Zhenwu decoction for chronic heart failure

Tang, Qi; Wang, Yuanping; Li, Kuangyi

doi:10.1097/md.0000000000011559

Cited by 14 publications

(8 citation statements)

References 12 publications

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“…As shown in Table 1 , there are up to 557, 408, 359, and 190 research reports, respectively, related to Zhenwu Decoction, Zhigancao Decoction, Wuling Powder, and Shengmai Powder. By 2020, there have been several systematic reviews and meta-analyses in which Zhenwu Decoction and Wuling Powder were used as the main intervention measures, which proved the clinical efficacy of these prescriptions in the treatment of chronic heart failure [ 26 , 27 ]. To show the research reports and systematic reviews of different recommended prescriptions more intuitively, we drew a bar chart in which the red histogram represents prescriptions whose clinical studies have been reviewed systematically, and the blue histogram represents prescriptions whose clinical studies have not been reviewed systematically ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of High-Frequency Prescription of Zhigancao Decoction Combined with Conventional Western Medicine in the Treatment of Chronic Heart Failure

Zhang

Li³

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Background. Chronic heart failure is the main critical illness and cause of death in the later stages of cardiovascular disease, and it is one of the two major challenges in the field of cardiovascular research. The clinical application of traditional Chinese medicine in the prevention and treatment of chronic heart failure has been relatively common in China, and the “Expert Consensus on the Diagnosis and Treatment of Chronic Heart Failure with Integrated Traditional Chinese and Western Medicine” has been published in China. Combining the literature in this field, the authors found that Zhigancao Decoction has been used in the treatment of chronic heart failure with more clinical research reports and higher frequency (this article refers to it as a high-frequency prescription for short). However, Zhigancao Decoction was not included in the recommended prescriptions in the “Expert Consensus on the Diagnosis and Treatment of Chronic Heart Failure with Integrated Traditional Chinese and Western Medicine,” and there was no relevant systematic review and meta-analysis. For this reason, this article has carried out two parts of work, including systematically organizing the literature in this research field and carrying out systematic review and meta-analysis. This can provide stronger evidence support for Zhigancao Decoction combined with conventional Western medicine in the treatment of chronic heart failure and provide a new option for the improvement and update of the “Expert Consensus on the Diagnosis and Treatment of Chronic Heart Failure with Integrated Traditional Chinese and Western Medicine.” Methods. This article used the bibliometric method to investigate the research articles on the treatment of chronic heart failure with integrated traditional Chinese and Western medicine and analyzed the high-frequency prescriptions which are used and reported frequently. In addition, we also used manual and computer-aided search methods, the search scope includes CNKI, WANFANG, VIP, SinoMed, Web of Science, PubMed, and Cochrane Library, and the search content is the clinical randomized control of Zhigancao Decoction combined with conventional Western medicine in the treatment of chronic heart failure trials (RCTs). The search period is from the establishment of the database to January 29, 2021. The literature was managed and screened by EndNote software; the quality of the included literature was evaluated according to the modified Jadad scale, and the risk bias was assessed using the Cochrane tool; the results of the included studies were analyzed using the Review Manager 5.3 software; the sources of heterogeneity between the studies were analyzed using Stata16.0 software for sensitivity analysis. Results. According to the bibliometric analysis, the maximum number of research reports is 553, which are arranged in descending order of 21 prescriptions, including Zhenwu Decoction, Zhigancao, and powder of five drugs containing poria. The second most frequently used prescription is Zhigancao Decoction combined with conventional Western medicine in the treatment of chronic heart failure, but its systematic review and meta-analysis still need further research. A total of 17 clinical randomized controlled trials of Zhigancao Decoction combined with conventional Western medicine in the treatment of chronic heart failure were included in the search, with a total of 1752 subjects. Meta-analysis results show that Zhigancao combined with conventional Western medicine is more effective than conventional Western medicine in the treatment of chronic heart failure. The advantages are the following 5 outcome indicators: total clinical effective rate, left ventricular ejection fraction, left ventricular end-diastolic diameter, B-type natriuretic peptide, and 6-minute walk test. Conclusions. There are many prescriptions combined with Western medicine to treat chronic heart failure, among which Zhigancao Decoction is the second most frequently used prescription. There are many original studies on Zhigancao Decoction combined with conventional Western medicine in the treatment of chronic heart failure. The quality of the evaluation research shows that the overall standard is scientific, and a few experimental designs are slightly irregular. Meta-analysis shows that Zhigancao Decoction combined with conventional Western medicine has better therapeutic effects and safety than conventional Western medicine. This shows the characteristics and advantages of integrated Chinese and Western medicine in the treatment of cardiovascular diseases and is worth recommending.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of High-Frequency Prescription of Zhigancao Decoction Combined with Conventional Western Medicine in the Treatment of Chronic Heart Failure

Zhang

Li³

et al. 2021

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

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“…It inculdes five herbs: Poria cocos (Schw.) Wolf [Polyporaceae; Poria], Paeonia lactiflora Pall [Ranunculaceae; Paeoniae Radix Alba], Zingiber officinale Rosc [Zingiberaceae; Zingiberis Rhizoma Recens], Aconitum carmichaelii Debx [Ranunculaceae; Aconiti Lateralis Radix Praeparata], Atractylodes macrocephala Koidz [Compositae; Atractylodis Macrocephalae Rhizoma], which is applied to treat chronic heart failure ( Tang et al, 2018 ; Han et al, 2022 ). It is believed in TCM that CVDs is related to the imbalance of Qi, Xue, Yin and Yang in the human body.…”

Section: Introductionmentioning

confidence: 99%

Shenfu injection: a review of pharmacological effects on cardiovascular diseases

Xu,

Xie,

et al. 2024

Front. Pharmacol.

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Shenfu injection (SFI), composed of ginseng and aconite, is a Chinese patent developed from the classic traditional prescription Shenfu Decoction created more than 700 years ago. SFI has been widely used in China for over 30 years for treating cardiovascular diseases. The main components in it include ginsenosides and aconitum alkaloids. In recent years, the role of SFI in the treatment of cardiovascular diseases has attracted much attention. The pharmacological effects and therapeutic applications of SFI in cardiovascular diseases are summarized here, highlighting pharmacological features and potential mechanisms developments, confirming that SFI can play a role in multiple ways and is a promising drug for treating cardiovascular diseases.

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“…ZWD possesses various bioactivities such as anti-inflammation, antiapoptotic, neuroprotection, etc. − Modern research shows that ZWD has a therapeutic effect on HF, diabetic nephropathy, and other diseases. , However, only a few studies have investigated the mechanisms of ZWD in HF therapy, and the effective material remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Serum Pharmacochemistry Combined with Network Pharmacology-Based Mechanism Prediction and Pharmacological Validation of Zhenwu Decoction on Alleviating Isoprenaline-Induced Heart Failure Injury in Rats

Li,

Zhu,

et al. 2023

ACS Omega

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Zhenwu decoction (ZWD) is a famous classical formula in the treatment of heart failure (HF) with significant clinical effects. Owing to the complex material basis of ZWD, it is challenging to elucidate the pharmacodynamic substances and pharmacological mechanisms of ZWD against HF. Therefore, an ultrahigh-performance liquid chromatography system coupled with a high-resolution orbitrap mass spectrometry method was used to profile the chemical components and the absorbed prototype constituents in ISO-induced HF rat serum after oral administration of ZWD, and 33 out of 115 compounds were identified. In the in vivo study, ZWD could improve cardiac function and reduce the content of serum biochemical indexes, which are heart failure markers. With the help of network pharmacology and molecular docking simulation analysis, 112 ZWD targets oriented by HF were obtained, with STAT3, TNF, AKT1, VEGFA, and ALB as the core targets. Furthermore, we found that paeoniflorin and its derivatives may play a bigger role than other serum migrant components. Enriched pathway analysis yielded multiple HF-related signaling pathways, which indicated that ZWD may attenuate HF through the effect of PI3K-Akt, and MAPK pathways by regulating key targets such as STAT3, TNF, and AKT1. Finally, STAT3/MAPK pathways were experimentally validated in the anti-HF effect of ZWD. The phosphorylation levels of p38, JNK, ERK, and STAT3 were significantly increased in the ISO group and reversed by ZWD intervention. The results provided a reasonable strategy for the rapid screening of bioactive components in ZWD and a reference for quality control and further mechanism study of ZWD.

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Zhenwu decoction for chronic heart failure

Abstract: Supplemental Digital Content is available in the text

Cited by 14 publications

References 12 publications

A Systematic Review and Meta-Analysis of High-Frequency Prescription of Zhigancao Decoction Combined with Conventional Western Medicine in the Treatment of Chronic Heart Failure

A Systematic Review and Meta-Analysis of High-Frequency Prescription of Zhigancao Decoction Combined with Conventional Western Medicine in the Treatment of Chronic Heart Failure

Shenfu injection: a review of pharmacological effects on cardiovascular diseases

Serum Pharmacochemistry Combined with Network Pharmacology-Based Mechanism Prediction and Pharmacological Validation of Zhenwu Decoction on Alleviating Isoprenaline-Induced Heart Failure Injury in Rats

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