Indigo naturalis (IN) is a traditional Chinese medicine, named Qing-Dai, which is extracted from indigo plants and has been used to treat patients with inflammatory bowel disease (IBD) in China and Japan. Though there are notable effects of IN on colitis, the mechanisms remain elusive. Regarding the significance of alterations of intestinal flora related to IBD and the poor water solubility of the blue IN powder, we predicted that the protective action of IN on colitis may occur through modifying gut microbiota. To investigate the relationships of IN, colitis, and gut microbiomes, a dextran sulfate sodium (DSS)-induced mice colitis model was tested to explore the protective effects of IN on macroscopic colitis symptoms, the histopathological structure, inflammation cytokines, and gut microbiota, and their potential functions. Sulfasalazine (SASP) was used as the positive control. Firstly, because it was a mixture, the main chemical compositions of indigo and indirubin in IN were detected by ultra-performance liquid chromatography (UPLC). The clinical activity score (CAS), hematoxylin and eosin (H&E) staining results, and enzyme-linked immunosorbent assay (ELISA) results in this study showed that IN greatly improved the health conditions of the tested colitis mice, ameliorated the histopathological structure of the colon tissue, down-regulated pro-inflammatory cytokines, and up-regulated anti-inflammatory cytokines. The results of 16S rDNA sequences analysis with the Illumina MiSeq platform showed that IN could modulate the balance of gut microbiota, especially by down-regulating the relative quantity of Turicibacter and up-regulating the relative quantity of Peptococcus. The therapeutic effect of IN may be closely related to the anaerobic gram-positive bacteria of Turicibacter and Peptococcus. The inferred metagenomes from 16S data using PICRUSt demonstrated that decreased metabolic genes, such as through biosynthesis of siderophore group nonribosomal peptides, non-homologous end-joining, and glycosphingolipid biosynthesis of lacto and neolacto series, may maintain microbiota homeostasis during inflammation from IN treatment in DSS-induced colitis.

This study aimed to systematically evaluate the clinical efficacy and safety of traditional Chinese medicine (TCM) compounds combined with standard treatments for diabetes mellitus (DM) complicated by coronary heart disease (CHD). We performed a systematic and comprehensive search of the China Knowledge Network, WanFang, WeiPu, PubMed, and Web of Science, including Chinese and English articles, for randomized controlled trials (RCTs) assessing the use of Chinese herbal compounds for the treatment of DM complicated by CHD published before June 1, 2020. The literature was screened according to standard criteria. Risk assessment, based on the Jadad scale, was performed using the Review Manager5.3 software for meta-analysis. In total, 23 articles were selected, including 2405 cases. The meta-analysis showed that the combination of standard treatments with TCM compounds significantly improved the overall treatment efficacy for DM complicated by CHD (OR(odds ratio) = 4.39; 95% confidence interval (95% CI), 3.30–5.84; $P<0.0001$ ), fasting blood glucose level (mean difference (MD) = −1.04; 95% CI, −1.96 to −0.13; $P=0.03$ ), total cholesterol level (MD = −1.16; 95% CI, −1.48 to −0.83; $P<0.0001$ ), triglyceride (MD = −0.46; 95% CI, −0.62 to −0.29; $P<0.0001$ ), low-density lipoprotein level (MD = −0.57; 95% CI, −0.87 to −0.27; $P=0.0002$ ), high-density lipoprotein level (MD = 0.19; 95% CI, 0.12 to 0.26; $P=0.02$ ), and electrocardiogram (OR = 4.20; 95% CI, 3.15 to 8.18; $P<0.0001$ ). In contrast, there was no improvement of 2-hour postprandial glucose level (MD = −1.03; 95% CI, −2.14 to 0.08; $P=0.07$ ), or adverse reactions (OR = 0.53; 95% CI, 0.19 to 5.50; $P=0.21$ ). We concluded that the combined therapy has some benefits in treating DM complicated by CHD. However, these results should be confirmed by further referenced evidence, high risk assessment, and lower publication bias.

Background: Chronic heart failure (CHF) is one of the most serious cardiovascular diseases. Shenqi Fuzheng injection (SQFZI), as a Chinese herbal injection, is usually used for the treatment of CHF. However, the clinical evidence of SQFZI for the treatment of CHF is unclear. Methods: Two researchers will dependently search literatures of SQFZI for CHF from Chinese National Knowledge Infrastructure database, VIP database, Chinese Biological and Medicine database, Wangfang database, MEDLINE, EMBASE, Cochrane Library and Web of Science. These inclusive data of included studies will be conducted by RevMan 5.3 software. Results: This meta-analysis and systematic review will provide a series of outcome measures to verify clinical efficacy and safety of SQFZI for treating CHF, including New York Heart Association (NYHA) function classification, left ventricular ejection fraction, left ventricular end-diastolic dimension, cardiac output, stroke volume, brain natriuretic peptide, N-terminal pro-brain natriuretic peptide, and adverse events. Conclusions: This meta-analysis and systematic review will provide up-to-date clinical evidence to assess SQFZI treatment efficacy for CHF patients.

Background: Danhong injection (DHI) has been widely in the treatment of chronic heart failure (CHF) in China; however, there is not enough clinical evidence DHI for treating CHF. Methods: Two researchers will search literatures of DHI for CHF in databases. Extracted data are analyzed with Review Manager 5.3 software. The selected studies should be conducted quality evaluation, forest plots and funnel plots will be run by RevMan5.3. Results: This systematic review validates the clinical efficacy and safety of DHI in the treatment of CHF through the analysis of New York Heart Association functional classification, left ventricular ejection fraction, left ventricular end-diastolic dimension, cardiac output, brain natriuretic peptide, adverse events. Conclusions: This systematic review will be provided a rational clinical evidence to evaluate the effectiveness and safety of DHI for the treatment of CHF. Registration Number: PROSPERO CRD42019144686.