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Clinical Study of Zuogui Jiangtang Shuluo Formula in Treating Diabetic Peripheral Neuropathy

2026年8月14日 更新者：The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine

Mechanistic Study of Zuogui Jiangtang Shuluo Formula in Regulating Lipid Metabolism and Inhibiting Ferroptosis for the Prevention and Treatment of Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes mellitus, affecting 35%-50% of diabetic patients. Its pathogenesis involves metabolic disorders induced by hyperglycemia and dyslipidemia, leading to irreversible damage to neurons and vascular endothelial cells. Distal symmetric polyneuropathy (DSPN) is the most representative form, characterized by distal pain, numbness, and sensory loss, which may progress to ulcers, gangrene, and even amputation in severe cases.

Current modern medical treatments for DPN primarily focus on nutritional nerve support, antioxidative stress, and microcirculation improvement, but these approaches are limited in variety and may carry side effects. Traditional Chinese Medicine (TCM) offers advantages including higher safety and diverse therapeutic options.

Based on long-term clinical observation, our research group proposes that the core pathogenesis of DPN is Qi-Yin deficiency with blood stasis obstructing collaterals. The treatment principle is to nourish Yin, supplement Qi, activate blood circulation, and unblock collaterals, with Zuogui Jiangtang Shuluo Formula (ZGJTSLF) as the primary prescription. Previous studies have shown that ZGJTSLF can improve TCSS scores and nerve conduction velocity in DPN patients compared with mecobalamin, but high-level evidence is still lacking.

This randomized, parallel-controlled trial aims to evaluate the clinical efficacy of ZGJTSLF in treating DPN, with TCSS score and nerve conduction velocity as primary outcomes. Metabolomics and lipidomics will be employed to compare metabolic profiles between healthy controls and DPN patients before and after ZGJTSLF treatment, aiming to identify potential biomarkers and explore the underlying mechanisms.

研究概览

地位

尚未招聘

条件

干预/治疗

详细说明

This study is a single-center, randomized, parallel-controlled trial. A total of 74 patients with DPN (37 per group) will be recruited from the outpatient and inpatient departments of Endocrinology at The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine between August 2026 and August 2027, along with 30 healthy volunteers as controls.

This study is a single-center, randomized, parallel-controlled trial. It is prepared to recruit 74 patients with diabetic peripheral neuropathy (DPN) from the outpatient and inpatient departments of Endocrinology at The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine between January 2026 and December 2026, along with 30 healthy volunteers as normal controls, based on clinical diagnostic criteria and screening criteria. Eligible DPN patients will be randomly assigned in a 1:1 ratio to either the Zuogui Jiangtang Shuluo Formula (ZGJTSLF) group or the mecobalamin control group using a random number generator in SPSS software with a fixed seed. This is an open-label trial for participants, care providers, and investigators; however, the outcomes assessor, specifically, the technician responsible for nerve conduction velocity measurements, will be blinded to group allocation. Patients in the ZGJTSLF group will receive Zuogui Jiangtang Shuluo Formula decoction, while those in the control group will receive mecobalamin tablets, both for 4 consecutive weeks. The primary outcomes include the Toronto Clinical Scoring System (TCSS) score and nerve conduction velocity (NCV), and secondary outcomes include TCM syndrome score, fasting plasma glucose, glycated hemoglobin, and lipid profile. Meanwhile, blood, urine, and fecal samples will be collected from all participants, including healthy volunteers, at baseline and after 4 weeks of treatment and frozen for further analysis. Plasma metabolomics and lipidomics profiling will be performed using UPLC-MS/MS technology to detect differential metabolites and lipids, analyze the differences among the groups, identify potential biomarkers, and explore the underlying mechanisms of ZGJTSLF in treating DPN. Correlation analysis between differential metabolites/lipids and clinical parameters will also be conducted. All statistical analyses will be performed using SPSS version 26.0, with a two-sided P < 0.05 considered statistically significant. This study has been approved by the Ethics Committee of The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine (Approval No. HN-LL-YJSLW-2026), and all participants will provide written informed consent.

研究类型

介入性

注册 (估计的)

74

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

研究联系人备份

  • 姓名：Xuerong Wu, Doctor
  • 电话号码：+8618274563501
  • 邮箱：1021595345@qq.com

学习地点

  • 中国
    • Hunan
      • Changsha、Hunan、中国、410000
        • The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine
        • 接触：
          • The First Affiliated Hospital of Hunan University of Tradition
          • 电话号码：0731-85600565

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人
  • 年长者

接受健康志愿者

是的

描述

DSPN inclusion criteria:

  1. Meet the diagnostic criteria for type 2 diabetes mellitus with distal symmetric polyneuropathy (DSPN) according to Western medicine standards.
  2. Meet the TCM syndrome differentiation criteria for consumptive thirst complicated with arthromyodynia of the pattern of Qi-Yin deficiency with blood stasis.
  3. Glycated hemoglobin (HbA1c) between 6.5% and 9.0% (inclusive).
  4. Aged 35 to 75 years (inclusive) at the time of screening, regardless of gender.
  5. Have not participated in any other clinical trial within 2 weeks prior to the start of treatment, and have not taken lipid-lowering agents, antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), antidepressants, immunosuppressants, or other traditional Chinese medicines that may affect metabolomic and lipidomic profiles.
  6. Willing to voluntarily participate in the trial and adhere to the 4-week traditional Chinese medicine treatment regimen.
  7. Right-handed.
  8. Provide written informed consent and are able to understand and comply with the study protocol requirements, including dietary and exercise recommendations and blood glucose monitoring.

DSPN exclusion criteria

  1. Patients with type 1 diabetes mellitus or other specific types of diabetes mellitus.
  2. Women who are pregnant, breastfeeding, planning pregnancy, or taking oral contraceptives long-term.
  3. Neuropathies caused by other conditions, including but not limited to multiple sclerosis, Parkinson's disease, Guillain-Barré syndrome, epilepsy, spinal cord injury, cervical or lumbar spine lesions (nerve root compression, spinal stenosis, cervical or lumbar degenerative diseases), neuromuscular diseases, severe arterial or venous vascular diseases (venous thrombosis, lymphangitis, etc.), sequelae of cerebrovascular disease, or post-surgical status of lower extremity vasculature.
  4. History of stroke, transient ischemic attack, unstable angina, or myocardial infarction within 3 months prior to study enrollment.
  5. History of acute diabetic complications (diabetic ketoacidosis, lactic acidosis, or hyperosmolar hyperglycemic state) within 3 months prior to study enrollment.
  6. Concomitant severe complications of diabetes, such as end-stage diabetic kidney disease, or proliferative diabetic retinopathy.
  7. Concomitant severe diseases of the heart, liver, kidney, cerebrovascular system, or malignant tumors, defined as serum creatinine >200 μmol/L, blood urea nitrogen >1.5 times the upper limit of normal, or alanine aminotransferase or aspartate aminotransferase >3 times the upper limit of normal.
  8. Any infection that, in the investigator's opinion, makes the patient unsuitable for participation prior to study enrollment, including but not limited to urinary tract infection, respiratory infection, or diabetic foot with infection requiring further treatment.
  9. Patients with psychiatric disorders, cognitive impairment, or inability to cooperate with the study procedures; or individuals with a history of alcohol abuse or drug addiction.

Healthy volunteer inclusion criteria:

  1. Aged 18 to 55 years (inclusive) at the time of screening, regardless of gender.
  2. Body mass index (BMI) within the range of 19.0 to 26.0 kg/m² (inclusive). No severe diseases of the heart, liver, kidney, cerebrovascular system, or malignant tumors; routine laboratory tests, electrocardiogram, and chest X-ray are essentially within normal limits.
  3. Have not participated in any other clinical trial within 2 weeks prior to the start of treatment, and have not taken lipid-lowering agents, antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), antidepressants, immunosuppressants, or other traditional Chinese medicines that may affect metabolomic and lipidomic profiles.
  4. Voluntarily sign the informed consent form and are willing and able to cooperate with the investigators to complete the clinical study.

Healthy volunteer exclusion criteria:

  1. Women who are pregnant, breastfeeding, planning pregnancy, or taking oral contraceptives long-term.
  2. Patients with psychiatric disorders, cognitive impairment, or inability to cooperate with the study procedures.
  3. Individuals with a history of alcohol abuse or drug addiction.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：单身的

武器和干预

参与者组/臂
干预/治疗
实验性的：Zuogui Jiangtang Shuluo Formula Group
Participants in this arm will receive Zuogui Jiangtang Shuluo Formula for 4 consecutive weeks.
药品：Zuogui Jiangtang Shuluo Formula
Oral decoction, twice daily for 4 weeks.
其他名称：
  • Regular treatment
有源比较器：Mecobalamin Control Group
Participants in this arm will receive mecobalamin tablets for 4 consecutive weeks.
药品：Mecobalamin
Tablet, 0.5 mg per dose, three times daily orally for 4 weeks.
其他名称：
  • Regular treatment

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Change in Nerve Conduction Velocity (NCV)
大体时间：Baseline and 4 weeks after treatment completion
NCV measurements include motor nerve conduction velocity of the median, ulnar, tibial, and common peroneal nerves, and sensory nerve conduction velocity of the median and sural nerves.
Baseline and 4 weeks after treatment completion
Change in Toronto Clinical Scoring System (TCSS) Score
大体时间：Baseline and 4 weeks after treatment completion
The Toronto Clinical Scoring System (TCSS) assesses neuropathic symptoms, sensory function, and reflexes. Neuropathic symptoms include foot pain, numbness, tingling, and ataxia; each symptom is scored 1 if present and 0 if absent (maximum 4 points). Sensory function tests include light touch, pain, temperature, vibration, and position sense; each test is scored 1 if abnormal and 0 if normal (maximum 5 points). Reflexes include knee and ankle reflexes bilaterally; each reflex is scored 0 if normal, 1 if reduced, and 2 if absent (maximum 8 points). The total score ranges from 0 to 19, with higher scores indicating more severe neuropathy.
Baseline and 4 weeks after treatment completion
Change in Traditional Chinese Medicine (TCM) Syndrome Score
大体时间：Baseline and 4 weeks after treatment completion
The TCM syndrome score assesses primary and secondary symptoms according to the Guiding Principles for Clinical Research of New Traditional Chinese Medicines and the Clinical Diagnosis and Treatment Guidelines for Diabetic Peripheral Neuropathy in TCM (2016 Edition). Primary symptoms (limb weakness, limb pain and/or numbness) are graded as none, mild, moderate, or severe, scored 0, 2, 4, or 6, respectively (maximum 12 points). Secondary symptoms (fatigue, shortness of breath, spontaneous sweating, night sweating, feverish sensation in palms and soles, soreness and weakness of waist and knees, localized stabbing pain aggravated at night, dry and scaly skin, and purplish lips) are graded as none, mild, moderate, or severe, scored 0, 1, 2, or 3, respectively (maximum 18 points). The total score ranges from 0 to 30, with higher scores indicating more severe symptoms.
Baseline and 4 weeks after treatment completion

次要结果测量

结果测量
措施说明
大体时间
Change in Fasting Blood Glucose (FBG)
大体时间：Baseline and 4 weeks after treatment completion
Venous blood will be collected after at least 8 hours of fasting. Fasting blood glucose (FBG) will be measured using an automated biochemical analyzer, with the unit expressed as mmol/L.
Baseline and 4 weeks after treatment completion
Change in Glycated Hemoglobin (HbA1c)
大体时间：Baseline and 4 weeks after treatment completion
Fasting venous blood will be collected. Glycated hemoglobin (HbA1c) will be measured using high-performance liquid chromatography (HPLC) and expressed as a percentage (%), reflecting the average blood glucose level over the preceding 2-3 months.
Baseline and 4 weeks after treatment completion
Change in DN4 Questionnaire Score
大体时间：Baseline and 4 weeks after treatment completion
The DN4 (Douleur Neuropathique 4) questionnaire is a validated screening tool for neuropathic pain, consisting of 10 items (7 related to symptom description and 3 related to clinical examination). The total score ranges from 0 to 10, with a score ≥4 indicating the presence of neuropathic pain.
Baseline and 4 weeks after treatment completion
Change in Visual Analog Scale (VAS) for Pain
大体时间：Baseline and 4 weeks after treatment completion
The VAS consists of a 100-mm horizontal line, with the left end labeled "0" (no pain) and the right end labeled "100" (worst imaginable pain). Participants will mark the line according to their average pain intensity over the past 24 hours, and the distance in millimeters will be recorded as the pain score.
Baseline and 4 weeks after treatment completion
Change in Lipid Profile
大体时间：Baseline and 4 weeks after treatment completion
Venous blood will be collected after at least 8 hours of fasting. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) will be measured using an automated biochemical analyzer. All parameters are expressed in mmol/L.
Baseline and 4 weeks after treatment completion
Changes in Serum Untargeted Metabolomic Profiles
大体时间：Baseline and 4 weeks after treatment completion
Fasting peripheral venous blood samples will be collected. Serum will be separated and stored at -80°C. Untargeted metabolomics analysis will be performed using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Raw data will be processed through peak extraction, alignment, and normalization, then imported into SIMCA software for multivariate statistical analysis. Principal Component Analysis and Orthogonal Partial Least Squares Discrimination Analysis will be used to distinguish metabolic profile differences among groups. Differential metabolites will be selected based on Variable Importance in Projection > 1, P < 0.05, and False Discovery Rate < 0.1. The aim is to identify potential metabolic biomarkers associated with DPN and ZGJTSLF intervention.
Baseline and 4 weeks after treatment completion
Changes in Serum Targeted Lipidomic Profiles
大体时间：Baseline and 4 weeks after treatment completion
Fasting peripheral venous blood samples will be collected from all participants at baseline and after 4 weeks of treatment. Serum will be separated and stored at -80°C. Targeted lipidomics analysis will be performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS), covering major lipid classes including glycerophospholipids, sphingolipids, and glycerolipids. Lipid identification will be performed using the LIPIDBLAST database, and quantification will be conducted using MultiQuant software. Missing values will be estimated using the K-Nearest Neighbors algorithm, and data will be normalized using internal standards. Differential lipids will be identified by unpaired t-test with Benjamin-Hochberg adjustment; an adjusted P < 0.05 will be considered statistically significant. The aim is to identify potential lipid biomarkers associated with DPN and ZGJTSLF intervention.
Baseline and 4 weeks after treatment completion

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine

调查人员

  • 研究主任：Rong Yu、The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine
  • 首席研究员：Juan Huang、The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年8月15日

初级完成 (估计的)

2027年8月15日

研究完成 (估计的)

2027年9月15日

研究注册日期

首次提交

2026年8月10日

首先提交符合 QC 标准的

2026年8月14日

首次发布 (实际的)

2026年8月18日

研究记录更新

最后更新发布 (实际的)

2026年8月18日

上次提交的符合 QC 标准的更新

2026年8月14日

最后验证

2026年8月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • HN-LL-YJSLW-2026-06

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

不

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

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