The Clinical And Experimental Study On "Qingfei Xiegan Decoction" In The Treatment Of Insulin Resistance

Diabetes is one of the most common metabolic diseases in the clinic.This disease can cause multiple system damage and lead to the characteristics of chronic progressive lesions,dysfunction and failure of multiple tissues and organs.Diabetes is divided into type 1 diabetes(T1DM)and type 2 diabetes(T2DM),which are mainly in T2DM patients.Insulin resistance(IR)is considered to be the central link in the pathogenesis of T2DM.Studies have shown that about 92%of T2DM patients have different degrees of insulin resistance,and it runs through the whole process of T2DM occurrence and development.Therefore,the treatment of IR can control one of the main ways of the development of T2DM.This topic is divided into two parts:clinical observation and ex perimental research.Clinical observation on selection of insulin res istance in type 2 diabetic patients taking Qingfei Xiegan Decoction f or clinical study;experimental study with high fat and high glucose diet fed SD rats,And intraperitoneal injection of streptozotocin(ST Z)model,intragastric administration of Qingfei Xiegan Decoction in conscious rats tail vessels'catheterization high insulin-positive e xperimental study on blood glucose clamp.Study 1:Clinical Observation of "Qingfei Xietang Decoction" in Trea ting Type 2 Diabetes Insulin ResistanceObjective:To observe the efficacy of "Qingfei Xietang Decoction" com bined with metformin and metformin alone in the treatment of T2DM pat ients with insulin resistance,and observe fasting glucose(FBG),pos tprandial 2h blood glucose(2hBG),and glycated hemoglobin before and after treatment in the two groups.(HbAlc),fasting insulin(FINS),f asting free fatty acid(FFA),insulin resistance index(HOMA-IR),tri glyceride(TG),total cholesterol(TC),low density lipoprotein(LDL-C),high Density lipoprotein(HDL-C)levels.To investigate the clini cal efficacy and drug safety of "Qingfei Xietang Decoction" in the tr eatment of T2DM patients with insulin resistance.Methods:80 patients with T2DM insulin resistance were randomly divid ed into 40 patients with Qingfei group and 40 patients with control g roup.Both groups of patients were given basic treatment such as cont rolled diet and appropriate exercise,and then hypoglycemic agent met formin sustained-release tablets,1g/time,once/d.On this basis,the Qingfei group also took "Pulmonary Liver Decoction" at the same time,and the drug composition:Puerariae 25g,Sakamoto 15g,Cimicifuga 15g,Angelica 15g,Radix Astragali 15g,Campanulaceae 15g,Radish 30g,Dan delion 25g Rhubarb 7.5g,Artemisia 15g.Day 1,decoction juice 400ml,sooner or later 2 times after meals.Observed for 2 months.The fasti ng blood glucose(FBG),postprandial 2h blood glucose(2hBG),glycate d hemoglobin(HbAlc),fasting insulin(FINS),fasting free fatty acid s(FFA),and insulin resistance index(HOMA-IR)were observed before and after treatment in the two groups of patients.,triglyceride(T G),total cholesterol(TC),low density lipoprotein(LDL-C),high den sity lipoprotein(HDL-C)conditions.HbAlc was detected by high press ure liquid phase method,FFA was determined by enzyme-linked method,and HOMA-IR was calculated using the formula(HOMA-IR=FPG×FINS/22.5).Results:the Qingfei group and the control group were effective in re ducing fasting insulin and insulin resistance index(P<0.05),and th e curative effect of Qingfei group was better than that of the contro I group(P<0.05).Conclusion:The treatment of Qingfei Xiegan Decoction in the treatmen t of patients with T2DM insulin resistance in Taiyin is effective and worthy of clinical application.Study II:Rats with tail-vein cannulation with high insulin-positiv blood glucose clamp during wakefulness Objective:To assess insulin resistance in rats by awake high-insulin-euglycemic clamps in tail-vein arteries.Methods:Thirty SD male rats were fed for 7 days,and one of team was set as a normal group by randomization method and fed with common die t.The other 25 rats were fed with high-fat and high-sugar diet for 4 weeks and then passed through the abdominal cavity.Injecting Strepto zotocin(STZ)to Produce Type 2 Diabetes Insulin Resistance Model.Af ter successful manufacture of type 2 diabetes insulin resistance mode 1,the five groups of rats were randomly divided into metformin group,model control group,Qingfei Xiegan Tang low-dose group,Qingfei Xieg an Tang middle-dose group,clear lung diarrhea.In the high-dose Tang group,the corresponding drugs were given intragastrically;the norma 1 group and the model control group were given only the same amountof saline for gavage for 4 consecutive weeks,and the body weight wasme asured every week,and the 10th,20th,and 30th days of intragastric administration.The fasting plasma glucose(FBG)in rats was measured after 4 weeks.After the administration of gastric juice for 4 weeks,a high-insulin-euglycemic clamp experiment was performed with a tail-vein catheter under awake state.The glucose infusion rate(GIR)and glucose infusion were measured in each group of rats.Infusion rate c oefficient of variation(CV mean),insulin(FINS).After the clamptes t,the eyeballs were collected and blood was collected.The levelsof high-density lipoprotein(HDL-C),low density lipoprotein(LDL-C),tot al cholesterol(TC),triglyceride(TG)and glycosylated hemoglobin(Hb Alc)were measured.Results:compared with the control group of Qingfei group can significantly reduce fasting blood glucose(P<0.05);rats in awake state tail arteriovenous intubation after operation,no rats died;compared with the control group of Qingfei group the glucose infusion rate is higher;can improve the insulin sensitivity of Qingfei group rats can reducedensity lipoprotein,total cholesterol,and increase high-density lipoprotein(P<0.05).Conclusion:The experimental data show that Qingfei Xiegan Decoction can reduce blood glucose and blood lipid in type 2 diabetic insulin resistance rats,and it can increase insulin sensitivity and reduce insulin resistance in rats.