Observation Of The Curative Effect Of Diabetic Foot In Patients With Early Stages Of Sppplementing Qi And Activating Blood Therapy And Regulation Of Channel Activity By HIF-1?/SDF-1 Rats

Objective:Diabetic foot No.1 with Yiqi Huoxue Onyang effect from two aspects of research and animal experiment to observe the clinical curative effect of traditional Chinese medicine since the experience of diabetic repair on vascular endothelial function in patients with early diabetic foot and the expression level influence of SDF-1 ?HIF-1?.From the cell and gene level of self-made diabetic foot No.1 by HIF-1/SDF-1pathway to improve the oxygen status of blood vessels,endothelial repair,prevention and treatment of early diabetic foot,promote the mechanism of angiogenesis.Method:First Clinical research136cases of early diabetic foot patients were divided randomly into treatment group and control group,68 cases in the treatment group,the group of 68 cases,the two groups were given conventional western medicine oral hypoglycemic,lipid,nerve nutrition,improve microcirculation and other symptomatic treatment,the treatment group on the basis of the control treatment,with Yiqihuoxue efficacy of Warming Yang of Chinese medicine experience of diabetic foot No.1.Two groups were treated for 12 weeks.The two groups were observed before and after treatment the total effective rate and the TCM syndrome integral,and to detect the FPG,2hPG,HbA1 C,AGEs,CRP,VEGF levels.Second Experimental research64 SD male rats,adaptive feeding for 7 days,10 rats were randomly selected as the blank control group(A),given common forage,the remaining 54 rats given high lipid diet.After 4 weeks of high fat diet,rats fasted for 12 h,weighing,measuring blood glucose.By intraperitoneal injection of 35mg/kg--STZ citric acid sodium citrate buffer solution intraperitoneal injection,after injection of 72 h,rats fasting blood glucose was more than 16.7mmol/L,the establishment of diabetes model successfully,made unsuccessful model rats,by the method of additional STZ mitigation solution.Knockoutmodel failed and the dead rats in the modeling process,the 45 meet the conditions of the establishment of rat model of diabetic foot.The 45 rats with 10% chloral hydrate intraperitoneal injection of anesthesia,the left groin skin of the middle longitudinal incision,separated from the femoral artery in the groin,ranging from the inguinal ligament of knee joint in the inguinal ligament until,before ceding spin iliac artery ligation and cut off the superficial femoral artery injection of penicillin,3 days after the400000 unit muscles the model,resulting in diabetic foot.The rats were randomly divided into diabetic foot No.1,low dose group of early diabetic foot(C)in line with the conditions of diabetic foot,No.1(D),high dose group and model group(B),11 rats in group C,11 rats in group D and group B 10.A,B group were given saline,C,D groups with different dosages of diabetic foot No.1,gastric lavage,for 12 weeks,the rats were observed behaviors,such as weight in general.After the experiment,take blood abdominal aorta,Detect serum levels of CRP and VEGF expression in rats,separation of gastrocnemius muscle tissue by rt-pcr detection of HIF-1 alpha m RNA and SDF-1 mRNA expression.Result:First Results of clinical studiesTwo groups of patients before treatment,gender,age,course of the disease,smoking history,history of drinking,BMI and other general information no difference(P > 0.05),comparable.The diabetic foot No.1,12 weeks after the treatment,the total effective rate of treatment group was 84.4%,67.7% in the control group,the treatment group curative effect surpasses the control group(P < 0.01);the treatment group and the control group before and after treatment,symptom scores improved significantly,with significant difference(P < 0.01),compared to treatment and after treatment group and control group,with significant difference(P < 0.05);the treatment group and the control group of limb superficial sensation was improved after treatment,the difference had statistical significance(P<0.05),the treatment group after treatment of patients with limb superficial sensation and control group after treatment,compared the differencewas statistically significance(P<0.05);ABI in the two groups after treatment than before treatment had different degree of improvement(P<0.01),the treatment group after treatment of ABI to improve the situation better than the control group,with significant difference(P<0.05).The patients in the two groups after treatment FPG,2hPG,HbA1 c levels compared with before treatment,with a certain degree of improvement,with significant difference(P< 0.05),after treatment,FPG,2hPG group is better than that of the control,the difference has statistical difference(P<0.05),there was no significant difference between two groups after treatment HbA1 c levels(P<0.05).Two groups of TG,TC level after treatment than before treatment reduced(P< 0.05),the treatment group after treatment of TG,TC level compared with the control group after treatment,statistically significant difference(P< 0.05);Two groups of CRP after treatment than before treatment improved to varying degrees(P< 0.05),the treatment group after treatment serum CRP and the control group after treatment compared with statistically significant difference(P< 0.05);VEGF in the two groups after treatment than before treatment were improved in different degrees(P<0.05),serum VEGF and control group after treatment compared,with statistically significant difference(P<0.05);VEGF in the two groups after treatment than before treatment decreased to some extent(P<0.05),serum VEGF and control group after treatment compared,with statistically significant difference(P<0.05).Second The results of animal experimentsAnimal experimental results show that the model group(B),diabetic foot No.1,low dose group(C),diabetic foot No.1,high dose group(D)compared with the group and control group,the expression of FPG,TG,TC,VFGF,CRP,HIF-1mRNA,SDF-1mRNA was higher than the control group(P<0.05 orP < 0.01).After the treatment of diabetic foot No.1,low dose group(C),diabetic foot 1,high dose group(D)rats FPG,TG,TC,VFGF,CRP,HIF-1 mRNA,SDF-1 mRNA significantly lower than the model group(P<0.05 or P<0.01).Diabetic foot No.1,low dose group(C)and diabetic foot 1,high dose group(D)compared to FPG,the difference was not statistically significant(P>0.05),diabetic foot No.1,low dose group(C)and diabetic foot 1,high dose group(D)compared with VFGF,CRP,HIF-1 mRNA,SDF-1mRNA,diabetic foot 1,high dose group(D)expression is relatively low,with a significant difference between two groups(P < 0.05 or P < 0.01).Conclusion:Supplementing qi and activating blood circulation method can improve the functions of vascular endothelial cells in the body of type 2 diabetes mellitus,intervention of vascular lesions,the possible mechanism is through the HIF-1 affects the/SDF-1 pathway,regulating blood sugar,improve tissue hypoxia,stress,decrease the level of serum CRP,VEGF level,expression and regulation of SDF-1 alpha mRNA and HIF-1 alpha,repair damaged vascular endothelial cells,promote angiogenesis related.