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Modified Huangqi Guizhi Wuwu Decoction (HGWD) is a traditional Chinese medicine compound decoction derived from the classical Huangqi Guizhi Wuwu Decoction, originally described in the Eastern Han Dynasty text Jingui Yaolue by Zhang Zhongjing. It consists primarily of Astragalus mongholicus (Huangqi), Neolitsea cassia (Guizhi), Paeonia lactiflora (Baishao), Zingiber officinale (Shengjiang), and Ziziphus jujuba (Dazao). The modified version may include adjustments to this formula. HGWD is used mainly for treating rheumatoid arthritis, diabetic peripheral neuropathy, cervical radiculopathy, coronary atherosclerotic heart disease, angina pectoris, sequelae of cerebral infarction, and complications such as cardiopulmonary damage related to rheumatoid arthritis. It has demonstrated anti-inflammatory, analgesic, antioxidant, immunoregulatory effects and can improve nerve function and prevent neurotoxicity including oxaliplatin-induced peripheral neuropathy. Mechanistically in diabetic cardiac autonomic neuropathy models and rheumatoid arthritis models in animals it reduces inflammation by downregulating proinflammatory cytokines like TNF-α, IL-1β and IL-6; inhibits MAPK pathway proteins ERK1/2, p38 and JNK; modulates AMPK/TrkA/TRPM7 signaling pathways; reduces myocardial hypertrophy; fibrosis; inflammatory infiltration; improves cardiac autonomic nervous system remodeling; decreases susceptibility to arrhythmias. Clinically it improves symptoms such as pain sensitization in neuropathies[1][3][4][8].
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