Effects And Mechanism Of "Yiqiyangyintongluo" Therapy For Type 2 Diabetes Mellitus

ObjectiveProfessor Xingfan Qiu has established "Buzangtongluo" Therapy for Type 2 Diabetes Mellitus (T2DM) after many years of his clinical practice. He has suggested that "Zangxuluobi" is the main pathogenesis of T2DM and found a recipe of "Yiqiyangyintongluo" (YQYYTL). YQYYTL is the foundation of the treatment for diabetes mellitus during many years of clinical trials. It has good results not only in declining the blood glucose, but also in prevention of T2DM. However its functional mechanism needs to be elaborated and proved through the modern scientific techniques. The aim of this topic is to observe fasting blood glucose (FBG), fasting Insulin (FINS), blood tumor necrosis factor-α(TNF-α) and the expressional level of glucosetransporter 4(GLUT4), protein tyrosine phosphatase 1B (PTP-1B) in skeletal muscles and GLUT4 PTP-1B, TNF-αin fat tissues to study the function on T2DM and its mechanism.Methods1. The theoretic researchThe method is connecting the clinical experiences of professor Qiu. 2. The experimental researchTen-week-old fat-fed STZ-treated rats,an animal model of T2DM, were divided into 4 groups randomly, plus a normal group, totally 5 groups: normal group; model group; high dosage of YQYYTL- treated group; middle dosage of YQYYTL -treated group; "Xiaokewan" (XKW) -treated group. After 8 weeks, the blood was collected to measure the levels of fasting blood glucose, fasting insulin, TNF-α. Then rats were investigated by assaying the expressional level of GLUT4,PTP-1B in skeletal muscles and GLUT4,TNF-α,PTP-1B in fat tissues with immunohistochemistry or Westernblotting techniques.Results1. "Zangxuluobi" is the main pathogenesis of T2DM. The deficiency of Qi and Yin in lung, spleen and kidney is the "Ben" of the disease while the obstruction in meridians by the blood stasis and the water-pathogen is the "Biao" of the disease.2. Laboratory results2.1 Characteristics of experimental animalsActivity of the models decreases while weight of the models increases compared with normal group rats. The difference is significant (P<0.01). After treatment with Chinese drugs, the models become active and their weight reduces significantly (P<0.01). Among the treated groups, weight of rats shows no difference (P>0.05).2.2 The level of FBG, FINS and insulin sensitivity index(ISI).The level of FBG in rats of model group and all Chinese drugs groups are significantly higher than in normal group (P<0.01). The level of FBG in rats of all Chinese drugs groups are significantly lower than model group (P<0.01). The level of FBG among rats of Chinese drugs groups show no difference (P>0.05). It should be noted that the level of FINS among rats of 5 groups show no difference (P>0.05). The level of ISI in rats of model group is lower than normal group (P<0.05; the level of ISI of all treated-group are higher than model group (P<0.05)2.3 The level of blood TNF-αThe level of blood TNF-αin rats of model group is significantly higher than normal group (p<0.01) and the level of all treated- group are significantly lower than model group (P<0.01); The level of blood TNF-αof high dosage and middle dosage of YQYYTL-treated groups are lower than XKW-treated group (p<0.05).2.4 The expressional level of GLUT4 in the skeletal musclesThe expressional level of GLUT4 in the skeletal muscles of model group is lower significantly than normal group (P<0.01) and the level of all treated-group increase significantly comparing to model group (P<0.01); The expressional level of GLUT4 in skeletal muscles among high dosage of YQYYTL-treated group,XKW-treated group and normal group show no difference(P>0.05).2.5 The expressional level of PTP-1B in the skeletal musclesThe expressional level of PTP-1B in skeletal muscles of model group is significantly higher than normal group (P<0.01) and the level of all treated-group decrease significantly comparing to model group (P<0.01); The expressional level of PTP-1B in skeletal muscles among high dosage of YQYYTL-treated group,XKW-treated group and normal group show no difference (P>0.05). 2.6 The expressional level of GLUT4 in fat tissuesThe expressional level of GLUT4 in fat tissues of model group is lower significantly than normal group (P<0.01) and the level of all treated-group increase significantly comparing to model group (P<0.01); The expressional level of GLUT4 in fat tissues among YQYYTL-treated-group, normal group show no difference(P>0.05).2.7 The expressional level of TNFαin fat tissuesThe expressional level of TNFαin fat tissues of model group is significantly higher than normal group (P<0.01) and the level of all treated-group decrease significantly comparing to model group (P<0.01); The expressional level of TNFαin fat tissues between high dosage of YQYYTL-treated group and normal group show no difference (P>0.05).2.8 The expressional level of PTP-1B in fat tissuesThe expressional level of PTP-1B in fat tissues of model group is significantly higher than normal group (3.2-fold,P<0.01) and the level of high dosage of YQYYTL-treated group decreases by 57% (P<0.01) comparing to model group, but higher than normal group (P<0.01).ConclusionsYQYYTL recipe can decrease the blood glucose and improve the insulin resistance of T2DM. Its mechanism may involve the insulin-enhancing effects in skeletal muscles and fat tissues through increasing the excessive expression of GLUT4 while decreasing the excessive expression of PTP-1B,TNFα.