Clinical Observation Of Jianpi Xiaoke Decoction In The Treatment Of T2DM And Experimental Study On The Regulation Of Islet β Cell Function Through AMPK/mTOR Pathway

Objective:To observe the clinical efficacy of Jianpi Xiaoke Decoction in treating spleen deficiency and dryness-heat syndrome of type 2 diabetes mellitus(T2DM)and explore the molecular mechanism of Jianpi Xiaoke Decoction regulating islet β cell function through AMPK/m TOR signaling pathway.Methods: 1.Clinical study: 64 cases of T2 DM with spleen deficiency and dryness-heat syndrome were randomly divided into experimental group and control group with 32 cases each.On the basis of basic treatment,the experimental group was treated with Jianpi Xiaoke Decoction combined with metformin,while the control group was treated with metformin.Taking 60 days as a course of treatment,observe the clinical symptoms of patients and changes in blood glucose,blood sugar,glycosylated hemoglobin,insulin and other indicators,and evaluate the clinical efficacy of Jianpi Xiaoke Decoction in patients with T2 DM.2.Experimental study:The Min6 islet cell strain was cultured in a high glucose environment,and the optimal concentration of Jianpi Xiaoke Decoction was screened.Min6 islet cells were randomly divided into 8 groups: normal group,model group,Chinese medicine group,Leucine group,(Chinese medicine +Leucine)group,Rapamycin group,(Chinese medicine+Rapamycin)group,liraglutide group.The activity of islet cells was detected by CCK-8 method.The insulin concentration was detected by ELISA.The m RNA activity of AMPKα and m TOR was determined by RT-PCR.The expression of AMPKα and m TOR protein was determined by Western Blot.Results: 1.In the clinical study,4 cases were shedding,60 cases were finally observed,and 30 cases were in the test group and the control group.Before the treatment,the general clinical data and laboratory indexes of the two groups were >0.05,no significant difference,and comparable.After treatment,the total effective rate of the syndrome in the experimental group was 86.67%,which was better than that of the control group 56.67%(<0.05).The symptom scores of the two groups were decreased( <0.01).The effect of the comparison between the two groups was significantly better than that of the control group(<0.01);laboratory indicators FPG,2h PG,Hb A1 c,HOMA-IR were decreased(<0.05),and the experimental group was better than the control group(<0.05);FINS,HOMA-β treatment group increased after treatment(<0.05),the control group decreased( <0.05);TC,LDL-C treatment decreased after both groups(<0.05),and the LDL-C test group was better than the control group(<0.05);TG compared with the treatment before the two groups Both decreased,but the difference was not statistically significant(>0.05).After treatment,the patient’s electrocardiogram,blood,urine,stool routine and liver function,kidney function and other indicators showed no abnormalities and significant changes,no serious adverse reactions occurred.2.In the experimental study,the islet β-cell activity of the Chinese medicine group was enhanced(<0.05),the insulin level was increased(<0.05),the relative expression of AMPKα m RNA was decreased(<0.05),and the relative expression of AMPKα protein was increased,but the difference was not significant(>0.05),the relative expression of m TOR m RNA and protein was increased(<0.05).Conclusions: 1.Jianpi Xiaoke Decoction can effectively reduce blood sugar,Hb A1 c,increase insulin secretion,improve IR,regulate blood lipids,effectively improve the clinical symptoms of patients with T2 DM,and have good safety.2.Jianpi Xiaoke Decoction can improve the islet β cell viability,improve insulin secretion,inhibit AMPKα activity,activate m TOR activity and play a role in protecting islet β cells.