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SYSTEMATIC REVIEW article

Front. Cardiovasc. Med.

Sec. General Cardiovascular Medicine

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1454647

Integrated meta-analysis and network pharmacology analysis: Evaluation of Zhigancao Decoction as treatment for Diabetic Cardiomyopathy

Provisionally accepted
Kangshou Ji Kangshou Ji 1*Meizi Han Meizi Han 2Mingqian Yang Mingqian Yang 1Xu Qian Xu Qian 1*Yan Zhang Yan Zhang 1*
  • 1 Liaoning University of Traditional Chinese Medicine, Shenyang, China
  • 2 Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China

The final, formatted version of the article will be published soon.

    Zhigancao Decoction (ZGCD) is derived from "Treatise on Febrile Diseases" and is traditionally prescribed for treating a variety of cardiovascular conditions. In the present study, clinical evidence for the efficacy of ZGCD in patients with DCM was examined using a meta-analysis and its underlying anti-DCM molecular mechanisms were explored via network pharmacology. The current study utilized an extensive search strategy encompassing various domestic and foreign databases databases to retrieve pertinent articles published up to June 2024.In light of this, a thorough evaluation of the benefits and safety of Zhigancao decoction (ZGCD) was conducted in this study using RevMan and Stata. Subsequently, a number of active compounds and target genes for ZGCD were gathered from the TCMSP and BATMAN-TCM databases, while the main targets for DCM were obtained from databases such as GenCards, OMIM, TTD, and DrugBank. To select core genes, protein-protein interaction networks were generated using the STRING platform, and enrichment analyses were completed using the Metascape platform. Meta-analysis results were ultimately derived from 9 studies involving 661 patients in total. In comparison with WM therapy alone, the pooled results showed that ZGCD significantly enhanced overall effectiveness. Additionally, the utilization of ZGCD was leading to a reduction in LVEDV, LVESV and LVDD, also a greater increase in LVEF. Meanwhile, the utilization of ZGCD during intervention was more effective in reducing SBP, and DBP. In addition, the ZGCD showed potential in reducing the occurrence of adverse events.In the context of network pharmacology, five constituents of ZGCD are posited to exert anti-DCM effects through interactions with the molecular targets ASS1, SERPINE1, CACNA2D1, INS etc. The primary mechanisms by which ZGCD may achieve its anti-DCM effects are likely mediated via the AGEs/RAGE signaling pathway,lipid metabolism and atherosclerosis. Taken together, ZGCD demonstrates greater efficacy and safety in the management of DCM. ZGCD not only significantly reduces blood pressure, but also enhances cardiac function while producing fewer adverse effects. The therapeutic effects of ZGCD on DCM can likely be ascribed to its capacity to modulate the AGEs-RAGE signaling pathway, as well as its efficacy in enhancing lipid metabolism and mitigating atherosclerosis.

    Keywords: Diabetic cardiomyopathy, ZhiGanCao Decoction, Meta-analysis, Network Pharmacology, AGEs/RAGE signaling pathway

    Received: 25 Jun 2024; Accepted: 19 Feb 2025.

    Copyright: © 2025 Ji, Han, Yang, Qian and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Kangshou Ji, Liaoning University of Traditional Chinese Medicine, Shenyang, China
    Xu Qian, Liaoning University of Traditional Chinese Medicine, Shenyang, China
    Yan Zhang, Liaoning University of Traditional Chinese Medicine, Shenyang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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