Clinical And Expeirmental Study On WSJPHT Decoction To Treating The Simple Obesity

objectiveThis study discussed WSJPHT Decoction effect of the treatmentof obesity,further clarify the mechanism and provide the basis forclinical application.MethodThis study carried out theoretical studies,experimental andclinical research in three aspects.Theoretical studies:Investigated systematically from obesitysusceptible populations,classification and pathogenesis,discussed the mechanism of WSJPHT Decoction from four aspectsprinciple,method,recipe and medicines.Experimental studies:The60healthy male SD rats weighing100～150g were randomly divided into two groups,one for the normalcontrol group,10,given normal diet,free access to food andwater,rest of the50given high fat diet, free access to food andwater too.Measured weight of rats twice a week,selected40ratswhich weight beyond the normal average to20%after feeding4weeksas a successful model.The40successful model rats were randomlydivided into four groups,namely model group,low-dose group,middle dose group and high-dose groups of10. Normal group and model grouprats given saline1ml/kg/d gavage;low,medium and high dose grouprats were given low, medium and high doses WSJPHT decoction1ml/kg/dgavage respectively. Normal group fed with normal diet continues,the other four groups were fed with high fat diet continues,measured weights of rats twice weekly and adjusted dose basing onweight, treatment for10weeks continuous. Observed changes inweight and general conditions of the rats, using automaticbiochemical analyzer to detect the serum lipid and liver functions.Observed pathological changes of rats in liver tissue and adiposetissue HE stained.Tested leptin and adiponectin levels byELISA,observed WSJPHT decoction effect on the FTO gene expressionin liver tissue and adipose tissue by IHCand RT-PCR.Clinical studies:60patients meeting the inclusion criteriawere randomly divided into treatment group and control group,eachgroup had30cases.The control group adopted the diet and exercisetherapy alone,the treatment group was given WSJPHT decoction orallyon the basis of the diet and exercise,a daily dose,decoction orallytwice one day, The course of treatment was2months.Two groups werecompared before and after treatment about weight,BMI,waistcircumference,hip circumference,WHR and the changes ofTC,TG,LDL-C,HDL-C.ResultExperimental studies:1) Changes in weight of rats in each group:The WSJPHT decoctioncan significantly slow the growth rate of obese rats weight,compared with the model group with statistical significance (P<0.01),the middle dose group and high dose group was significantly better than the low-dose group and was statistically significant(P <0.01), but the difference between the medium and high dosegroups was not statistically significant.2)The pathological changes of rat liver tissue and adiposetissue in each group: Normal liver cells are arranged normally,lobular rules, The cytoplasm uniform; model group appeared varyingdegrees of diffuse hepatic steatosis, liver cell volume increases,varying amounts and different sizes round lipid droplets or fatvacuoles were seen in the cytoplasm,the nucleus are pushed to thesurrounding;Low-dose group steatosis hepatocytes with the modelgroup quite Low-dose group steatosis hepatocytes are equal to themodel group; The medium and high-dose group was significantlyreduced hepatic steatosis cells than the model group, showing asmall amount of adipose vacuoles.Compared with the normal grouprats,adipose cells volume in the rats of model group increasedsignificantly, adipose cells number decreased vision unit.Low-dosegroup adipose cells are epual to the model group.The volume ofadipose cells in medium and high dose groups significantly reducedand the number increased significantly vision unit compared withthe model group,the changes in medium dose group was significantlymore.3)Comparison of liver function in rats:compared with the normalgroup,model group and the low,middle and high dose group,ALT andAST were significantly increased(P<0.01,P<0.05); Compared with themodel group, WSJPHT decoction can significantly reduce ALT and ASTlevels (P<0.01); The effect of middle and high dose group wassignificantly better than the low-dose group (P<0.01), High-dosegroup was significantly better than the middle dose group (P<0.01) in reducing AST levels,but in reducing ALT levels had no significantdifference (P>0.05).4) Comparison of serum lipid in rats: compared with the normalgroup, model group and the low,middle and high dose group TC, TG,LDL-C were significantly higher (P<0.01), HDL-C was significantlylower(P<0.01), prompt obesity rat model exists dyslipidemiaobvious. Compared with the model group, WSJPHT decoction cansignificantly reduce TC,TG and LDL-C(P<0.01),increaseHDL-C(P<0.01),there was significant difference among the threegroups(P<0.01).5)Comparison of leptin levels in rats:compared with the normalgroup, model group and the low,middle and high dose group leptinlevels were significantly increased (P<0.01),Compared with themodel group, WSJPHT decoction can significantly decrease leptinlevels(P<0.01),there was significant difference among the threegroups(P<0.01),and the effect of high dose group was most obvious.6)Comparison of adiponectin levels in rats:compared with thenormal group,model group and the low,middle and high dose groupadiponectin levels were significantly decreased (P<0.01), Comparedwith the model group, WSJPHT decoction can significantly increaseadiponectin levels(P<0.01), there was significant difference amongthe three groups(P<0.01),and the effect of high dose group was mostobvious.7)Expression of FTO gene in liver tissue of rats in eachgroup:the expression level of FTO gene in liver of the model groupwas significantly increased(P<0.01). the expression levels of FTOgene in liver of the treatment group by WSJPHT decoction weresignificantly decreased(P<0.01).There was significant difference among the three groups(P<0.01),but no significantdifference(P>0.05) compared with the normal group.8)Expression of FTO gene in adipose tissue of rats in each group:the expression level of FTO gene in adipose tissue of the model groupwas significantly increased(P<0.05). The expression levels of FTOgene in adipose tissue of the treatment group by WSJPHT decoctionwere significantly decreased(P<0.01).High, medium dose groupshowed no significant difference(P>0.05),but there was asignificant difference compared with the low dose group were (P<0.01).9)FTO gene immunohistochemistry results in liver tissue of ratsin each group:Liver cell nuclei in brown yellow or brown areFTO-positive cells under light microscope, negative nuclei in blueor blue purple. Observing liver cells of rats in each group,theFTO-positive cells in liver cells of the model group rats were morethan that of the normal group significantly, The FTO-positive cellsin liver cells of the treatment group by WSJPHT decoction weresignificantly decreased,the effect of middle and high dose groupwere most obvious. The IPP analysis results also show that: comparedwith the normal group,model group and the low,middle and high dosegroup FTO-positive expression was significantlyincreased(P<0.05),after treatment,the expression of FTO-positivein liver was significantly decreased compared with the modelgroup(P<0.01).10)FTO gene immunohistochemistry results in adipose tissue ofrats in each group: adipose cell nuclei in brown yellow or brownare FTO-positive cells under light microscope, negative nuclei inblue purple. Observing adipose cells of rats in each group, the FTO-positive cells in adipose cells of the model group rats weremore than that of the normal group significantly, The FTO-positivecells in adipose cells of the treatment group by WSJPHT decoctionwere significantly decreased,the effect of middle and high dosegroup were most obvious. The IPP analysis results also show that:compared with the normal group,model group and the low,middle andhigh dose group FTO-positive expression was significantlyincreased(P<0.05),after treatment,the expression of FTO-positivein adipose was significantly decreased compared with the modelgroup(P<0.05).Clinical studies: Symptoms of the treated patients wereimproved significantly, there were significant differences aboutweight,BMI,waist circumference,WHR, serum lipids after treatmentcompared with before(P<0.05).The total effective rate was90%,significantly better than the control group (P<0.05).ConclusionTheoretical studies: Pathological factors of obesity isdeficiency ben and excessive biao.The performance of the deficiencyin spleen and kidney deficiency,phlegm and blood stasis insuperficiality mainly.The compositions of WSJPHT decoctionembodies the fundamental law of obesity treatment,provides atheoretical basis for the treatment of obesity.Experimental studies:1)The WSJPHT decoction has a good role in controlling weightgain in obese rat model,reducing the damage of liver function，decreasing intra-abdominal fat and hepatic steatosis,reducingserum cholesterol and triglycerides.2)The WSJPHT decoction can reduce the leptin level in obese rats, increase adiponectin level, thus suppressing appetite, increasingenergy consumption, inhibiting the synthesis of fat,improveglucose and lipid metabolism and reducing weight.3)The WSJPHT decoction could reduce the expression of FTO genein liver tissue and fatty tissues of the obesity model rats,and theexpression level of FTO gene decline not only can directly affectthe appetite and diet, improve the efficiency of energy consumption,but also reduce obesity through the regulation of leptin andadiponectin.Clinical studies: The WSJPHT decoction has a good effect in thetreatment of obesity, worthy of clinical application.