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Radix Astragali and Radix Angelicae Sinensis in the Treatment of Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-analysis.

ABSTRACT: Introduction:There are many clinical studies in the treatment of idiopathic pulmonary fibrosis (IPF) with herbal medicine including Astragalus mongholicus Bunge, Radix Astragali (RA) and Angelica sinensis (Oliv.) Diels, Radix Angelicae Sinensis (RAS). These have obtained good curative effect. There is no systematic evaluation on the clinical efficacy of RA and RAS in patients with IPF. The aim of this systematic review and meta-analysis was to critically evaluate the current evidence of efficacy and safety of RA and RAS in IPF. Methods:We searched the primary database for randomized controlled trial (RCT) of RA and RAS treating IPF. We assessed the quality of included studies using the Jadad rating scale and referred to the Cochrane Reviewer's Handbook for guidelines to assess the risk of bias. We extracted the main outcomes of included RCTs and a meta-analysis was conducted using the Cochrane Collaboration's RevMan5.3 software. Results:Seventeen eligible RCTs were identified and made a systematic review and meta-analysis. Risk of bias and quality of included RCTs were carried out. The results of meta-analysis showed that total effective rate and traditional Chinese medicine syndrome effective rate were statistically significantly higher in the experimental group than the control group, main pulmonary function index, six minute walking distance and Borg scale questionnaire score were statistically significantly better in the experimental group than the control group and incidence of adverse reactions was statistically significantly lower in the experimental group than the control group. Conclusion:RA and RAS are effective and safe in the treatment of IPF, which is beneficial to pulmonary function and exercise tolerance of these patients.

SUBMITTER: Zhang Y

PROVIDER: S-EPMC7203419 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Radix Astragali and Radix Angelicae Sinensis in the Treatment of Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-analysis.

Zhang Yufeng Y Gu Lina L Xia Qingqing Q Tian Lijun L Qi Jia J Cao Mengshu M

Frontiers in pharmacology 20200430

<h4>Introduction</h4>There are many clinical studies in the treatment of idiopathic pulmonary fibrosis (IPF) with herbal medicine including Astragalus mongholicus Bunge, Radix Astragali (RA) and Angelica sinensis (Oliv.) Diels, Radix Angelicae Sinensis (RAS). These have obtained good curative effect. There is no systematic evaluation on the clinical efficacy of RA and RAS in patients with IPF. The aim of this systematic review and meta-analysis was to critically evaluate the current evidence of ...[more]

PMID: 32425767

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Project description:BACKGROUND:Radix Astragali and Radix Angelicae Sinensis are two herbs that compose Danggui Buxue Tang (an herbal formula for treatment of anemia diseases). In this study, we explored the molecular mechanism and effective targets to immune destruction of bone marrow (BM) cells treated with Radix Astragali, Radix Angelicae Sinensis or a combination of two agents. The potential synergic advantages of two herbs should also be explored. METHODS:The constituents of Radix Astragali and Radix Angelicae Sinensis were analyzed by high performance liquid chromatography-electrospray ionization/mass spectrometer system BM cells were separated from limbs of BALB/c mice, and immune destruction was induced with IFN-?. The percentages of hematopoietic stem cells (HSCs) and CD3+ T cells were detected by flow cytometry. The distribution of T-bet and changes in the combination of SAP and SLAM in BM cells were observed by immunofluorescence. Western blotting was used to assay the expression of key molecules of the eIF2 signaling pathway in BM cells. RESULTS:Seven constituents of Radix Astragali and six constituents of Radix Angelicae Sinensis were identified. The percentages of HSCs increased significantly after treatment with Radix Angelicae Sinensis, especially at high concentrations. The percentages of CD3+ T cells were significantly decreased after Radix Astragali and Radix Angelicae Sinensis treatment. However, the synergistic function of two-herb combinations was superior to that of the individual herbs alone. The distribution of T-bet in BM cells was decreased significantly after Radix Angelicae Sinensis treatment. The number of SLAM/SAP double-stained cells was increased significantly after Radix Astragali treatment at low concentrations. The phosphorylation levels of eIF2? were also reduced after Radix Astragali and Radix Angelicae Sinensis treatment. CONCLUSIONS:Radix Astragali and Radix Angelicae Sinensis could intervene in the immunologic balance of T lymphocytes, inhibit the apoptosis of BM cells induced by immune attack, restore the balance of the T cell immune response network and recover the hematopoietic function of HSCs. The synergistic effects of Radix Astragali and Radix Angelicae Sinensis were superior to those of each herb alone.

Dataset Information

Radix Astragali and Radix Angelicae Sinensis in the Treatment of Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-analysis.

Publications

Radix Astragali and Radix Angelicae Sinensis in the Treatment of Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-analysis.

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