| Objective:To observe the influence of Yiqiyangyinhuoxue method(supplementing qi, nourishing yin and promoting blood circulation)on patients with type 2 diabetic insulin resistance in glucose metabolism, lipid metabolism and adipocytokines. By establishing type 2 diabetic insulin resistance rat models with high fat diet for 28 weeks, to observe the influence of Yiqiyangyinhuoxue method on rats with type 2 diabetic insulin resistance in glucose metabolism, lipid metabolism and HMGB1, TLR4-protein expression level. To investigate the molecular mechanism of Yiqiyangyinhuoxue herbal in improving insulin resistance, preventing and treating type 2 diabetes.Method:1. Part of clinical research:According to the WHO diagnostic criteria and standards of TCM,84 cases of outpatients and hospitalized patients with type 2 diabetes from September 2013 to September 2014 in Shenzhen Hospital Of Traditional Chinese Medical were selected and randomly assigned to control group and experimental group, with 42 cases in each group. The control group received diabetes education, diet control, exercise therapy and metformin. Experimental group received diabetes education, diet control, exercise therapy, and Yiqiyangyinhuoxue traditional Chinese herbals(formed with Huang Qi, Sheng Di, Dan Shen, Tai Zi Shen, Wu Wei Zi, Mai Dong, Shan Yao, Huang Jing, Dan Pi, Da Huang, Hong Hua, Tao Ren. ect). The treatment lasted for 12 weeks. To observe the changes of fasting blood glucose (FPG),2h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbAlc), fasting insulin (FINS), body mass index (BMI) and blood lipid indexes and TCM symptom score of all patients before and after treatment. With enzyme-linked immunosorbent assay (Elisa) method to detect fat factor, interleukin -6 (IL-6), tumor necrosis Factor alpha (TNF- alpha), secreted curl associated protein 5 (SFRP5) levels, and insulin resistance index (Homa-IR=FPGxFINS/22.5, FINS units were mu/L, FPG units were mmol/L).2. Part of experimental research:To establish rat models of type 2 diabetes insulin resistance by intravenous injection of a small dose of streptozotocin (STZ) and high fat high calorie diet for 28 weeks. The rats were randomly divided into model group, TCM group, bete group, each group was treated with corresponding drugs gavage treatment. Besides, control group of normal rats was set. The intervention lasted for 8 weeks, then to observe the oral glucose tolerance test (OGTT) and insulin release test (IRT), free fatty acid (FFA), blood lipid (TC, TG, LDL-C, HDL-C) and insulin resistance index (HOMA-IR), insulin sensitivity index (ISI). With Western blot, to detect the high mobility group box-1 protein 1 (HMGB1) and toll like receptor 4 (TLR4) protein expression level, and Liver HE staining was performed.Result:1. Part of clinical research:Baseline characteristics were well balanced between the two groups before treatment. (P＞0.05). After the treatment, two groups of FPG,2hPG, HbAlc, BMI, fins, TC, TG, LDC-C, HOMA-IR, TNF alpha, IL-6, TCM symptom score decreased significantly (P<0.05), SFRP5 level was significantly higher after the treatment (P＜0.05). Furthermore, the indexes of experimental group improved more significantly and compared with the control group, the differences were significant (P＜0.05). At the same time, the safety indicators of the two groups changed unsignificantly before and after treatment. There were no obvious adverse reactions in the course of treatment.2. Part of experimental research:Compared with normal group, the following items of Model group were significantly increased:blood glucose, IRT abnormalities, weight, TC, TG, LDL-C, FFA and HOMA-IR (P＜0.05), while HDL-C, ISI decreased significantly (P＜0.05). Compared with model group, items of TCM group and fenofibrate group, blood glucose, IRT, TC, TG, LDL-C, FFA, HOMA-IR were significantly lower (P＜0.05), ISI was significantly increased (P＜0.05) and HDL-C was not obvious. Compared with normal group, items of the model group, HMGB1, TLR4 Protein expression were increased (P＜0.01). Compared with model group, items of TCM group and fenof ibrate group, HMGB1, TLR4 protein expression were significantly decreased (P＜0.05).Conelusion:1. Part of clinical research:Traditional Chinese medicine of supplementing qi, nourishing yin and promoting blood circulation can not only control weight of type 2 diabetic patients with insulin resistance and deficiency of both qi and Yin and blood stasis, improve the clinical symptoms and signs, but also significantly modulate the patient’s sugar, lipid metabolic disorder, and improve IR by affecting fat factors like IL-6, TNF alpha, Sfrp5.ect. The effect of Huoxuejiangtangyin on adipokines regulating provided clues for effective traditional Chinese medicine component. In addition, little dverse reactions occurred in clinical application of Yiqi Yangyin Huoxue traditional Chinese medicine, witch means it was safe and effective.2. Part of experimental research:Traditional Chinese medicine of supplementing qi, nourishing yin and promoting blood circulation can not only reduce the weight blood glucose, blood lipid in type 2 diabetic insulin resistance rats, but also improve insulin resistance by regulating the expression of HMGB1, TLR4 Protein. |
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