Study On The Medication Rules And Mechanism Of Yitangkang In The Treatment Of Type 2 Diabetes Combined With Lipid Metabolism Disorder Based On Data Minin

Purpose:As a mentor professor Shi Yan experience of Yitangkang,has a lot of clinical and experimental research results.In this study,we explored the medication rule of Yitangkang for type 2 diabetes mellitus with lipid metabolism disorder through data mining and investigated its effect on macrophages through experimental studies,furthering explore the mechanism of action.It also enriches the clinical efficacy experience and provides new ideas and new methods for the active prevention and treatment of type 2 diabetes mellitus with lipid metabolism disorder.Material and method:1.From 1 February 2013 to 1 February 2023,Literature on TCM treatment of Type 2 diabetes mellitus with lipid metabolism disorders in the full-text databases of CNKI,Wipu,Wanfang and others.Screening according to the inclusion,exclusion criteria,organize the literature obtained after screening,to extract the valid information,perform data orchestration,set up an independent database,upload to the TCM Inheritance Assistance System(V3.0).The functions of "statistical analysis" and "prescription analysis" were used to make the statistics of medication frequency,meridian tropism,four natures,five flavors and efficacy.Association rule analysis using the FP-Tree-based optimization algorithm,explore the rule of medication,and visualization display through the network topology.Clustering analysis by using the k-means algorithm and the regression simulation,and exploring the new prescription.The above results are analyzed and concluded.2.Forty 8-week-old db/db mice were selected for the experimental group,and eight db/m mice for the blank control group were divided into 6 groups altogether,8 in each group.The high,medium and low Yitangkang dose groups were 28g/(kg·d),14g/(kg·d)and 7g/(kg·d)respectively.Mice in the dapagliflozin group were 1.29mg/(kg·d),blank db/m and db/db groups were infused with saline 10ml/(kg·d)once daily,gavaging for 8 weeks.Specimens were collected at 8 weekends.Mouse abdominal organs(pancreas,liver,spleen,skeletal muscle,adipose tissue,etc.)were dissected out and mice ATMs were cultured.The expression of ATMs specific markers CD81,TSG101,and Syntenin 1 was detected by Western-Blot,and their morphology was confirmed by imaging with transmission electron microscopy.Mice serum lipids were examined by automatic biochemical analyzer.The content changes of IL-1β,IL-6 and IFNγ were detected by ELISA.The protein expression of ABHD5,TLR4,JNK and P38 was detected by Western-Blot.The gene expression of ABHD5,TLR4,JNK and P38 m RNA were detected by RT-q PCR.Results:1.A total of 74 articles were finally included in this study.The application frequency of 27 drugs was more than or equal to 10 times.Poria cocos,salvia miltiorrhiza,astragalus membranaceus,coptis chinensis and licorice were used more frequently.The four natures of traditional Chinese drugs is mainly cold,five flavors of sweet drugs accounted for the largest proportion.Most of the drugs belong to the spleen,lung and liver meridian,and the effects are mainly tonifying deficiency,clearing heat,promoting blood circulation and removing blood stasis,disinhibiting water and percolating dampness.According to the analysis method of association rules,Five drug combinations of "radix astragalus,pueraria and salvia miltiorrhiza","salvia miltiorrhiza,hawthorn and poria cocos "," hawthorn and poria cocos ","salvia miltiorrhiza,pueraria and radix Astragalus"," tangerine peel and poria cocos " were used frequently.Five core drug combinations were obtained based on the cluster analysis method.A total of 46 cases were included in the treatment of type 2 diabetes mellitus with lipid metabolism disorder.The application frequency of 22 drugs was more than or equal to 5times.Licorice,coptis chinensis,astragalus,poria cocos and atractylodes were used more frequently.The four natures of traditional Chinese drugs is mainly cold,five flavors of sweet drugs accounted for the largest proportion.Most of the drugs belong to the spleen,lung and heart meridian,and the effects are mainly tonifying deficiency,clearing heat,disinhibiting water and percolating dampness,and promoting blood circulation and removing blood stasis.According to the analysis of association rules,it is concluded that "licorice and coptis chinensis","licorice and astragalus","astragalus and red ginseng","astragalus and red ginseng" and "polygonatum kingianum and red ginseng" were used more frequently.Five core drug combinations were obtained based on the cluster analysis method.Yitangkang is the basic prescription when Professor Shi Yan treats type 2 diabetes mellitus with lipid metabolism disorder,its main components also accord with medication rule of type 2 diabetes mellitus with lipid metabolism disorder.Based on the clinical experience of Professor Shi Yan,it is proved that it can achieve good results through clinical addition and subtraction,and can be used as a good choice for the prevention and treatment of type 2 diabetes mellitus with lipid metabolism disorders in traditional Chinese medicine.2.Through the detection and electron microscopic observation of exosomes surface markers of ATMs,we can prove that ATMs were successfully cultured and can conduct subsequent experimental studies.Compared with the db/m group,in db/db group,the levels of TC,TG,LDL-C increased significantly(P<0.01),the level of HDL-C decreased significantly(P<0.01);the levels of inflammatory factors IL-1β,IL-6 and IFNγ increased significantly(P<0.01);the levels of ABHD5 protein and its m RNA decreased significantly(P<0.01),the levels of TLR4,JNK and P38 proteins and their m RNA increased significantly(P<0.01).Compared with the db/db,in the treated groups,the levels of TC,TG,LDL-C decreased significantly(P<0.01),the level of HDL-C increased significantly(P<0.01),and the blood lipid was improved better in dagliflozin group and Yitangkang high dose group;the levels of IL-1β,IL-6,IFNγdecreased significantly(P<0.05 or P<0.01)in dagliflozin group,Yitangkang high dose group,and Yitangkang medium dose group,the level of IL-6 decreased significantly(P <0.01)in Yitangkang low dose group;the level of ABHD5 protein increased significantly(P<0.01)in dagliflozin,Yitangkang high dose,and Yitangkang medium dose groups,the levels of TLR4,JNK,and P38 proteins decreased significantly(P<0.05 or P<0.01),the level of ABHD5 protein increased(P<0.01),and JNK decreased significantly(P<0.01)in Yitangkang low dose group;the level of ABHD5 m RNA increased significantly(P<0.01),and the levels of TLR4,JNK,and P38 m RNA decreased significantly(P<0.05 or P<0.01)in the treated groups.Conclusion:1.Traditional Chinese medicine treatment of type 2 diabetes mellitus with lipid metabolism disorders is mainly from the spleen,lung and liver,the principle of treatment are suppiementing qi and nourishing yin,promoting blood circulation to remove meridian obstruction,supplement by enforcing spleen and nourishing kidney,both the symptoms and root cause.2.Yitangkang is the basic prescription when Shi Yan treats type 2 diabetes mellitus with lipid metabolism disorder,treatment based on syndrome differentiation,modification according to symptoms,conform to the medication rule of type 2 diabetes mellitus with lipid metabolism disorder,and has a good clinical effect.It fully embodies Professor Shi Yan’s academic thought of "treatment from the spleen".3.Basic experiments further confirmed that Yitangkang may improve the index of dyslipidemia in db/db mice and regulate the level of the related inflammatory factors.4.Yitangkang may affect the reprogramming of lipid metabolism and the level of the related factors,and improve the disorder of lipid metabolism by promoting the expression of ABHD5 in ATMs of db/db mice,so as to provide new ideas and new targets for the prevention and treatment of type 2 diabetes mellitus with lipid metabolism disorders by traditional Chinese medicine.