Discuss "gangrene" Through The Aldose Reductase And Mechanism Of The Effect Of Endothelial Progenitor Cells (epcs) In The Treatment Of Diabetic Foot

Background:Diabetic foot maims fatality rate is high, belong to "gangrene" in TCM. Recent studies have shown that ulcer healing is the formation of new blood vessels in vascular stroma, and aldose reductase is activated when blood sugar rises, which catalyzes mass conversion of glucose to sorbitol. Sorbitol is a kind of substances with strong polar, which is hard to through the cell membrane and can cause cell permeability damage. Then leads to tissue endothelial damage. And endothelial progenitor cells as stem cells can repair vascular through endothelial regeneration. Zhao Yongchang, a famous Surgical experts of traditional Chinese medicine, accumulated nearly60years experience, put forward enough to clip toxic heat and blood stasis resistance type diabetes is, created "Zhao’s Prescription". Previous studies showed that the prescription has significant effect, can control the blood sugar, reduce inflammation, improve microcirculation and hemorrheology and reduce glycosylation end products.Purpose:In the guidance of holism and treatment based on syndrome differentiation of traditional Chinese medicine, centering on the clinical, using modern research methods to reveal the mechanism of "Zhao’s Prescription" in treating of diabetic foot, to expand its application in clinical, to establish the theoretical foundation for scientifically formulate corresponding treatment strategies, in order to inherit and enrich Doctor zhao’s academic thoughts and clinical experience.Methods:39cases of diabetic foot patients were divided into three groups, and each group were given conventional treatment of diabetes. Chinese medicine group (13cases) is given oral Zhao’s Prescription soup, twice a day, and with Zhao’s Prescription cream; Integrative medicine group (13cases) is given Zhao’s Prescription soup, twice a day, and use topical ethacridine; Comparison group (13cases) is given administration of pentoxifylline,three times a day, and topical use ethacridine. Healthy control is not processing. A course of treatment is six weeks. Before and after treatment aldose reductase was measured using AR ELISA KIT, and endothelial progenitor cells was measured using inverted biological microscope and flow cytometry. Using SPSS18.0statistical software to analyze data.Results:The three groups had significant differences before and after treatment (P<0.05).The expression of aldose reductase in control group and treatment group had no statistical significant(P<0.05). after treatment with three groups of drugs AR has a downward trend in the cell. Traditional Chinese medicine group and normal control group comparison (P=0.032<0.05), the Chinese and western medicine group and normal control group comparison (P=0.566>0.05), western medicine group and normal control group comparison (P=0.873>0.05, explain Chinese and western medicine group and western medicine is Chinese traditional medicine group curative effect is remarkable.Conclusions:Zhao’s Prescription has a preventive effect on the diabetic foot may be to inhibit the activation of the polyol pathway by inhibiting the expression of the aldose reductase thereby protecting endothelial-related. Yinneipizu cell culture failed," Zhao’s Prescription " by the promotion of endogenous endothelial progenitor cell proliferation, and thus play its function to repair damaged blood vessels to reach the treatment of diabetic foot purposes, as well as endothelial progenitor cells and aldose reductase in diabetic foot development of the intrinsic relationship needs further study.