The Study On The Influence Of The Method Of Tonifying Kidney Supplementing Qi And Activating Blood Circulation On Elderly Type2Diabetic Carotid Atherosclerosis And Endothelial Function

Objective: To observe the influence of the method of Tonifying the kidney,Supplementing Qi and Activating blood circulation on elderly type2diabetic carotidatherosclerosis and endothelial function, we conduct clinical study and experimental studyto discuss the mechanism on this therapeutic method how to improve the vascularendothelial function and reduce atherosclerosis.Method:1. Clinical research: Select61patients of eldly type2diabeticarteriosclerosis which both meet the Western diagnosis standard, and simultaneously meetTCM syndrome type of kidney-deficiency and blood stasis, randomly assigned to thecontrol group (30patients) and the test group (31patients).The control group receivedconventional hypoglycemic therapy, the test group also received conventionalhypoglycemic therapy, but add the Chinese medicine decoction based of the method ofTonifying the kidney, Supplementing Qi and Activating blood circulation in addition. After8weeks of treatment, we observed the change of blood glucose, glycosylated hemoglobin,the efficacy of TCM symptoms before and after treatment, and compared the relevantindicators such as hemorheology, endothelin (ET) and nitric oxide (NO), thromboxane B2(TXB2) and6-Keto-prostacyclin (6-Keto-PGF1α), carotid intima-media thickness andarterial plaque area.Experimental study: Thirty male Wistar rats were randomly divided into3groups, i.e.the blank control group (hereinafter referred to as the blank group), the model controlgroup (hereinafter referred to as the model group) and the experimental group whichreceived the Chinese medicine decoction based of method of Tonifying the kidney,Supplementing Qi and Activating blood circulation (hereinafter referred to as the experimental group), each group had10rats. The latter two groups were fed with the highfat and sugar diet for4weeks to make the experimental modle, After the modeling, theexperimental rats fed with the Chinese medicine decoction based of method of Tonifyingthe kidney, Supplementing Qi and Activating blood circulation for6weeks. After thetreatment, we observed the results including the body weight, blood glucose, blood lipid,and ET, N0,TXB2,6-Keto-PGF1α, AGEs, eNOS of each group, and took the myocardium,aortic pathological sections to observe under the microscope.Results: The clinical study displayed that the TCM clinical symptoms of the patientsof the test group were improved clearly, and their Fasting glucose,2-hour postprandialblood glucose and glycosylated hemoglobin were reduced than before treatment. Aftertreatment, glycosylated hemoglobin declined clearly in the test group compared with thecontrol group control group. The test group significantly improved endothelial function inpatients, clearly reduced triglycerides, total cholesterol, low-density lipoprotein cholesterollevels, reduced carotid intima-media thickness, and reduced arterial plaque area, theeffects are better than the control group.Experimental studies have shown that the experimental group drugs can improve thegeneral condition of the type2diabetic rat models, and have a clear role in hypoglycemic,regulation of blood lipid and regulating endothelial functions. Arteriosclerosis situation ofthe experimental group was significantly reduced compared with the model group fromhistological observation. On the other hand, the experimental group drugs can furtherreduce the model rat serum AGEs content and increase eNOS content.Conclusions:1. The study results show that the method of tonifying the kidney,Supplementing Qi and Activating blood circulation have significant endothelial protectioneffect and can reduce arteriosclerosis, so it can improve the clinical symptoms of thepatients with elderly type2diabetes mellitus which differentiated as kidney-deficiency andblood stasis type.2. The method of tonifying the kidney, Supplementing Qi and Activatingblood circulation can improve arteriosclerosis and enhance endothelial function does notdepend only on lower blood sugar, but also possibly through regulation of blood lipid,reducing the AGEs generating, regulating eNOS activity. These multiple targets, multiplemechanisms play as a role.