague-Dawley (SD) rats LF-supplemented (1000 mg/kg bw) for four weeks were explored by Liquid chromatography-tandem mass spectrometry (LC-MS/MS). The serum markers of bone formation and bone resorption, the bone mass, and the osteogenesis markers of femur were measured by an enzyme-linked immunosorbent assay, micro-computerized tomography, and immunohistochemistry, respectively. Compared with the control, LF supplementation improved bone formation (p < 0.05), reduced bone resorption (p < 0.05), enhanced femoral bone mineral density and microarchitecture (p < 0.05), and upregulated osteocalcin, osterix, and Runx-2 expression (p < 0.05) of femur. LF upregulated 69 urinary metabolites. KEGG and pathway enrichment analyses of those urinary metabolites, and the Person's correlation analyses among those urinary metabolites and bone status revealed that LF impacted on bone formation via regulatory comprehensive pathways including taurine and hypotaurine metabolism, arginine and proline metabolism, cyanoamino acid metabolism, nitrogen metabolism, nicotinate and nicotinamide metabolism, and fatty acid biosynthesis. The present study indicated the metabolomics is a useful and practical tool to elucidate the mechanisms by which LF augments bone mass formation in growing animals.
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Suplementos Nutricionais , Lactoferrina/administração & dosagem , Lactoferrina/farmacologia , Osteogênese/efeitos dos fármacos , Osteogênese/fisiologia , Ratos Sprague-Dawley/crescimento & desenvolvimento , Animais , Arginina/metabolismo , Arginina/urina , Biomarcadores/metabolismo , Biomarcadores/urina , Cromatografia Líquida , Masculino , Metabolômica/métodos , Nitrogênio/metabolismo , Nitrogênio/urina , Prolina/metabolismo , Prolina/urina , Espectrometria de Massas em Tandem , Taurina/análogos & derivados , Taurina/metabolismo , Taurina/urinaRESUMO
Chemical pesticides are commonly used during the cultivation of agricultural products to control pests and diseases. Excessive use of traditional pesticides can cause environmental and human health risks. There are ongoing searches for new plant-derived pesticides to reduce the use of chemical pesticides. In this study, tea saponin extracts of different purities were extracted from Camellia oleifera seeds using AB-8 macroporous resin and gradient elution with ethanol. The insecticidal effects of the tea saponin extracts were evaluated by contact toxicity tests and stomach toxicity tests using the lepidopteran pest of tea plantation, Ectropis obliqua. The total saponins extracted using 70% ethanol showed strong contact toxicity (LC50 = 8.459 mg/L) and stomach toxicity (LC50 = 22.395 mg/L). In-depth mechanistic studies demonstrated that tea saponins can disrupt the waxy layer of the epidermis, causing serious loss of water, and can penetrate the inside of the intestine of E. obliqua. After consumption of the tea saponins, the intestinal villi were shortened and the cavities of the intestinal wall were disrupted, which resulted in larval death. This study highlights the potential of tea saponins as a natural, plant-derived pesticide for the management of plant pests.
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Camellia/química , Inseticidas/química , Inseticidas/farmacologia , Saponinas/química , Animais , Fenômenos Químicos , Insetos/efeitos dos fármacos , Inseticidas/isolamento & purificação , Dose Letal Mediana , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/farmacologia , Solubilidade , Testes de ToxicidadeRESUMO
Ectropis obliqua Prout is the main pest of the tea plant Camellia sinensis (L.) O. Kuntze in China, affecting an annual area of more than one million acres. (-)-Epigallocatechin-3-gallate (EGCG) is the major catechin in tea leaves. Here, we show that EGCG is highly efficient in increasing the survival rate of E. obliqua larvae. We also compared the gut peroxidase (PO) activity between EGCG-fed and control larvae. EGCG-fed larvae had significantly greater PO activity levels than control larvae. Western blotting validated these results. Gut PO activity levels of larvae fed an artificial diet gradually decreased and disappeared completely by day 5. We hypothesize that the increased survival rate of EGCG-fed larvae was associated with increased PO activity. This research provides evidence that E. obliqua larvae have adapted to, and may even benefit from, secondary compounds found in tea leaves.
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Catequina , Mariposas , Animais , Catequina/análogos & derivados , Catecol Oxidase , China , Precursores Enzimáticos , CháRESUMO
Ectropis obliqua Prout (Lepidoptera: Geometridae) is the most devastating insect pest of tea plants in China and infests thousands of hectares of tea plantations in China annually. (-)-Epigallocatechin-3-gallate (EGCG) is a major phenolic compound in tea leaves and has a strong antibacterial function. Here, we show that EGCG can effectively improve the fitness of E. obliqua larvae and present the reason by which EGCG promotes larval fitness. In this study, we compared the fitness difference among Control, Antibiotic and Treatment of larvae. The fitness of larvae treated with EGCG and antibiotic was similar and better than that of control group. We also demonstrated that EGCG treatment could significantly reduce species richness and abundance of gut bacteria in E. obliqua larvae. Hence that we speculate that EGCG promotes larval fitness and is associated with ECGG antimicrobial activity. In short, our study provides evidence of the E. obliqua larvae have adapted to secondary compounds found in tea leaves, and may even benefit from these compounds. Our study also contributes to a greater understanding of the reason involved in plant-insect interactions.
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Bactérias/efeitos dos fármacos , Camellia sinensis/química , Catequina/análogos & derivados , Sistema Digestório/efeitos dos fármacos , Mariposas/efeitos dos fármacos , Animais , Antibacterianos/farmacologia , Bactérias/crescimento & desenvolvimento , Camellia sinensis/parasitologia , Catequina/farmacologia , Sistema Digestório/microbiologia , Interações Hospedeiro-Parasita , Larva/efeitos dos fármacos , Larva/microbiologia , Larva/fisiologia , Mariposas/microbiologia , Mariposas/fisiologia , Folhas de Planta/química , Folhas de Planta/parasitologia , Densidade Demográfica , Pupa/efeitos dos fármacos , Pupa/fisiologiaRESUMO
[This corrects the article DOI: 10.1155/2016/5473015.].
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Background. The study was designed to assess the efficacy and safety of Chinese herbal decoction in treating outpatients with T2DM. Methods. All patients enrolled received decoction for at least 6 months. The primary outcome was the control rate of HbA1c and the change in HbA1c. FPG, 2hPG, HOMA-IR, and HOMA-ß were also collected and evaluated. Results. The control rates after treatment at months 6, 12, 18, 24, 36, 48, and 60 were 45.07%, 52.78%, 47.22%, 45.83%, 50.00%, 57.14%, and 40.00%. Multiple linear regression showed the change of HbA1c has a significant relationship with the baseline HbA1c and duration of DM and BMI (p < 0.05). Both FPG and 2hPG levels significantly decreased compared to the baseline (p < 0.05). Chinese herbal decoction also improved islet cell function with decreased HOMA-IR and increased HOMA-ß (p < 0.05). 19 and 4 subjects deactivated the antidiabetes drugs or insulin, respectively, after taking decoction. One subject developed DKD and one developed DPN, and another subject showed abnormal liver function which was irrelevant to decoction treatment. Conclusions. Chinese herbal decoction significantly enhanced the hypoglycemic action and had certain effect on protecting islet cell function. As a candidate diabetes therapy, it may reduce the use of antidiabetes drugs and slow the progression to diabetes complications.
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OBJECTIVE: This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction (HGWWD) for treating diabetic peripheral neuropathy. DATA SOURCES: Six electronic databases, including the Cochrane Library, MEDLINE database, Chinese Biomedical Database, Chinese National Knowledge Infrastructure Database, Chinese Science and Technique Journals Database, and the Wanfang Database, were searched on the internet for randomized controlled trials published up until 1 December 2015. The search terms included "Chinese herbal medicine", "diabetic peripheral neuropathy" and "randomized controlled trials" in Chinese and in English. DATA SELECTION: We included randomized controlled trials using HGWWD/modified HGWWD for the treatment group, without restriction for the control group. We assessed literature quality in accordance with the Cochrane Review Handbook. A random or a fixed effects model was used to analyze outcomes using RevMan 5.2 software. OUTCOME MEASURES: The primary outcomes were changes in symptoms and nerve conduction velocities. The secondary outcomes were fasting blood glucose and hemorheological indexes. RESULTS: Sixteen randomized controlled trials, with a total of 1,173 patients, were included. Meta-analysis revealed that the efficacy of HGWWD for diabetic peripheral neuropathy was significantly superior compared with the control treatment (i.e., control group) (risk ratio = 0.36, 95% confidence interval (CI): 0.29-0.46, Z =8.33, P < 0.00001) Compared with the control group, there was an increase in median motor nerve conduction velocity (mean difference (MD) = 3.46, 95%CI: 1.88-5.04, Z = 4.30, P < 0.01) and median sensory nerve conduction velocity (MD = 3.30, 95%CI: 2.04-4.56, Z = 5.14, P < 0.01). There was also an increase in peroneal motor nerve conduction velocity (MD = 3.22, 95%CI: 2.45-3.98, Z = 8.21, P < 0.01) and peroneal sensory nerve conduction velocity (MD = 3.05, 95%CI: 2.01-4.09, Z = 5.75, P < 0.01) in the treatment groups. No significant difference in fasting blood glucose was found between the treatment groups and the control groups (MD = -0.12, 95%CI: -0.42-0.19, Z = 0.76, P = 0.45). Plasma viscosity was significantly decreased after treatment (MD = -0.11, 95%CI: -0.21 to -0.02, Z = 2.30, P = 0.02). No significant difference in fibrinogen was detectable (MD = -0.53, 95%CI: -1.28-0.22, Z = 1.38, P = 0.17). Four trials reported that treatment groups experienced no adverse reactions. Adverse events were not mentioned in the other 12 trials. No trial reported the incidence of complications, quality of life outcomes, or health economics. CONCLUSION: HGWWD treatment improves diabetic neurologic symptoms and ameliorates nerve conduction velocities. Our study suggests that HGWWD may have significant therapeutic efficacy for the treatment of diabetic peripheral neuropathy. However, the methodological quality of the randomized controlled trials was generally low. Larger and better-designed randomized controlled trials are required to more reliably assess the clinical effectiveness of HGWWD.
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Placebo-controlled randomized trials are often used to evaluate the absolute effect of new treatments and are considered gold standard for clinical trials. No studies, however, have yet been conducted evaluating the reporting quality of placebo-controlled randomized trials. The current study aims to assess the reporting quality of placebo-controlled randomized trials on treatment of diabetes with Traditional Chinese Medicine (TCM) in Mainland China and to provide recommendations for improvements.China National Knowledge Infrastructure database, Wanfang database, China Biology Medicine database, and VIP database were searched for placebo-controlled randomized trials on treatment of diabetes with TCM. Review, animal experiment, and randomized controlled trials without placebo control were excluded. According to Consolidated Standards of Reporting Trials (CONSORT) 2010 checklists items, each item was given a yes or no depending on whether it was reported or not.A total of 68 articles were included. The reporting percentage in each article ranged from 24.3% to 73%, and 30.9% articles reported more than 50% of the items. Seven of the 37 items were reported more than 90% of the items, whereas 7 items were not mentioned at all. The average reporting for "title and abstract," "introduction," "methods," "results," "discussion," and "other information" was 43.4%, 78.7%, 40.1%, 49.9%, 71.1%, and 17.2%, respectively. The percentage of each section had increased after 2010. In addition, the reporting of multiple study centers, funding, placebo species, informed consent forms, and ethical approvals were 14.7%, 50%, 36.85%, 33.8%, and 4.4%, respectively.Although a scoring system was created according to the CONSORT 2010 checklist, it was not designed as an assessment tool. According to CONSORT 2010, the reporting quality of placebo-controlled randomized trials on the treatment of diabetes with TCM improved after 2010. Future improvements, however, are still needed, particularly in methods sections.
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Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Medicina Tradicional Chinesa , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , China , Humanos , Medicina Tradicional Chinesa/métodos , Medicina Tradicional Chinesa/normas , Ensaios Clínicos Controlados Aleatórios como Assunto/métodosRESUMO
The rapidly increasing diabetes mellitus (DM) is becoming a major public health issue globally; considerable progress has been made in the field of western hypoglycemic drug and insulin, but some shortages still exist. As one of the most important parts in complementary and alternative therapies, traditional Chinese medicine (TCM) performs a good clinical practice and is showing a bright future in the treatment of DM. TCM therapy has certain advantages of less toxicity and/or side effects, and Chinese herbal medicine which usually contains various active ingredients could provide multiple therapeutic effects. Huang Lian (Rhizoma coptidis, RC) is a herb frequently used in many traditional formulas for properties of "clearing damp-heat, quenching fire, and counteracting poison" in Asia for centuries. In this review, we summarize the application of RC in the treatment of DM from two aspects of contents. Firstly, theoretical principles are explained, including the properties and related records about RC in ancient references and modern pharmacological researches and pharmacokinetics on RC and its active components. Secondly, the clinical application of RC is mainly reviewed, such as applicable stage and syndrome, the reasonable dose range, the preparation formulations, and the toxicity and/or side effects and solutions to its adverse actions. This review provides scientific evidence about the effective components, pharmacological researches, and toxicity of RC, as well as introducing traditional Chinese medical theory and clinical experience, in order to guide clinician to use RC more suitably and reasonably in the clinical practice.
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The rapidly increasing incidence of diabetes mellitus (DM) is becoming a major public health issue. As one of the important parts in complementary and alternative therapies, traditional Chinese medicine (TCM) is promising in treating DM. In this review, we summarize new thoughts on treating DM that aim to improve the clinical efficacy of TCM from the perspectives of principle, methods, formula, herbs, and doses. Our approach is as follows: principle: we use a combination of symptoms, syndromes, and diseases as a new mode for treating diabetes; methods: emphasizing heat-clearing in the early and middle stage of T2DM and invigorating blood circulation throughout the whole process of T2DM are two innovative methods to treat T2DM; formulas and herbs: choosing formulas and herbs based on the combination of TCM theory and current medicine. We will emphasize four strategies to help doctors choose formulas and herbs, including treatment based on syndrome differentiation, choosing herbs of bitter and sour flavors to counteract sweet flavor, choosing formulas and herbs aimed at main symptoms, and using modern pharmacological achievements in clinical practice; dose: reasonable drug dose plays an important role in the treatment of DM and a close relationship exists between dose and clinical efficacy.
RESUMO
Traditional Chinese medicine (TCM) performs a good clinical practice and is showing a bright future in the treatment of diabetes mellitus (DM). TCM treatment has certain advantages of less toxicity and/or side effects, and herbs could provide multiple therapeutic effects. Berberine (BBR) is a classical natural medicine. In this review, we summarize the application of BBR in the treatment of DM from two aspects. First, modern pharmacological effects of BBR on glucose metabolism are summarized, such as improving insulin resistance, promoting insulin secretion, inhibiting gluconeogenesis in liver, stimulating glycolysis in peripheral tissue cells, modulating gut microbiota, reducing intestinal absorption of glucose, and regulating lipid metabolism. BBR is used to treat diabetic nephropathy (DPN), diabetic neuropathy (DN), and diabetic cardiomyopathy due to its antioxidant and anti-inflammatory activities. Second, the clinical application of BBR is reviewed, such as listing some clinical trials on the effectiveness and safety of BBR, explaining applicable stage and syndrome, the reasonable dose and dose formulation, and the toxicity and/or side effects. This review provides scientific evidence about BBR, as well as introducing some traditional Chinese medical theory and clinical experience, in order to guide clinician to use BBR more suitably and reasonably.