The Selected Traditional Chinese Medicinal Formulas for Treating Diabetic Nephropathy: Perspective of Modern Science

Abstract

With the increasing patients and limited therapeutic options, diabetic nephropathy (DN) is a long-term complication of diabetic mellitus. The precise mechanism of DN is not yet fully understood and the effective blockade of the progression of nephropathy remains a therapeutic challenge. Application of traditional Chinese medicine (TCM) for diabetes and its related complications has received increasing attention due to its wide availability, low side effects, and proven therapeutic mechanisms and benefits. In the current review, we mainly focus on the recent laboratory studies of the TCM formulas including Wu-Ling-San (Poria Five Powder; Wǔ Líng Sǎn), Danggui-Buxue-Tang (Tangkuei and Astragalus Decoction; Dāng Guī Bǔ Xuè Tang), and Danggui-Shaoyao-San (Tangkuei and Paeonia Formula; Dāng Guī Sháo Yào Sǎn), conducted by the Committee on Chinese Medicine and Pharmacy at the Department of Health of Taiwan Government, in the amelioration of DN. These selected TCM formulas have anti-diabetic properties, with antihyperglycemic activity accompanied by amelioration of advanced glycation end product–mediated renal damage in streptozotocin-induced diabetic rats. However, the renoprotective effects of the selected TCM formulas did not correlate with suppressing renal renin–angiotensin system hyperactivity in diabetic rats. These TCM formulas also have the capacity to ameliorate the defective antioxidative defense system, leading to modulation of the oxidative stress, thereby resulting in downregulation of nuclear factor-kB as well as transforming growth factor-β1 and, consequently, attenuation of extracellular matrix components such as fibronectin or type IV collagen expression in diabetic renal cortex tissue. More detailed mechanistic researches and long-term clinical evaluations, as well as evaluation of safety of the selected TCM formulas are needed for their future applications in DN therapy.

Ferulic acid combined with astragaloside IV protects against vascular endothelial dysfunction in diabetic rats

“…In recent years, application of traditional Chinese medicines (TCMs) for DM and its related complications has received increasing attention due to their wide availability, low side effects, and proven therapeutic mechanisms and benefits. Many TCMs and their active components have been reported to have antihyperglycemic effects, for example Angelica sinensis, Radix astragali, Radix rehmanniae, Panax ginseng (10,11).…”

Effects of <i>Astragalus</i> Combined with <i>Angelica</i> on Bone Marrow Hematopoiesis Suppression Induced by Cyclophosphamide in Mice

“…The most popular formulation is Danggui Buxue Tang (DBT) composed of Astragalus and Angelica at a 5 : 1 ratio, which is mainly used to treat anemia due to various causes via promoting hematopoiesis. 1) In recent years, studies have shown that DBT also has other pharmacological effects, such as enhancing immunity, 2) antagonizing diabetic nephropathy, 3) cardiovascular protection, 4) anti-fibrosis, 5,6) estrogen-like effect, 7,8) among others. Concerning the hematopoietic function of the AstragalusAngelica combination, most studies have revealed that Astragalus mixed with Angelica at 5 : 1 can strongly promote hematopoiesis.…”

A study on the recent 20 years&rsquo; herbal medication rules and syndromes distribution in TCM treatment of Diabetic Nephropathy by Data mining

“…As it is fully understood that the syndrome of DN is not fixed but a dynamic development progress. 25 In TCM perspective, in the early stage of the disease, the lung, stomach, lung and kidney suffer from the loss of Yin fluid. Throughout time, the Yin deficiency affects Qi and Yang, causing Qi and Yin deficiency, Yin and Yang deficiency, and spleen and kidney Yang deficiency.…”