Chinese medicine and diabetic foot ulcers

NewsBot · Apr 17, 2024

Summary and evaluation of randomized controlled trial on Chinese patent medicine in treatment of diabetic foot ulcer
Wen-Ting Song et al
Zhongguo Zhong Yao Za Zhi. 2024 Feb;49(4):1113-1121.

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.
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NewsBot · Apr 19, 2024

Research progress of traditional Chinese medicine monomer in treating diabetic peripheral neuropathy: A review
Shi Xiaoqin et al
Medicine (Baltimore). 2024 Mar 29;103(13):e37767

Diabetes peripheral neuropathy is one of the most common complications of diabetes. Early symptoms are insidious, while late symptoms mainly include numbness, pain, swelling, and loss of sensation in the limbs, which can lead to disability, foot ulcers, amputation, and so on. At present, the pathogenesis is also complex and diverse, and it is not yet clear. Western medicine treatment mainly focuses on controlling blood sugar and nourishing nerves, but the effect is not ideal. In recent years, it has been found that many drug monomers have shown good therapeutic and prognostic effects in the prevention and treatment of diabetes peripheral neuropathy, and related research has become a hot topic. To understand the specific mechanism of action of traditional Chinese medicine monomers in treatment, this article provides a review of their mechanism research and key roles. It mainly includes flavonoids, phenols, terpenes, saponins, alkaloids, polysaccharides, etc. By nuclear factor-κB (NF-κB), the signaling pathways of adenosine monophosphate-activated protein kinase (AMPK), Nrf2/ARE, SIRT1/p53, etc, can play a role in lowering blood sugar, antioxidant, anti-inflammatory, inhibiting cell apoptosis, and autophagy, promoting sciatic nerve regeneration, and have great potential in the prevention and treatment of this disease. A systematic summary of its related mechanisms of action was conducted, providing ideas for in-depth research and exploration of richer traditional Chinese medicine components, and also providing a relatively complete theoretical reference for clinical research on diabetes peripheral neuropathy treatment.
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NewsBot · Sep 15, 2024

Accelerating diabetic wound healing with Ramulus Mori (Sangzhi) alkaloids via NRF2/HO-1/eNOS pathway
Fugang Xiao et al
Phytomedicine. 2024 Aug 31:134:155990

Diabetic foot ulcers (DFUs) represent a severe complication of diabetes mellitus. Ramulus Mori (Sangzhi) alkaloids (SZ-A), an approved oral medication for type 2 diabetes, have not been explored for their potential to enhance the processes involved in diabetic wound healing. This study aims to investigate SZ-A's role in diabetic wound healing mechanisms. The in vivo experimentation involves dividing the subjects into NC and SZ-A groups, with SZ-A dosed at 200 and 400 mg/kg, to assess the therapeutic efficacy of SZ-A. The results of the animal studies show that SZ-A intervention accelerates the processes of diabetic angiogenesis and wound healing in a manner dependent on its concentration. Additionally, a pathological model using advanced glycation end products (AGEs) in HUVECs demonstrates SZ-A's cytoprotective effect. In vitro, SZ-A intervention significantly increases cell proliferation, migration and tube formation, protecting HUVECs from oxidative stress injury induced by AGEs. Mechanistically, SZ-A exerts a protective effect on HUVECs from oxidative stress damage through the activation of the NRF2/HO-1/eNOS signaling pathway. The findings suggest that SZ-A exhibits considerable potential as a promising candidate for treating DFUs, which will aid in more effectively integrating plant-based therapies into clinical settings.
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NewsBot · Oct 4, 2024

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Effect of Chinese herbal compound dressings in treating patients with diabetic foot ulcers: A meta-analysis
Qian Yang, Fei Liu, Changxiu Zhao, Xin Xu, Yaqi Wang, Weiwei Zuo
05 March 2024
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RETRACTION: Effect of Chinese herbal compound dressings in treating patients with diabetic foot ulcers: A meta-analysis
Int Wound J. 2024 Sep;21(9):e70077. doi: 10.1111/iwj.70077.
Retraction: Q. Yang , F. Liu , C. Zhao , X. Xu , Y. Wang , W. Zuo , "Effect of Chinese Herbal Compound Dressings in Treating Patients with Diabetic Foot Ulcers: A Meta-Analysis," International Wound Journal 21, no. 3 (2023): e14767, https://doi.org/10.1111/iwj.14767. The above article, published online on 05 March 2024, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction has been agreed on as the peer review and publishing process for this article were found to be manipulated.

NewsBot · Oct 24, 2024

Summary and evaluation of randomized controlled trial on Chinese patent medicine in treatment of diabetic foot ulcer
Wen-Ting Song et al
Zhongguo Zhong Yao Za Zhi. 2024 Feb;49(4):1113-1121

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.
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NewsBot · Nov 6, 2024

Clinical Effects of Thread-Dragging Therapy on Gangrene of Non-ischemic Diabetic Foot Ulcers
Fang-Fang Wu et al
Chin J Integr Med. 2024 Nov 5

Objective: To investigate the clinical effects of thread-dragging therapy on gangrene of non-ischemic diabetic foot ulcers (NIDFU).

Methods: A total of 136 patients with NIDFU were recruited from the Department of Peripheral Vascular Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine between June 21, 2021 and February 1, 2023, and randomized into an intervention group and a control group, with 68 cases in each group. Both groups received basic treatment. The intervention group was treated with thread-dragging therapy, while the control group was treated with debridement combined with routine dressing changes after surgery. Both groups were treated continuously for 2 months. The amputation rates and changes in the ulcer area were compared between the groups. The inflammatory response index including peripheral white blood cells (WBCs), neutrophil percentage (NEUT%), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), and interleukin 6 (IL-6) were compared between the two groups.

Results: After treatment, the ulcer areas in the intervention group were significantly smaller than that of the control group (8.50±3.88 cm2 vs. 10.11±4.61 cm2, P<0.05). The amputation rates of the two groups were not statistically significant (4.4% vs. 5.9%, P>0.05). Differences of WBCs count, CRP, and ESR before and after therapy in the intervention group were better than the control group (P<0.05). However, there were no significant differences in changes of NEUT%, PCT, and IL-6 between the two groups (P>0.05).

Conclusion: Thread-dragging therapy may be effective in the treatment of NIDFU, with the additional advantages of less tissue damage after healing.
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NewsBot · Nov 28, 2024

Shengji ointment combined with bromelain promotes granulation of exposed tendons in diabetic foot ulcers: A multicenter, randomized, positive-controlled clinical trial
Xu Sun et al
Heliyon. 2024 Oct 31;10(22):e39716

Background: Exposed, infected and necrotic tendons often occur in the middle and late stages of diabetic foot ulcers (DFUs). The exposed tendon is both a potential source and route of infection, which prolongs the treatment period and affects recovery, leading to amputation and even death. Therefore, management of the exposed tendon in patients with DFU is the key to treatment. This study aimed to evaluate the clinical efficacy of Shengji ointment combined with bromelain in the treatment of DFU with tendon exposure and to provide clinical treatment options and evidence-based medicine.

Methods: This study was a multicenter, nonblinded, randomized, positive controlled clinical trial involving 180 patients with DFU with tendon exposure at four tertiary-grade A-class hospitals. The included patients were randomly assigned 1:1 to an observation group (n = 90) that received Shengji ointment combined with bromelain and a control group (n = 90) that received hydrocolloid dressing, with dressing changes once daily for 4 weeks. Patients in both groups continued with conventional treatments, such as blood glucose and blood pressure medication, lipid regulation, and antiplatelets. The primary outcome measure was wound coverage with granulation tissue. The secondary outcome measures included the wound healing rate, time to granulation, Maryland foot score, time to debridement of necrotic tendon tissue, and granulation tissue score. We performed measurements before enrollment and after the end of treatment for comparison.

Results: There was no significant difference in the baseline data between the two groups before treatment (P > 0.05). After treatment, the primary outcome indicators of the two groups were compared, and the wound granulation tissue coverage rate of the treatment group was greater than that of the control group (P = 0.003). For the secondary outcome outcomes, the wound healing rate, time to granulation, Maryland foot function score, time to debridement of necrotic tendon tissue, and granulation tissue score in the treatment group were significantly better than those in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P = 0.444).

Conclusions: Shengji ointment combined with bromelain effectively promotes the removal of exposed necrotic tendons in patients with DFU, promotes the regeneration of healthy granulation tissue, accelerates wound healing, and protects the limb and its function. It also appears to be safe as an intervention for the treatment of patients with DFU.
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NewsBot · Dec 19, 2024

News Release 19-Dec-2024
Suboptimal reporting of randomized controlled trials on non-pharmacological therapies in Chinese medicine

Nonpharmacological treatments in Chinese medicine (NPTCM), including acupuncture, cupping, moxibustion, and Tuina, have gained global recognition for their efficacy in various health conditions. However, the reporting quality of randomized controlled trials (RCTs) on these interventions has been suboptimal, with many lacking sufficient descriptions of interventions, blinding details, and exhibiting significant interstudy heterogeneity. This has led to the development of CONSORT extension guidelines, including STRICTA for acupuncture, STRICTOM for moxibustion, STRICTOC for cupping, and STRICTOTM for Tuina/massage, aiming to standardize the reporting of NPTCM trials. Despite these guidelines, adherence has been variable, with significant room for improvement in the reporting quality of RCTs, particularly in the areas of treatment regimens, practitioner background, and safety assessments.

This review analyzed RCTs published in 2022 to assess the reporting quality of NPTCM interventions based on the respective CONSORT extensions. A total of 387 eligible RCTs were identified, with the majority published in Chinese journals. The review revealed that while acupuncture trials had the highest reporting rate at 62.6%, Tuina/massage trials had the lowest at 47.9%. The reporting of treatment regimens was relatively high at 79.9%, but the reporting of practitioner background was alarmingly low at 14.9%. Subgroup analysis showed that publications in English had a significantly higher reporting score than those in Chinese. The review also identified major deficiencies in the reporting of safety assessments, the incorporation of CM patterns in trial design, and the implementation of blinding in NPTCM trials.

The review highlights the need for enhanced reporting of safety assessments, standardized reporting of CM pattern-related diagnostic criteria and outcomes, and more research into the reasons for poor reporting of certain items such as treatment environment and provider background information. It recommends that journals strengthen their endorsement of reporting guidelines, particularly for Chinese journals, to improve the quality of NPTCM interventional studies. The review concludes that while progress has been made in adhering to reporting guidelines, there is a pressing need for further improvement to ensure accurate documentation and enhance the quality and reliability of research in the field of NPTCM.

NewsBot · Dec 19, 2024

Predicting the diabetic foot in the population of type 2 diabetes mellitus from tongue images and clinical information using multi-modal deep learning
Zhikui Tian et al
Front Physiol. 2024 Dec 3:15:1473659.

Aims: Based on the quantitative and qualitative fusion data of traditional Chinese medicine (TCM) and Western medicine, a diabetic foot (DF) prediction model was established through combining the objectified parameters of TCM and Western medicine.
Methods: The ResNet-50 deep neural network (DNN) was used to extract depth features of tongue demonstration, and then a fully connected layer (FCL) was used for feature extraction to obtain aggregate features. Finally, a non-invasive DF prediction model based on tongue features was realized.

Results: Among the 391 patients included, there were 267 DF patients, with their BMI (25.2 vs. 24.2) and waist-to-hip ratio (0.953 vs. 0.941) higher than those of type 2 diabetes mellitus (T2DM) group. The diabetes (15 years vs. 8 years) and hypertension durations (10 years vs. 7.5 years) in DF patients were significantly higher than those in T2DM group. Moreover, the plantar hardness in DF patients was higher than that in T2DM patients. The accuracy and sensitivity of the multi-mode DF prediction model reached 0.95 and 0.9286, respectively.

Conclusion: We established a DF prediction model based on clinical features and objectified tongue color, which showed the unique advantages and important role of objectified tongue demonstration in the DF risk prediction, thus further proving the scientific nature of TCM tongue diagnosis. Based on the qualitative and quantitative fusion data, we combined tongue images with DF indicators to establish a multi-mode DF prediction model, in which tongue demonstration and objectified foot data can correct the subjectivity of prior knowledge. The successful establishment of the feature fusion diagnosis model can demonstrate the clinical practical value of objectified tongue demonstration. According to the results, the model had better performance to distinguish between T2DM and DF, and by comparing the performance of the model with and without tongue images, it was found that the model with tongue images performed better.
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NewsBot · Jun 25, 2025

Network pharmacology, docking, and molecular dynamics analysis of Sanhuang decoction in diabetic foot ulcers
Bo Wu et alt
Comput Methods Biomech Biomed Engin. 2025 May 23:1-18.

This study aims to systematically and comprehensively elucidate the mechanism of action of Sanhuang decoction (SHD) in the treatment of diabetic foot ulcers (DFUs). The active ingredients and potential targets of SHD, as well as the human targets associated with DFUs, were obtained from various databases, including TCMSP, GeneCards, OMIM, PharmGKB, DrugBank, and others. STRING, Cytoscape 3.10.1, and Metascape were utilized for a series of network constructions and module analyses of common targets. Subsequently, the pivotal targets were chosen for molecular docking with the principal active constituents. A comprehensive screening of 59 active compounds and 447 targets associated with SHD was conducted, resulting in the identification of 182 intersection targets. Notably, key targets involved in this study included IL10, CCL2, IL6, IFNG, IL1B, CXCL8, IL2, CXCL10, IL1A, and TNF. It found that SHD was rich in various active ingredients that regulate the targets of DFUs. Molecular dynamics simulations indicate that β-sitosterol, stigmasterol, and 5,8,2'-trihydroxy-7-methoxyflavone bind tightly to IL2. Our study provides preliminary insights into the modulatory effects of SHD on DFUs and identifies SHD as an effective strategy for treating DFUs through multi-component and multi-target modulation of the inflammatory response. Subsequent trials will be conducted to confirm that the above findings are expected to help improve personalized treatment for patients with DFUs.
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Chinese medicine and diabetic foot ulcers

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Chinese medicine and diabetic foot ulcers

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Patent granted for Chinese medicine treatment for "pedopathy"

Chinese Medicine & Acupuncture for Plantar Fasciitis

HPC to regulate Acupuncture, Herbal Medicine and Traditional Chinese

Chinese speaking podiatrist wanted!! new grad welcome

Chinese Foot Binding

Chinese Foot Binding project on Kickstarter

Relationship Between Leg Length and Gestational Diabetes Mellitus in Chinese Pregnant Women

Share This Page

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