| Purpose:This article is to observe the clinical effect of Jianpi Xiaoke Recipe on type 2 diabetes mellitus(T2DM)and the effect on isletβ cell apoptosis and its molecular mechanism.Methods:1.Clinical study:84 patients with T2DM belonging to the“damp-heat sleepy spleen”type were randomly divided into a treatment group(42 cases)and a control group(42 cases).The control group was treated with metformin.The treatment group was treated with the Chinese medicine Jianpi Xiaoke Recipe on the basis of the same group as the control group.The treatment period was 60 days.The fasting blood glucose(FPG),postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),blood lipid(TC,TG,LDL-C),body mass index(BMI),insulin level,insulin resistance index,β cell function index,clinical symptoms of traditional Chinese medicine were compared between the two groups.2.Experimental study:The Min6 cells were divided into blank group,model group and traditional Chinese medicine group.The blank group was given low-glucose medium(containing 5.5mmol/L glucose),and the model group and the Chinese medicine group were given high-glucose(containing 25mmol/L glucose).Using tunicamycin to induce Min6 cells to produce endoplasmic reticulum stress,the Chinese medicine group was given Jianpi Xiaoke Recipe.After intervention,the survival rate,apoptosis and the expression of endoplasmic reticulum stress-related proteins IRE1 and JNK.Result:1.Clinical study:In the clinical study,there were 4 cases of abscission,80 cases of final observation,40 cases in the experimental group and 40 cases in the control group.After treatment,the syndrome score of the treatment group was lower than that of the control group(P<0.05),and the syndrome efficacy was higher than control group(P<0.05);FPG,2hPG,HbAlc and HOMA-IR were all decreased after treatment(P<0.05),and the effect of the treatment group was better than that of the control group(P<0.05).The levels of FINS and HOMA-β increased in the treatment group(P<0.05),but decreased in the control group(P<0.05).The blood lipid index TC,TG and LDL-C decreased after treatment in both groups(P<0.05).Compared with the control group,LDL-C in treatment group was better than the control group(P<0.05);TG and TC of both groups were decreased after treatment,but the difference was not statistically significant(P>0.05).No abnormality was found in blood routine,urine routine,stool routine,liver and kidney function and ECG in the two groups.2.Experimental study:The experimental results showed that the cell survival rate of the model group was lower than the blank group(P<0.05),and when the concentration of traditional Chinese medicine was 0.001mg/ml,the cell survival rate was the highest.The cell survival rate of traditional Chinese medicine group was better than that of model group(P<0.05),and the total apoptosis rate of traditional Chinese medicine group was lower than that of model group(P<0.05).The expression of IRE1 and JNK protein in Chinese medicine group was lower than that in model group(P<0.05).Conclusions:1.In clinical research,Jianpi Xiaoke recipe can effectively reduce blood glucose and HbAlc,increase insulin level,improve insulin resistance,regulate blood lipid,and effectively improve TCM symptoms of T2DM patients belonging to the“damp-heat sleepy spleen”type.Its curative effect is better than metformin alone,with definite curative effect and high safety.2.In the experimental study,Jianpi Xiaoke recipe can improve the activity and apoptosis of islet β cells,and its function may be achieved by regulating the endoplasmic reticulum stress-related apoptosis pathway. |
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