The Effect Of Biling Prescription On Serum Cys-C And ESR In Patients With Diabetes Complicated With Gout And The Intervention Of P2X7R,NLRP3,URAT1 In Model Rats

Objectives: To observe the effects of Biling prescription on serum Cys-C and ESR in patients with diabetes and acute gout;To research the intervention of P2X7 R,NLRP3 and URAT1 in model rats;To analyze the effects of Biling prescription on blood sugar,blood uric acid and related inflammation;To explore its mechanism of action on diabetes and gout.Methods:1.Clinical research Select 64 patients with diabetes mellitus complicated with acute gouty arthritis then randomly divide them into two groups: Biling group and control group.Ensure there are 32 patients in each group.The two groups are given oral hypoglycemic as usual.Add Biling Qutong prescription to the Biling group based on western medicine and the control group need take indomethacin tablets for 2 weeks.The joint function symptom scores of patients treated for 0d,3d,and 7d were recorded separately.The TCM symptom,FPG,2hPG,UA,TC,TG,LDL-C,HDL-C,ESR,hs-CRP,Cys-C,mAlb,ACR and other indicators need to be recorded and the difference among these indicators should be compared before and after the treatment.2.Animal Experiment Select 50 healthy male SD rats.After adaptive feeding for one week,choose 9 rats randomly as the normal group and feed them with normal fodder.The experimental group need to be fed with high-fat fodder until the end of the experiment.Make successful models of diabetes by intraperitoneal injection of streptozotocin 40 mg/kg when the blood sugar is greater than or equal to 16.7 mmol/L.Then randomly divide rats in the experimental group into the model group,Biling group,pioglitazone group and indomethacin group.Inject 0.2 ml of sodium urate solution into the joint cavity to make the gout model,and the ankle joint circumference was measured at 3h,1d,3d,and 7d after modeling.After the establishment of the diabetes mellitus combined gout model,continuous feeding them with medicine at different doses.After two weeks,take blood samples to test PG,TG,TC,LDL-C,UA,P2X7 R,NLRP3,and URAT1 levels.Leave the joints and adopt the RT-qPCR method to detect URAT1 mRNA relative quantity in the joints.Observe the rat general conditions including mental state,behavioral performance,gait changes,food and water intake before and after treatment.Results: 1.Clinical Research The clinical results show that after 2 weeks of treatment,the total effective rate of the Biling group and control group are 86.7% and 64.5% respectively.The curative effect of Biling group is better than that of the control group(P<0.05).The joint function symptoms scores after 3 days and 7 days of treatment,and the total TCM syndrome scores after 2 weeks of the two groups are obviously lower than those before treatment(P<0.05 or P<0.01).The total score of TCM syndromes in the Biling group is lower than that in the control group(P<0.01);FPG,2hPG,UA,TC,TG,LDL-C,Cys-C,ESR,hs-CRP,mAlb and urinary ACR levels decrease distinctly in the two groups after treatment compared with before treatment(P<0.05 or P<0.01).HDL-C level in the Biling group significantly increases(P<0.05).Compared with the control group,the UA,HDL-C,ESR,Cys-C,mAlb,and urinary ACR levels of Biling group significantly improve(P<0.05 or P<0.01).2.Experiments The results of animal experiments show that compared with the normal group,the joint swelling of the rats in the model group increased significantly at different time points after modeling(P<0.01).Compared with the model group,the swelling degree of the joints in Biling group and indomethacin group was significantly decreased at 3d and 7d after modeling(P<0.01).Compared with the normal group,the levels of PG,TG,TC,LDL-C,UA,P2X7 R,NLRP3 and URAT1 in the model group were visibly increased(P<0.01).After medicine-feeding,these indicators significantly reduce in Biling group(P<0.01).Compared to the normal group,the relative quantity of URAT1 mRNA in joints in the model group obviously rises(P<0.01).Also,the relative quantity of URAT1 mRNA in Biling group distinctly decreases(P<0.01).Conclusions: Biling prescription,which has the function of dispelling turbidity,detoxification and dredging meridians,could effectively improve the TCM symptom and joint function symptom of patients with diabetes and gout.It could reduce related inflammation and distinctly make expression quantity of P2X7 R,NLRP3,URAT1 decrease in animal models.Also,it could inhibit arthritis swelling in rats,correct glycolipid metabolism,reduce blood uric acid and resisted inflammatory conditions.