| Objective:This trial was conducted to observe the clinical efficacy of Danzhi Jiangtang Capsule(DJC)on patients with diabetes mellitus(DM)macroangiopathy and the effect on AMPK/mTOR pathway-related proteins in the carotid artery of rats in a diabetic model,and to investigate the clinical efficacy of DJC on DM macroangiopathy and the mechanism of action of related pathways,so as to provide a basis for better clinical application in the future.Methods:1.Clinical observation: In addition to the basic treatment,the control group was treated with atorvastatin calcium tablets at 10 mg per night,while the observation group was treated with DJC at 5 capsules three times a day(0.4 g/capsule)in addition to the control group(0.4g/capsule).Before treatment,the general conditions of patients were recorded,the Chinese medical symptoms of patients were evaluated,and indicators such as blood glucose,blood lipids,carotid intima-media thickness(IMT),and plaque number and size were measured.2.Animal experiment: Ten rats were randomly selected from 80 SD rats as the blank group(NC group)for normal feeding,and the remaining rats were fed with high sugar and high fat diet and 1%streptozotocin intraperitoneally to induce DM macroangiopathy model,and then randomly divided into diabetic model group(MC group),metformin group(Met group),and DJC low,medium and high dose groups(DJC-L,DJC-M,DJC-H groups),and weight and blood glucose were measured in each group before intervention.After 8 weeks of intervention,body weight and blood glucose were retested,anesthesia,blood collection and sampling were performed to detect blood glucose and lipid profile of rats,and staining methods were used to observe carotid artery pathology,and Western Blot was used to detect AMPK/mTOR pathway and related aging protein expression.Results:1.Clinical trial:(1)Chinese medicine evidence points: after treatment,the Chinese medicine evidence points of both groups were significantly lower than those before intervention(P<0.05),and the total effective rate of Chinese medicine evidence efficacy was 91.30% in the observation group and 66.67% in the control group,which was better than that of the control group(P<0.05).(2)Blood glucose related indexes: compared with previous treatment,blood glucose in both groups improved(P<0.05),and fasting(FPG)and postprandial blood glucose(2h PG)in the observation group decreased more significantly(P<0.05),and there was no significant difference in glycated hemoglobin(Hb A1c)indexes between the two groups after treatment(P>0.05).(3)Lipid-related indicators: the four lipid levels in the two groups improved compared with those before the intervention(P<0.05),and the improvement effect of triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)levels after treatment was better in the observation group than in the control group(P<0.05).(4)Carotid artery pathological morphology: carotid artery vascular damage and vascular aging were reduced in each drug intervention group compared with the MC group as seen by staining.2.Animal experiment:(1)Body weight: After 8 weeks of drug intervention,the body weight of rats in the MC group and the 4 groups of each drug intervention decreased compared with the NC group(P<0.05),and the DJC-M,DJC-H and Met groups decreased significantly compared with the MC group(P<0.05).(2)Fasting blood glucose: compared with the NC group,fasting blood glucose increased in all the remaining groups(P<0.01);compared with the MC group,fasting blood glucose levels decreased in the four groups of drug intervention,except for the DJC-L group(P<0.05).(3)Lipid-related indexes: compared with the NC group,the lipid levels in the remaining groups were abnormal to different degrees(P<0.05);compared with the MC group,the four lipid indexes in the Met and DJC-H groups improved significantly(P<0.05),while TG and high-density lipoprotein(HDL)in the DJC-L group improved significantly compared with the MC group(P<0.05).(4)Carotid artery pathological morphology: carotid artery vascular damage and vascular aging were reduced in each drug intervention group compared with the MC group as seen by staining.(5)Protein expression: WB results showed that AMPK and LKB1 protein expression decreased and mTOR,p70S6 K,mmp-2,and p21 expression increased in the remaining groups compared with the NC group(P<0.01);compared with the MC group,AMPK and LKB1 protein expression increased and mTOR,p70S6 K,mmp-2,and p21 expression decreased in the drug intervention groups(P<0.01).Conclusion:Danzhi Jiangtang Capsule can improve the clinical symptoms and signs of Chinese medicine in patients with DM macroangiopathy with Qi-Yin deficiency and stasis,and has a certain degree of effect on glucolipid level and carotid atherosclerosis.The results of animal experiments suggest that Danzhi Jiangtang Capsule can reduce the level of glucolipid-related indexes,reduce the degree of vascular damage and decrease the expression of related senescence proteins in diabetic rats to a certain extent.The mechanism of action may be related to the regulation of AMPK/mTOR pathway to slow down the process of macroangiopathy in DM. |
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