Welcome to the Podiatry Arena forums, for communication between foot health professionals about podiatry and related topics.
You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members (PM), upload content, view attachments, receive a weekly email update of new discussions, earn CPD points and access many other special features. Registered users do not get displayed the advertisments in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!
If you have any problems with the registration process or your account login, please contact contact us.
Influence of an anti-diabetic foot ulcer formula and its component herbs on tissue and systemic glucose homeostasis. J Ethnopharmacol. 2006 Jun 27;
Quote:
Complications of diabetes impose major public health burdens worldwide. The positive effect of a Radix Astragali-based herbal preparation on healing diabetic foot ulcers in patients has been reported. Formula 1 is also referred as the 'Herbal drink to strengthen muscle and control swelling'. This formula contains six Chinese medical herbs, including Radix Astragali, Radix Rehmanniae, Rhizoma Smilacis Chinensis, Rhizoma Atractylodis Macrocephalae, Radix Polygoni Multiflori Preparata, and Radix Stephania Tetrandrae. Three of these herbs (Radix Astragali, Radix Rehmanniae, Rhizoma Atractylodis Macrocephalae) are commonly used in different anti-diabetic formulae of Chinese medicine. The objective of the current study is to use an interdisciplinary approach to test the hypothesis that Formula 1 and its components influence tissue and systemic glucose homeostasis. In vitro and in vivo models have been established including: (1) glucose absorption into intestinal brush border membrane vesicles (BBMV); (2) gluconeogenesis by H4IIE hepatoma cells; (3) glucose uptake by 3T3-L1 adipocytes and Hs68 skin fibroblasts; (4) normalization of glycaemic control in a diabetic rat model. The results of in vitro studies indicated that all herbal extracts can modify cellular glucose homeostasis. Since Formula 1 and Rhizoma Smilacis Chinensis extracts demonstrated potent effects on modifying glucose homeostasis in multiple tissues in vitro, they were further studied for their anti-diabetic activities in vivo using a streptozotocin (STZ)-induced diabetic rat model. The results showed that Formula 1 and Rhizoma Smilacis Chinensis extracts did not significantly improve oral glucose tolerance or basal glycaemia in diabetic rats. In conclusion, the anti-diabetic foot ulcer Formula 1 contains ingredients active in modifying tissue glucose homeostasis in vitro but these biological activities could not be associated with improved glycaemic control of diabetes in vivo.
I did read about a case locally where a clinic was having almost miraculous results treating eczema with homeopathic creams. This was until somebody had a severe reaction and it was discovered that these creams were being made by putting all natural homeopathic ingredients... into a rather concentrated hydrocortizone base.
It seems slightly strange that people who were quite happy to use a cream made by blending bits of greenery stopped when they found it also contained a "chemical" (shock horror, steps back in terror and awe)
Is Oral Administration of Chinese Herbal Medicine Effective and Safe as an Adjunctive Therapy for Managing Diabetic Foot Ulcers? A Systematic Review and Meta-Analysis.
Chen M, Zheng H, Yin LP, Xie CG. J Altern Complement Med. 2010 Aug 1. [Epub ahead of print]
Quote:
Objective: This meta-analysis aimed to assess the effectiveness and safety of Chinese herbal medicine (CHM) as an adjunctive method to standard therapy for patients with diabetic foot ulcers (DFU).
Methods: Randomized controlled trials (RCTs) of CHM to treat DFU were searched in the following electronic databases: MEDLINE((R)); EMBASE; Chinese Biomedical Database (CBM); Cochrane Central Register of Controlled Trials (CENTRAL); Allied & Complementary Medicine Resources (AMED); and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Two (2) researchers independently assessed the quality and validity of included trials and extracted outcome data for synthesis.
Results: Six (6) trials were included for analysis. Compared to using standard therapy alone, CHM combined with standard therapy significantly increased the number of patients whose ulcers healed (risk ratio [RR], 0.62, [95% confidence interval (CI), 0.39-0.97]) and number of patients with at least a 30% reduction in the ulcer area (RR, 0.81 [95%CI, 0.71-0.92]). In addition, the two therapies combined significantly decreased the number of patients without any improvement (RR, 0.34 [95%CI, 0.21-0.53]). However, with respect to blood flow volume in the dorsal artery of the foot, no significant difference between the two therapies was observed (standardized mean difference, 1.71 [95% CI -1.25-4.67]), but the result favored the CHM combined with standard therapy group. Only 2 of 6 trials reported adverse events, which included nausea, epigastric pain, and dry mouth.
Conclusions: CHM may be effective and safe as an adjunctive therapy for treating DFU. However, a firm conclusion could not be reached because of the poor quality of the included trials. Further trials with higher quality are justified.
Recently had a patient who ditched conventional dressings, offloading and diabetic management to trial chinese medicine. It involved a mix of herbal drinks and a yellow powder to be applied to the wounds.
The treating GP and myself had a bit of a chuckle when he presented 3 weeks later begging to be squeezed in because the wounds had increased in size and there was obvious infection creating a lovely smell from under the dressings.
Prospective randomized controlled study of a Chinese Herbal Medicine Compound Tangzu Yuyang Ointment for chronic diabetic foot ulcers: A preliminary report.
Li S, Zhao J, Liu J, Xiang F, Lu D, Liu B, Xu J, Zhang H, Zhang Q, Li X, Yu R, Chen M, Wang X, Wang Y, Chen B. J Ethnopharmacol. 2010 Nov 30. [Epub ahead of print]
Quote:
Aim of the study The purpose of this study was to evaluate the efficacy and safety of a topical Chinese herbal medicine (CHM) compound Tangzu Yuyang ointment (TYO) for treatment of chronic diabetic foot ulcers.
Materials and methods This multi-center, prospective, randomized, controlled and add-on clinical trial was conducted at seven centers in the China mainland. Fifty-seven patients with chronic diabetic foot ulcers of Wagner's ulcer grade 1 to 3 were enrolled in this study. Patients who were randomly assigned to the control group (n=28) received standard wound therapy (SWT), whereas those randomized to the treatment group (n=28) received SWT plus topical TYO. Only 48 patients who finished 24 weeks of observations were entered for data analysis.
Results The TYO and SWT groups were comparable for baseline characteristics. Ulcer improvement was 79.2% in the TYO group and 41.7% in the SWT group (P=0.017) at 12 weeks, and 91.7% vs. 62.5% (P=0.036) at 24 weeks. The number of ulcers that were completely healed at 4, 12 and 24 weeks were similar in both groups, as were the numbers of adverse events. Healing time was 96±56 days (n=19) in the TYO group and 75±53 days (n=14) in the SWT group (P=0.271).
Conclusion TYO plus SWT is more effective than SWT in the management of chronic diabetic foot ulcers and has few side-effects.
A pilot study on the effects of a polyherbal formulation cream on diabetic foot ulcers.
Viswanathan V, Kesavan R, Kavitha KV, Kumpatla S. Indian J Med Res. 2011 Aug;134(2):168-73.
Quote:
Background & objectives : Diabetic foot ulcers are the most common cause of non-traumatic lower extremity amputations in developing countries. The aim of this pilot study was to evaluate the safety of using a polyherbal formulation in healing diabetic foot ulcers in comparison with standard silver sulphadiazine cream among patients with type 2 diabetes.
Methods: A total of 40 (M:F=29:14) consecutive type 2 diabetes patients with foot ulcers were enrolled in this study. They were randomly assigned to two groups of 20 each; Group 1 was treated with polyherbal formulation and group 2 with silver sulphadiazine cream. All the patients were followed up for a period of 5 months. The baseline ulcer size was noted and photograph of the wound was taken at the baseline and at each follow up visit. Number of days taken for healing of the wound was recorded.
Results: The mean age of patients, duration of diabetes and HbA1c% were similar in both the study groups. The mean length and width of the ulcers was also similar in both the groups at baseline visit. There was a significant decrease in the size of the wound (length and width) in both the study groups (P<0.001). The mean time taken for the healing of the ulcer was around 43 days in both groups.
Interpretation & conclusions : Diabetic wound cream prepared by using polyherbal formulation was found to be effective as well as safe in healing diabetic foot ulcers like the standard silver sulphadiazine cream.
There was a significant decrease in the size of the wound (length and width) in both the study groups (P<0.001). The mean time taken for the healing of the ulcer was around 43 days in both groups.
Right...
Quote:
Diabetic wound cream prepared by using polyherbal formulation was found to be effective as well as safe in healing diabetic foot ulcers like the standard silver sulphadiazine cream.
Wait, what?
So it did exactly the same as its control group. Which the cochrane database was fairly unimpressed with (at least for deep burns).
Never have I seen a negative result so artfully expressed in a positive way! "IT WORKS!!! exactly as well as the control sample
The full text is worth a read.
Quote:
Active ingredients of diabetic wound care cream: (Polyherbal formulation):
Glycyrrhiza glabra 0.20 per cent (Yastimadhu Athimathuram) - It improves normal cell multiplication in a wound and in combination with ketaki and Shorea robusta (kumkilium) it forms a fine protective layer over the wound, accelerating the growth of normal tissue, which gets absorbed into the tissue later.
Musa paradisiaca 19.42 per cent (Kadali vazhaikilangu Kadali) - It tightens the open wound, reduces the wound area and accelerates wound healing. It also reduces the kelloid growth and accelerates the normal tissue growth.
Curcuma longa 2.43 per cent (Manjal turmeric) - It possess anti-inflammatory activity, antiseptic and helps in wound healing. It effectively controls normalcy of tissue glucose level in the wound area. It helps in the natural repair of micro vascular structure.
Pandanus odaratissimus 9.70 per cent (Thazhai / Chevuda Ketaki) - This contains natural fibres with microcrystalline calcium embedded in it which forms foundation layer for the tissue growth like natural fibrogen network over which normal dermal layer can grow.
Aloe vera 4.85 per cent (Sothukathazhai) - It increases the cytogenesis, cleanses the wound and controls the tissue glucose level. Various constituents of aloe vera have been shown to have anti-inflammatory activity as well as it stimulates the wound healing.
Cocos nucifera oil (Kera thailam, coconut milk) - It supplies nutrition and polysaccharides and enhances the growth of the tissue.
I've not taken the references out BTW. This the longest and most enthusiastic list of unreferenced claims since the last pile of dross from Rothbart landed in my inbox!!
A microarray study on the molecular mechanism for the therapeutic effect of Antidotal and Myogenic Ointmen on the foot ulcer in diabetic rats
Han HM, Guo L, Jiang LJ, Jiang XY, Lv YL, Pang JK, Bai ZM, Che WJ, Xu RH, Yu P, Li Q. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2011 Oct;23(10):621-4.
Quote:
OBJECTIVE:
To investigate the underlying mechanism for the therapeutic effect of a traditional Chinese medicinal recipe, Antidotal and Myogenic Ointment (AMO), on the foot ulcer in diabetic rat using cDNA microarray technology.
METHODS:
45 rats were made diabetic by i. p. injection of streptozocin. The treated animals were then fed for 6 months,and subjected to the dissection of distal popliteal artery after ligation of the vessels. Another month later, grade IIburn injury was produced on the bottom of their foot as a model of diabetic foot ulcer. The rats were then randomly divided into three groups (15 each) to receive AMO, epidermal growth factor (EGF) and saline for 30 days, with dressing change in every 2 days. The area of ulcer wound and their healing rate were recorded before and after the treatment. Total RNA was extracted from the tissue samples collected near the wound, and the expression profile of cytokine genes demonstrated using the microarry for rats.
RESULTS:
In comparison with the saline group, difference in the level of expression was found in 25 genes (23 of them were up-regulated and 2 down-regulated) in EGF group, and 30 genes in AMO groups (29 of them up-regulated and 1 down-regulated ). In comparison with EGF group, difference in level of expression was found in 16 genes in AMO group, with 11 up-regulated and 5 down-regulated. Neurotrophic factors and chemotactic factors, etc were among the genes involved.
CONCLUSION:
In comparison with EGF, AMO is more effective in the treatment of foot ulcer in diabetic rats. It is possible that AMO produces such effects through the regulation of balance in cytokine expression
So it did exactly the same as its control group. Which the cochrane database was fairly unimpressed with (at least for deep burns).
Never have I seen a negative result so artfully expressed in a positive way! "IT WORKS!!! exactly as well as the control sample
The full text is worth a read.
I've not taken the references out BTW. This the longest and most enthusiastic list of unreferenced claims since the last pile of dross from Rothbart landed in my inbox!!
hi Robert,
It seems like in both your posts in this thread, you've had it out for natural therapies. is it a poor personal experience?
if Chinese medicine have been around for thousands of years,couldn't the developers of that study write what certain herbs effects were in historical literatures without citations?
Furthermore, sure some natural remedies would be a sham,as we've ALL seen in today tonight etc , but lets not be negative and judge Chinese / alternative medicine in the " bad" pot!
Regards
To paraphrase Dara O'Briain - if Chinese/alternative medicine actually worked it would simply be called..medicine
We are seeing more people taking it up In the past few years though..
Anyhoo I won't be replying anymore to this thread as its diverging a bit away from pod. :-)
It seems like in both your posts in this thread, you've had it out for natural therapies.
Curses. Foiled
Quote:
is it a poor personal experience?
Rather more profound than that. We might start with the moniker of "natural therapies". There seems to be a feeling that if something is "natural" it is safe and/or efficatious and/or intrinsically virtuous. Even if this WERE true (and its really, really not) Chinese herbal medicine is about as natural as pizza. Also posessed of approximately the same medicinal properties.*
But my personal feelings on the whole mess aside, the post you quoted was simply a critique of a truly diabolical paper. And if you stick around for a while you'll notice that I tend to have a downer on them whatever the subject matter. If it seems that I do it more with alternative medicine, its because alternative medicine tends to produce such God awful literature.
Quote:
if Chinese medicine have been around for thousands of years,couldn't the developers of that study write what certain herbs effects were in historical literatures without citations?
No. No no no no no. No.
Firstly, if its in historical literature then that historical literature should be cited. *** But secondly and more importantly, Just because something has been done for hundreds or thousands of years don't mean its any good. Bloodletting was used for thousands of years. In what proports to be a scientific paper, you just can't get away with "it is thought that". Besides, how do you KNOW that those things have been used for thousands of years? Without a historical citation that person could have just made that up on the spot!
If I tell you that the ancient mayans used to stick purple spotted tree frogs in their bottoms to cure piles, you'd be right to ask me for a reference before you handed over $70 for a dessicated purple spotted tree frog. You would be foolish to believe that just because I TELL YOU its been used for thousands of years I'd be exempt from providing evidence of the fact. You'd be of questionable judgement to believe that the ancient mayans were better at curing piles than modern medicine, or that just because rectally administered purple spotted tree frogs are natural, they are either safe or effective.
Sucks for the frog too.
Quote:
Furthermore, sure some natural remedies would be a sham,as we've ALL seen in today tonight etc , but lets not be negative and judge Chinese / alternative medicine in the " bad" pot!
Why on earth not? We should not view therapies as sound until shown to be a placebo (which is very different to a sham BTW) but as ineffective until shown to be effective. New we might split hairs about the value of deductive evidence, rationales etc in mechanics, but we're not talking about mechanics here, we're talking about stuff you eat / rub on / stick up your nose (I don't know!). There is no deduction possible for these without pharmacological data. The models along the lines of "like cures like" and "balances yang" are, in common parlance, ********. As my learned colleague so appositely quoted:-
Quote:
if Chinese/alternative medicine actually worked it would simply be called..medicine
So yeah. You could say I've got a bit of a downer on "natural" (lit, unproven) medicine. On the terrible literature, the misleading abstract, the special dispensation they demand for research methods, the potential harm they can do, either by comission or omission, the woolly thinking they promote, the damage they do to the public psyche, and the links they have to some truly sinister and destructive groups / individuals (Matthias Rath springs to mind).
Kind regards
Robert
PS. Just don't get me started on MMS. I have rather stronger feelings on that stuff. The people who sell that should be publically flogged in my humble (arf) opinion.
* Less actually. There is good deductive evidence that a dominos Mighty meaty pizza** would be an effective treatment for malnutrition. Which is more evidence than there is for any chinese remedy I've ever heard of!
** Other brands are available.
*** I checked the wiki entry on glaucoma today. That too was only partially cited
Reading that back, I got a little carried away there. I'll go sniff some lavender or something.
My wife bought some arnica last weekend when my son bounced his head off a marble floor. Told her there were two ways she could use it, over my dead body or behind my turned back.
Its still in the box so I'm assuming it was neither. And miraculously the bruise still cleared up in no time at all. Perhaps the homeopathy principle applied and some air which had been near the tube touched the skin.
We are seeing more people taking it up In the past few years though..
Anyhoo I won't be replying anymore to this thread as its diverging a bit away from pod. :-)
Just because people are taking it up doesnt mean to say it actually works/good for them, more and more people are taking up smack, that doesnt mean im going be jumping on the bandwagon any time soon.
The idea behind chinese/alternative 'medicine' is bad enough, but the real problem is when it actually stops people from seeking the medical help they really need..or maybe its natural selection in full flow...
Reading that back, I got a little carried away there. I'll go sniff some lavender or something.
My wife bought some arnica last weekend when my son bounced his head off a marble floor. Told her there were two ways she could use it, over my dead body or behind my turned back.
Its still in the box so I'm assuming it was neither. And miraculously the bruise still cleared up in no time at all. Perhaps the homeopathy principle applied and some air which had been near the tube touched the skin.
Maybe the wife should have asked where you stand on the use of tea tree oil
but the real problem is when it actually stops people from seeking the medical help they really need..or maybe its natural selection in full flow...
Might be better if it actually worked like that, but unfortunatley not. It only kills people slowly. For natural selection it would have to affect things which killed people more quickly and effectively.
Strangely however, no matter how much faith people evince in alternative medicine, or how much suspicion in "kemiculs" and "western drugs", that is still where they turn when they have a broken leg, a stomach ulcer or a steering wheel embedded in their rib cage.
Until we hear the options as "fire, ambulance, police or homeopath" or see people googling "acupuncture for compound fracture of the tibial", or see them going to the reiki practitioner when they start vomiting blood and digesting their own stomach lining, they will probably continue to breed.
Maybe the wife should have asked where you stand on the use of tea tree oil
A fabulous tool to prevent parents from blowing large holes in their childrens feet with OTC caustics or cryotherapy applicators in well meaning but misguided attempts to treat small, inoffensive and previously painless VPs.
The fundamental difference between VPs and Diabetic ulcers being that the former will generally self resolve in short order and without complications wheras the latter will not.
Although I seem to remember Blinda saying its the shizzle for OM nails...
A fabulous tool to prevent parents from blowing large holes in their childrens feet with OTC caustics or cryotherapy applicators in well meaning but misguided attempts to treat small, inoffensive and previously painless VPs.
Agreed, so long as the TTO is applied via a suitable vehicle cream, ie not neat, nor oxidated. Love a placebo, me.
Quote:
Originally Posted by Robertisaacs
The fundamental difference between VPs and Diabetic ulcers being that the former will generally self resolve in short order and without complications wheras the latter will not.
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
I generally apply a few seconds of cosmic energy over injection sites by shaking my shakra over it. And I also have no complaints of soreness in the area
I generally apply a few seconds of cosmic energy over injection sites by shaking my shakra over it. And I also have no complaints of soreness in the area
So that's OK then
Now your talkin silly
What I said works and has done for many a long year my son. When you grow up and your as old as me you will be able to make a firm judgement on a lot of things including this ( if the NHS can afford arnica gel that is )
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
Don`t worry, Dad. He`s always making stuff up in the name of `science`, like he did about that chap Isaac Newton who supposedly shot an apple off his son's head. How, exactly, does this gravity stuff explain how Oliver French threw his bouncy ball up in the playground on Thursday and it never EVER came back down again? I know it happened because I saw it with my own eyes..... Another time he even tried to convince us that God doesn't make new clean water for us to drink every day, but instead we get the old stuff that has been flushed down the toilet with turds and bits of dental floss in it that's just floated off back into the sky somehow. Honestly, he must think we're all so thick!
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
strange...from my experience with several chinese pts with diabetic ulcer before none of them reported use of herbal or anything just traditional western medicine, and btw they dont have podiatry there......
Chinese medicine and diabetic foot ulcers
Linear Mode
