The Effect Of Yiqi Bushen Recipe On Intestinal Flora Of Diabetic Rats

Part one: A systematic review of the effects of traditional Chinese medicine therapy on clinical efficacy and intestinal flora in patients with diabetes mellitus.Objective Meta analysis system was used to evaluate the clinical efficacy of traditional Chinese medicine in the treatment of diabetes and its effect on intestinal flora in patients with diabetes.Methods The randomized controlled clinical trials of traditional Chinese medicine in the treatment of diabetes in Pub Med,EMbase,China knowledge Network(CNKI),Wanfang Medical Database,VIP Database and other databases were searched by computer from the establishment of the database to November 10,2020.The literatures that meet the criteria were selected strictly according to the inclusion criteria,and the Rev Man5.3 software was used for statistical analysis.Results A total of 17 randomized controlled clinical trials was included in the data study.The results of Meta analysis showed that the clinical efficacy of traditional Chinese medicine was significantly better than that of conventional western medicine in the treatment of diabetes [OR=4.63,95%CI(3.5,6.03)].It can increase the number of bifidobacteria [SMD=0.52,95%CI(0.41,0.63)],Bacteroides [SMD=0.5,95%CI(0.24,0.75)] and Lactobacillus [SMD=0.72,95%CI(0.45,0.99)] in the intestines of diabetic patients,and reduce the number of enterobacteria [SMD=-0.58,95%CI(-0.78,-0.39)] in the intestines of patients with diabetes.The number of yeasts,SMD=0.69,95%CI(-0.85-0.53),and enterococci(SMD=-0.77,95%CI(-1.17,-0.37).Conclusion: The clinical effect of traditional Chinese medicine in the treatment of diabetes is remarkable,and its mechanism may be achieved by improving the disorder of intestinal flora in patients with diabetes.Part Two: Study on the effect of Yiqi Bushen recipe on intestinal microflora of diabetic ratsObjective To study the effect of Yiqi Bushen recipe on intestinal flora of diabetic rats,and to explore whether the change is one of the mechanisms of Yiqi Bushen recipe in the treatment of disease.Methods 45 male SD rats were randomly divided into 5 blank control groups and 40 experimental groups.One month after feeding with high-sugar and high-fat diet,the model was made by intraperitoneal injection of 1%streptozotocin solution diluted by sodium citrate solution.The high and low dose groups were given 800mg/kg/d and 200mg/kg/d suspension respectively,the metformin group was given metformin hydrochloride suspension of 200mg/kg/d,and the blank control group and model group were given the same amount of double distilled water every day for 8 weeks.Random blood glucose,body weight,general state and drinking water of rats were recorded.At the end of the experiment,the serum was taken,the intestinal tissue was placed in the fixed solution,and the feces were frozen at-80 ℃.In order to observe the changes of intestinal pathological tissue and detect the changes of intestinal flora.Results1.General state: the rats in the model group showed obvious typical symptoms of diabetes,such as polydipsia,polyuria,polyuria and so on.The rats in the high and low dose groups and metformin group also showed the symptoms of excessive drinking,polyuria and polyuria,but the mental state of the rats in the high and low dose groups was less than that in the model group.2.Serum index: Compared with the blank control group,the content of homocysteine in the other four groups increased significantly(P<0.05),and compared with the model group,the content of cysteine in the high and low dose groups decreased significantly(P<0.05).The decrease was greater in the high dose group.3.Intestinal tissue staining: HE staining showed that the colon tissue structure of the blank control group was intact,the cell morphology was normal,there was no edema in the lamina propria,and a small amount of inflammatory cell infiltration could be seen;in the model group,the intestinal cell morphology was irregular and there were more inflammatory cell infiltration in the lamina propria.Compared with the model group,the high-dose group,low-dose group and metformin group had relatively normal cell shape,compact arrangement and less inflammatory cell infiltration,among which the intestinal injury in the high-dose group was slighter.4.Intestinal microflora:(1)OTU level: Compared with the blank control group,the OTU value of microflora in the model group decreased significantly(P<0.05).The OTU values in the high-dose and low-dose groups were similar,but lower than those in the metformin group,without significant(P>0.05).The Venn diagram shows that 366 samples are shared by five groups of samples.(2)species note: a.At the phylum level,compared with the blank control group,the relative abundance of Bacteroides increased and the relative abundance of thick-walled bacteria decreased in the model group and traditional Chinese medicine group,with the greatest change in the model group,and the flora structure of metformin group was similar to that of the blank control group.the relative abundance of Bacteroides and Proteus increased slightly.Compared with metformin group,the relative abundance of thick-walled bacteria decreased and the relative abundance of Bacteroides increased slightly in high and low dose groups.Compared with the two groups of traditional Chinese medicine,the high dose group increased the relative abundance of Proteus.b.At the order level,compared with the blank control group,the relative abundance of Clostridium in the model group decreased significantly,while the relative abundance of Bacteroides and Lactobacillus increased in the model group,and the relative abundance of Vibrio Desulfuricus increased in the metformin group.Compared with the model group,metformin group and traditional Chinese medicine group decreased the relative abundance of Bacteroides and increased the relative abundance of Clostridium.c.At the genus level,compared with the blank control group,the relative abundance of Colletobacter in the model group increased significantly,while that of Bacteroides decreased.Compared with the model group,high and low traditional Chinese medicine increased the relative abundance of flutter bacteria and rumen cocci and decreased the relative abundance of Escherichia coli in the two groups.The proportion of flora structure of high and low doses of traditional Chinese medicine at the genus level was still similar,but compared with the metformin group,the relative abundance of fecal cocci decreased and the relative abundance of Lactobacillus increased in the two groups.(3)Alpha diversity: the species richness of the model group was much lower than that of the blank control group,while the species richness of the three groups treated with drugs was higher than that of the model group,and the species richness of the high dose group was slightly higher than that of the low dose group,but the species richness of both groups was lower than that of metformin group.(4)Beta diversity: there was the greatest difference in β diversity between the blank control group and other groups,and there was a certain difference between the model group and the three treatment groups,but there was no significant difference between the two groups of traditional Chinese medicine and metformin group.Conclusion1.Yiqi Bushen recipe can improve the general condition of diabetic rats successfully induced by STZ,reduce the content of serum homocysteine and improve intestinal pathological injury.2.Yiqi Bushen recipe can improve the disorder of intestinal flora of diabetic rats,increase the species richness of intestinal tract of diabetic rats,and promote the relative abundance of some beneficial bacteria.The change of total microflora abundance is not affected by the dose of traditional Chinese medicine.