CC BY 4.0 · Chinese medicine and natural products 2022; 02(02): e60-e66
DOI: 10.1055/s-0042-1750321
Review Article

Application of Huangqi Guizhi Wuwu Decoction in Orthopaedics and Traumatology

Peng Xu
1   The First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
,
Miao Tan
1   The First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
,
Mingming Wang
1   The First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
,
Yan Cheng
2   Outpatient Office, Shaanxi Provincial Hospital of Chinese Medicine, Xi'an, Shaanxi, China
› Author Affiliations
Funding This study was funded by the Project of Shaanxi Administration of Traditional Chinese Medicine (2021GJ-LC011),and the Hospital-Level “Nursery Cultivation Plan” of Shaanxi Provincial Hospital of Chinese Medicine (2021-23).

Abstract

The Huangqi Guizhi Wuwu Decoction(HQGZWWT) is composed of Huangqi (Astragali Radix), Shaoyao (Paeoniae Radix Alba), Guizhi (Cinnamomi Ramulus), Shengjiang (Zingiberis Rhizoma Recens), and Dazao (Jujubae Fructus) which has various pharmacological anti-inflammatory, analgesic, antioxidant, antitumor, lipid-lowering, and immunity-regulating activities. It has certain advantages in the treatment of orthopaedic diseases, such as cervical spondylosis, scapulohumeral periarthritis, lumbar disc herniation, knee osteoarthritis, rheumatoid arthritis, myofascial pain syndrome, etc., with outstanding clinical efficacy, few adverse reactions, and high patient compliance. However, modern pharmacological researches on the whole prescription of HQGZWWT are insufficient and the therapeutic targets are not clear which needs further exploration. Besides, this prescription cannot treat all orthopaedic diseases, so we should adhere to the thinking of four diagnostics in traditional Chinese medicine (TCM), select prescriptions based on syndrome differentiation, closely follow the pathogenesis, innovate and expand its scope of application, reflect the application advantages of this prescription in orthopaedics and traumatology and improve the total clinical efficiency.

Credit Authorship Contribution Statement

Peng Xu: Searching, sorting out and summarizing the literature, formal analysis, writing—original draft. Yan Cheng: Conceptualization, methodology, supervision, and writing—review & editing. Miao Tan and Mingming Wang: Searching, sorting out and summarizing the literature, and writing—review & editing.




Publication History

Received: 10 January 2022

Accepted: 26 February 2022

Article published online:
22 August 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Zhang ZJ. Synopsis of Golden Chamber. Beijing, China: Chinese Medicine Science Press; 1997. :15
  • 2 Tian ZY, Li J, Zhao LY. et al. Historical evolution and modern study of Huangqi Guizhi Wuwu Decoction. Educ Teach Forum 2020; (29) 74-76
  • 3 Yang QF, Jiang YW, Yu JK. et al. Clinical application of Huangqi Guizhi Wuwu Decoction in orthopedics. Clin J Tradit Chin Med 2020; 32 (12) 2381-2384
  • 4 Zhu LP. Pharmacology research progress of Astragalus membranaceus . Nei Mongol J Tradit Chin Med 2018; 37 (03) 98-99
  • 5 Ma W, Li HY, He X. et al. Research progress of anti-aging effect of Astragalus membranaceus . Liaoning Zhongyiyao Daxue Xuebao 2020; 22 (04) 21-24
  • 6 Fang HL, Zhang H, Tao YY. et al. Research progress of Astragalus and Angelica . Hainan Yixueyuan Xuebao 2020; 26 (08) 633-636 , 640
  • 7 Zheng Y, Ren W, Zhang L, Zhang Y, Liu D, Liu Y. A review of the pharmacological action of Astragalus polysaccharide. Front Pharmacol 2020; 11: 349
  • 8 Chai Y, Pu X, Wu Y. et al. Inhibitory effect of Astragalus Membranaceus on osteoporosis in SAMP6 mice by regulating vitaminD/FGF23/Klotho signaling pathway. Bioengineered 2021; 12 (01) 4464-4474
  • 9 Wang ZH, Qin C, Ran T, Yang DQ, Guo JH. Effects of astragalus glycoprotein on Th17/Treg cells in mice with collagen-induced arthritis. J Biol Regul Homeost Agents 2018; 32 (04) 951-957
  • 10 Peng Y, Wang YX, Qin HY. et al. Study on mechanism of Astragalus membranaceus in treatment of coronary heart disease based on network pharmacology. Chin J Integr Tradit West Med 2020; 40 (08) 935-940
  • 11 Zhang HH, Liang YN, Zhang L. Current situation of clinical research and pharmacology of Huangqi. World J Tradit Chin Med 2020; 33 (12) 146-149
  • 12 Niu JT, Cao R, Si XL. et al. Research progress on immune regulation and antioxidation of Hongqi (hedysari Radix) and Huangqi (astragali Radix). Zhonghua Zhongyiyao Xuekan 2021; 39 (04) 21-23
  • 13 Li Q. Study on pharmacological action of Cassia twig and its clinical application. Home Med 2018; (09) 174-175
  • 14 Li LP. Study on pharmacological action of Cassia twig and its clinical application. Guide China Med 2017; 15 (04) 180-181
  • 15 Wang XL. Study on pharmacological action of Cassia twig and its clinical application. J Clin Med Lit 2016; 3 (55) 11025-11026
  • 16 Wang D, Wu X-M, Zhang D-D. et al. Study on chemical constituents of cinnamomi Ramulus [in Chinese]. Zhongguo Zhong Yao Za Zhi 2020; 45 (01) 124-132
  • 17 Zhang LQ, Zhang ZG, Fu Y, Xu Y. [Research progress of trans-cinnamaldehyde pharmacological effects]. Zhongguo Zhongyao Zazhi 2015; 40 (23) 4568-4572
  • 18 Wu JR, Zhong WJ, Chen ZD, Zhu BQ, Jiang YY, Wierzbicki PM. The protective impact of trans-cinnamaldehyde (TCA) against the IL-1b induced inflammation in in vitro osteoarthritis model by regulating PI3K/AKT pathways. Folia Histochem Cytobiol 2020; 58 (04) 264-271
  • 19 Wu LF, Wang XQ, Chen XM. et al. Chemical constituents and pharmacological activities of Radix Paeoniae Alba:research advances. J Int Pharm Res 2020; 47 (03) 175-187
  • 20 Xu JX, Xu J, Cao Y. et al. [Modern research progress of traditional Chinese medicine Paeoniae Radix Alba and prediction of its Q-markers]. Zhongguo Zhongyao Zazhi 2021; 46 (21) 5486-5495
  • 21 Zhang YL, Tian Y, Fu QF. et al. Research progress of chemical constituents and pharmacological action of Paeonia tactilora pall. Acta Chin Med Pharmacol 2021; 49 (02) 104-109
  • 22 Yan B, Shen M, Fang J, Wei D, Qin L. Advancement in the chemical analysis of Paeoniae Radix (Shaoyao). J Pharm Biomed Anal 2018; 160: 276-288
  • 23 Bai LL, Chen H, Zhou P, Yu J. Identification of tumor necrosis factor-alpha (TNF-α) inhibitor in rheumatoid arthritis using network pharmacology and molecular docking. Front Pharmacol 2021; 12: 690118
  • 24 Wang HH, Kong QL, Guo Q. et al. Analysis of ancient documents and research progress in modern pharmacology of ginger. Tradit Chin Drug Res Clin Pharmaco 2021; 32 (10) 1582-1590
  • 25 Lashgari NA, Momeni Roudsari N, Khayatan D. et al. Ginger and its constituents: Role in treatment of inflammatory bowel disease. Biofactors 2022; 48 (01) 7-21
  • 26 Unuofin JO, Masuku NP, Paimo OK, Lebelo SL. Ginger from farmyard to town: nutritional and pharmacological applications. Front Pharmacol 2021; 12: 779352
  • 27 Bashir N, Ahmad SB, Rehman MU. et al. Zingerone (4-(four-hydroxy-3-methylphenyl) butane-two-1) modulates adjuvant-induced rheumatoid arthritis by regulating inflammatory cytokines and antioxidants. Redox Rep 2021; 26 (01) 62-70
  • 28 Wang J. Modern research and analysis of Zizyphus jujuba Mill. Based on literature mining. Chin J Ration Drug Use 2021; 18 (09) 20-23
  • 29 Chen X, Li YJ, Yang Q. et al. Advance in modern research and development of Ziziphus jujuba. Mod Tradit Chin Med Mater Med World Sci Technol 2015; 17 (03) 687-691
  • 30 Lu Y, Bao T, Mo J, Ni J, Chen W. Research advances in bioactive components and health benefits of jujube (Ziziphus jujuba Mill.) fruit. J Zhejiang Univ Sci B 2021; 22 (06) 431-449
  • 31 Zou M, Chen Y, Sun-Waterhouse D, Zhang Y, Li F. Immunomodulatory acidic polysaccharides from Zizyphus jujuba cv. Huizao: insights into their chemical characteristics and modes of action. Food Chem 2018; 258: 35-42
  • 32 Ji X, Peng Q, Yuan Y, Shen J, Xie X, Wang M. Isolation, structures and bioactivities of the polysaccharides from jujube fruit (Ziziphus jujuba Mill.): a review. Food Chem 2017; 227: 349-357
  • 33 Editorial Board of Chinese Journal of Surgery. [The experts consensus on the classification, diagnosis and non-surgical treatment of cervical spondylisis(2018)]. Zhonghua Wai Ke Za Zhi 2018; 56 (06) 401-402
  • 34 Li HT, Wang JK, Li J. et al. Clinical researches on the treatment of cervical spondylosis with pestle needle. J Clin Acupunct Moxibustion 2021; 37 (12) 85-89
  • 35 Zhang JY. Clinical value of Guizhi plus Gegen Decoction combined with acupuncture in the treatment of cervical spondylotic radiculopathy. World Latest Med Inf 2019; 19 (56) 211-212
  • 36 Wu HB, Liu JH, Xie GX. et al. Clinical efficacy of Wei's spine-massage manipulation combined with nerve mobilization for treating cervical spondylotic radiculopathy. Guangxi Med J 2020; 42 (18) 2444-2446
  • 37 Lun JY, Lin DK, Hou Y. et al. Investigation on the treatment and maintenance of cervical spondylosis from sinew-bone syndrome differentiation perspective. J Tradit Chin Orthop Traumatol 2021; 33 (11) 56-57 , 63
  • 38 Liu J, Zhang XW. Research progress of traditional Chinese medicine for cervical spondylosis. J Pract Tradit Chin Intern Med 2021; 35 (04) 65-67
  • 39 Hu K, Zhang BC, Fan SL. et al. Clinical study on Huangqi Guizhi Wuwu Tang combined with acupuncture and Tuina for cervical spondylosis with radiculopathy. J New Chin Med 2021; 53 (22) 5-9
  • 40 Zhang Q, Zhang Y, Zhang FX. Clinical observation on the treatment of cervical spondylosis of radiculopathy with Modified Huangqi Guizhi Wuwu Decoction. J Pract Tradit Chin Med 2016; 32 (06) 535-536
  • 41 Chen CY, Chen PH, Chen B. et al. Systematic evaluation of Huangqi Guizhi Wuwu Decoction in the treatment of cervical spondylotic radiculopathy. Rheum Arthritis 2018; 7 (02) 37-42
  • 42 Yuan M, Wang X, Yan X. et al. Effects of heat-sensitive moxibustion combined with naprapathy and warming needle moxibustion combined with naprapathy in patients with periarthritis of shoulder. Am J Transl Res 2021; 13 (07) 7804-7811
  • 43 Tang L, Chen K, Ma Y, Huang L, Liang J, Ma Y. Scapular stabilization exercise based on the type of scapular dyskinesis versus traditional rehabilitation training in the treatment of periarthritis of the shoulder: study protocol for a randomized controlled trial. Trials 2021; 22 (01) 713
  • 44 Wu XX, Zheng WC, Guo HY. et al. Research progress in conservative treatment of periarthritis of shoulder. Hebei J Tradit Chin Med 2021; 43 (10) 1742-1748
  • 45 Zheng W. Research progress on acupuncture combined with medicine in the treatment of periarthritis of shoulder. Chin Med Mod Distance Educ China 2021; 19 (16) 203-205
  • 46 Wang QQ. Clinical observation on targeted penetration combined with joint mobilization in the treatment of periarthritis of shoulder. Guangming J Chin Med 2021; 36 (21) 3655-3657
  • 47 Hu K. Analysis of curative effect of modified Huangqi Guizhi Wuwu Decoction combined with electroacupuncture on periarthritis of shoulder. J Clin Med Lit 2016; 3 (29) 5877-5878
  • 48 Zhang YJ, Yang R. Clinical observation on the treatment of scapulohumeral periarthritis by Huangqi Guizhi Wuwu Decoction combined with Hui Medical Ligin technique. Guangming J Chin Med 2019; 34 (07) 1064-1066
  • 49 Dong Q, Zan Q. Experimental study on determination of hydroxyproline and total protein content of Huangqi Guizhi Wuwu Decoction in rabbit model with periarthritis of shoulder. Shaanxi J Tradit Chin Med 2015; 36 (08) 1081-1082
  • 50 Ruschel LG, Agnoletto GJ, Aragão A, Duarte JS, de Oliveira MF, Teles AR. Lumbar disc herniation with contralateral radiculopathy: a systematic review on pathophysiology and surgical strategies. Neurosurg Rev 2021; 44 (02) 1071-1081
  • 51 Kong B, Yan W, Liu SJ. et al. Research progress in non-pharmacological conservative treatment of lumbar intervertebral disc herniation. Shanghai J Tradit Chin Med 2022; 56 (04) 97-101
  • 52 Yuan N, Chen F, Long XR. et al. Modern application and analysis of buyang Huanwu Decoction in treatment of lumbar intervertebral disc herniation. Liaoning Zhongyiyao Daxue Xuebao 2021; 12: 1-13
  • 53 Li Y, Yao XS. Treatment of lumbar disc about Chinese and Western medicine herniation overview. Liaoning Zhongyiyao Daxue Xuebao 2016; 18 (04) 231-234
  • 54 Xu RH, Ma Y, Wang XY. et al. Clinical study of Yibi Decoction combined with acupuncture on lumbar intervertebral disc herniation. Zhonghua Zhongyiyao Xuekan 2022; 40 (03) 244-247
  • 55 Li YB, Qi HL, Cai YF. et al. Clinical observation of eight-section brocade exercise combined with disc decoction on the treatment of lumbar intervertebral disc herniation with liver and kidney deficiency. Chin J Tradit Med Traumatol Orthop 2022; 30 (01) 45-49
  • 56 Li H, Xu WJ. Huangqi Guizhi Wuwu Decoction combined with acupuncture for treatment of lumbar disc herniation. Clin J Tradit Chin Med 2020; 32 (04) 688-691
  • 57 Mao YP, Zhou YJ. The clinical research of Huangqi Guizhi Wuwu Decoction combined with transforaminal endoscopic discectomy in the treatment of lumbar disc herniation. Chin Med Mod Distance Educ China 2016; 14 (04) 94-96
  • 58 Jang S, Lee K, Ju JH. Recent updates of diagnosis,pathophysiology,and treatment on osteoarthritis of the knee. Int J Mol Sci 2021; 22 (05) 2619
  • 59 Zhang K. Clinical study of Fujihuang Jiangu Capsule combined with celecoxib capsule in treatment of knee osteoarthritis. Liaoning J Tradit Chin Med 2022; 49 (01) 95-98
  • 60 Wang XJ, Li SG, Wang PH. et al. Treating knee osteoarthritis based on the ‘myeloid bone disease’ theory. Zhonghua Zhongyiyao Zazhi 2021; 36 (11) 6500-6503
  • 61 Wei XE. Never forget your original intention and treat it according to this principle—on treating knee osteoarthritis by integrated Chinese and Western medicine. Chin J Integr Tradit West Med 2021; 41 (07) 778-781
  • 62 Chen LZ, Chen B, Lin AY. et al. Clinical research progress of traditional Chinese and Western medicine on knee osteoarthritis. Liaoning J Tradit Chin Med 2020; 47 (02) 203-206
  • 63 Ye QJ, Shen HL, Ren GW. Huangqi Guizhi Wuwu Tang has effect on cartilage injury and NLRP3/Caspase1 pathway in rats with knee osteoarthritis. J New Chin Med 2020; 52 (08) 25-29
  • 64 Wang C, Zhu MS. Clinical observation on the treatment of knee osteoarthritis with modified Huangqi Guizhi Wuwu Decoction and sodium hyaluronate. World Latest Med Inf 2019; 19 (66) 267-268
  • 65 Tang XL, Pan HY, Wang Y. Clinical efficacy of warm needling moxibustion plus Huangqi Guizhi Wuwu Decoction for knee osteoarthritis and its effect on articular cartilage. Shanghai J Acupunct Moxibustion 2021; 40 (06) 703-708
  • 66 Neumann E, Frommer K, Diller M, Müller-Ladner U. Rheumatoide arthritis. Z Rheumatol 2018; 77 (09) 769-775
  • 67 Gao CX, Qiang JH, Feng YF. et al. Effects of Paidu Gabi Decoction on the treatment of rheumatoid arthritis. World Chin Med 2021; 16 (24) 3648-3652
  • 68 Ma CX, Yang YL. Research progress in the treatment of rheumatoid arthritis by Traditional Chinese medicine. World Latest Med Inf 2019; 19 (66) 65-66
  • 69 Yang Y, Mao WX, Gan W. et al. Research progress of rheumatoid arthritis in Traditional Chinese medicine. Electron J Clin Med Lit 2019; 6 (44) 182-183
  • 70 Zhang YX. Effect analysis of Huangqi Guizhi Wuwu Decoction on rheumatoid arthritis. Guangming J Chin Med 2020; 35 (07) 968-971
  • 71 Tao JT. Clinical study on the treatment of rheumatoid arthritis with Huangqi Guizhi Wuwu Decoction. Asia Pac Tradit Med 2017; 13 (12) 137-139
  • 72 Lin WN, Su HL, Li HM. et al. Therapeutic mechanism of Huangqi Guizhi Wuwutang on rheumatoid arthritis. Zhongguo Shiyan Fangjixue Zazhi 2022; 28 (09) 9-15
  • 73 Liu JW, Wang YH, Li YY. et al. Effect of Huangqi Guizhi Wuwu Tang on joint synovial cell apoptosis in CIA rat models. Zhongguo Shiyan Fangjixue Zazhi 2017; 23 (14) 171-176
  • 74 Wang D, Zhang LX, Gong L. et al. 49 cases of carpal tunnel syndrome of qi deficiency and blood stasis treated with Huangqi Guizhi Wuwu Decoction and wrist immobilization. Chin J Tradit Med Traumatol Orthop 2021; 29 (05) 69-72
  • 75 Zhang P. Clinical observation on the treatment of qi Deficiency and Blood stasis syndrome of primary osteoporosis with Huangqi Guizhi Wuwu Decoction. Hebei J Tradit Chin Med 2017; 39 (02) 227-230
  • 76 Shi WC, Nie CX, Hu XL. et al. Clinical study on the treatment of early ankylosing spondylitis with Huangqi Guizhi Wuwu Decoction and Xuefu Zhuyu Decoction combined with acupuncture. Shaanxi J Tradit Chin Med 2020; 41 (03) 315-317 , 337