| Diabetes is a series of metabolic disorder syndrome in protein, fat, water and electrolytes, which due to the interaction of genetic and environmental factors, and causes absolutely or relatively to shortage of insulin secretion and sensitivity decrease of target cells to insulin. Diabetic patients with long-term elevated blood sugar can cause organ damage, which leads to function failure due to the viscera dysfunction. Because of the serious harmfulness of diabetes and the incidence rate increases year by year, coupling with the need for the high cost, which has become the world to face a serious challenge to prevent and therapy diabetes. Likewise, anti-diabetes drugs also have great market prospects, which makes anti-diabetes drugs researched and developed to become one of the focus in the world.As the incidence of type 1 diabetes is low, less than 5 percent, and mainly relies on insulin therapy, this study is for type 2 diabetes primarily. The knowledge about type 2 diabetes has been confined to the lack of insulin secretion more than half a century, which causes the treatment for it has been focused on promoting insulin secretion agent naturally. Drugs research and development has been focused on promoting insulin secretion agent, leading to the relative lack of long-term treatment.Insulin resistance (Insulin resistance, IR) is the peripheral insulin target tissues to insulin sensitivity and responsiveness decreases, leading to it is difficult for insulin to produce the normal physiological effects. Research shows that IR is the key driving factor leading to the incidence of type 2 diabetes. It is also a range of metabolic disorders, leading to cardiovascular complications such as the core. It is the "common soil" where diabetes, coronary heart disease and hypertension happen. Therefore, the treatment for IR is the key of treating type 2 diabetes.Since the awareness about the pathogenesis of type 2 diabetes have changed fundamentally, the attention of which transits from the islet cells their own secretion to the action of IR and outside the pancreas. It leads to drug research and development continuing to accelerate, which causes that it is constantly available to improve insulin resistance to the treatment of type 2 diabetes drugs.Diabetes belongs to Chinese medicine "wasting-thirst". The awareness about the pathogenesis of "wasting-thirst" has been considered to be the deficiency of body fluid that causes dryness-heat being excessive in the interior. Doctors take the way of treatment for diabetes in accordance with the lung, stomach and kidney. However, since the deficiency of both vital energy and yin and stagnation of blood theory has been founded by Shi jinmo and zhu chenyu this contemporary, which has been accepted by the majority of clinicians. It drives enormously to have research on the pathogenesis of diabetes. Subsequently, sputum, humid, and harm as such pathogenesis theories were constantly raised, greatly enriching the awareness on the pathogenesis of diabetes, which makes therapeutic effect continue to increase. The awareness for pathogeny and pathogenesis of "wasting-thirst" has deepened constantly, which makes anti-diabetes drugs varieties of Chinese medicine from scratch to rapid growth in nearly past 10 years. According to the report by Ji shoaling, the approval of new Chinese medicine treatment of diabetes drug have not been declared from 1985 to 1992; 14 had been approved from 1992 to April 1999; while about 30 had been approved to have clinical research from 1999 to 2002. However, the current clinical anti-diabetes drug is still mainly western medicine, Chinese medicine is still in secondary status. The reasons: First, traditional Chinese medicine research and development of new drugs continues to follow the thinking of western medicine research, the main efforts are concentrated on active ingredients purification and research on the pharmacological effects; Second, the design of new Chinese medicine prescription lacks guiding of pathogeny and pathogenesis theory of Chinese medicine and Chinese medicine compatibility theories, drugs selecting confined to the ancient prescription and experimental prescription. Third, the researchers of new drugs are not closely associated with the clinic, the ideas of research and development drop behind the clinical practice. The awareness of diabetes is still confined to the pathogenesis of deficiency of yin feverish sensation and deficiency of both vital energy and yin. Some new theories of pathogenesis such as blood stasis, phlegmatic hygrosis, pyretic toxicity have not enter into the the vision of the anti-diabetes drug researchers. Therefore, it is urgent to take full advantage of the guiding of Chinese medicine theory, for the new pathogenesis theory of blood stasis, phlegmatic hygrosis, pyretic toxicity, expanding the scope of drugs selected with aim, researching and developmenting certain effect of the anti-diabetes drug Chinese medicine.The pathogenesis of modern traditional Chinese medicine theory considers that deficiency of both vital energy yin-deficiency of yin feverish sensation-simultaneous asthenia of yin and yang is the basic rule for the occurrence and development of the type 2 diabetes, while the blocking collaterals of blood stasis traverses from the beginning and the end of type 2 diabetes. Qi is the commander of blood, the deficiency of qi causing it incapable to circulate, while deficiency of yin must cause blood stasis, slow flow blood easily leads to blood stagnation. Clinical studies show that blood stasis of type 2 diabetes is closely related to insulin resistance. They also show that it is significantly effective to lower blood sugar and prevent complications for activating blood to resolve stasis treatment.This study is inspired by the theory of insulin resistance- the "common soil" and blood stasis blocks collaterals-"common pathogenesis theory", selecting compound Danshen tablet generic medicine, that is, it has the effect of activating blood to resolve stasis and the small compound preparation which is often used to therapy coronary heart disease - as a point of penetration. Facing the key link of insulin resistance and blood stasis blocks collaterals, first of all its anti-diabetic role of the clinical and experimental verification, discussing the possibility of lowering blood sugar about different types of activating blood to resolve stasis drugs, expecting to develop the selected scope of anti-diabetic effective parts with aim. Then demolition research has been done and the effective parts are selected. Observing the effect of its lowering blood sugar and prevent chronic complications of diabetes, discussing its mechanism, which lays the foundation to form medicine over again about effective parts for the next step. To explore a new way of selecting anti-diabetes Chinese medicine.Modern medicine considers that insulin resistance is the major factor which causes type 2 diabetes to start and develop. Type 2 diabetes and coronary heart disease have a common soil - insulin resistance. Traditional Chinese Medicine considers that blood stasis is not only the pathology production of diabetes, but also is the agent of the occurrence and development of diabetes. Type 2 diabetes and coronary heart disease have a common pathogenesis- blood stasis blocks collaterals. Accordingly, we speculate that any Chinese medicine formulations relieving blood stasis role can therapy coronary heart disease, which may also be used for the treatment of type 2 diabetes caused by insulin resistance.First of all, we have a control research on the clinical efficacy of type 2 diabetes about the representative Chinese medicines to therapy coronary heart disease which can relieve blood stasis-compound Danshen tablet and compound Danshen injection. The results indicate that compound Danshen tablet and compound Danshen injection can lower blood sugar, increase insulin sensitivity and improve the clinical symptoms in a way. They are superior to the control group in the elimination of clinical symptoms and improvement of insulin sensitivity.Secondly, due to these Chinese medicine are made up of a few ingredients, relatively clear active parts, so we choose Fufang danshen diwan, Suxiao jiuxin wan, Diao xinxuekang capsule and Fufang danshen tablet to compare with Rosiglitazone, and have experimental verification of lowering blood sugar, which showed that they all show some certain effect of lowering blood sugar. At the same time, they all can improve insulin sensitivity index. Among them, Fufangdanshen tablet is the best, which points out the direction t for our selecting of the next step. The results of this study fully demonstrate that under the guidance of traditional Chinese medicine, we can take the effect of getting twice the result with half the effort, by narrowing the selection scope of new drug research and development, which makes no goal-selecting of the nets become the hunt for selecting with aim.Third, due to the major components of a different nature in Fufang danshen tablet, it is split into water-soluble part and fat-soluble part, the experimental anti-diabetes research is done. It is found that both water-soluble part and fat-soluble part of Fufang danshen tablet can lower blood sugar and improve insulin resistance, but the action of water-soluble part is relatively stronger than that fat-soluble part.Fourth, water-soluble part of Fufang danshen tablet is further split into and re-group and the experimental research is conducted on the anti-diabetes. The results show that blood sugar decreases significantly in the salvianolic acid group, the salvianolic acid+ notoginsenoside group and the salvianolic acid+ notoginsenoside+ borneol group in addition to notoginsenoside group. Among them, blood sugar of the salvianolic acid+ notoginsenoside+ borneol group decreases most severely. We also find that the new section of the salvianolic acid which can lower blood sugar significantly.Fifth, the mechanism of anti-diabetes is discussed by splitting the effective parts of Fufang danshen tablet. It is found that they can depress superoxide dismutase MDA and repair pancreatic tissue. They can reduce plasma FFA, TNF-α, enhance the sensitivity of insulin receptors. They can improve the expression of ISR-1, IRS-2 and PI3K and reduce the insulin resistance. They also lower TG, improve fatty liver and reduce the output of liver glycogen. It is the aim to control blood sugar and therapy type 2 diabetes by much more links, multi-channel and multi-role target. It is also found that the new group medicine of the salvianolic acid+ notoginsenoside+ borneol group has obvious role and unique advantages in improving insulin resistance, reducing the islet cell damage and improving fat metabolism and depressing fatty liver, which is worth the further development of research.Sixth, the study also found that maybe Fufang danshen tablet improves the proliferation of type 2 diabetic rats' chronic complications by reducing the glycosylation product, lowering blood fat and depressing organized suppression of the product produced. Pathological examination reveals that the action of depressing the model rats' small vascular thrombosis in the eyeball is extremely significant for Fufang danshen tablet, which can improve blood circulation of the eyeball. It can reduce the extent of atherosclerosis or disease. It can alleviate the extent of sciatic nerve injury. It can depress model rats' kidney serous membrane of the invasion and tubular-film thickness to reduce the extent of kidney disease.The main innovation of this study have four points: First, using the blood stasis blocks collaterals of diabetes pathogenesis theory of traditional Chinese medicine as guidance, which is successful in transplanted Fuangdanshen tablet to the type 2 diabetes therapy, which is effective to reduce the selecting scope of anti-diabetes Chinese medicine. The second is that the new section of the salvianolic acid which can lower blood sugar significantly is found. Third, the invention of this new set of anti-diabetes, which is the salvianolic acid+notoginsenoside+borneol group. Fourth, it was found that the Fufang Danshen category-the lowering blood sugar effect of Fufang danshen diwan, Suxiao Jiuxin pill, Diao xinxuekang capsule.In short, this study makes a useful attempt to guide the anti-diabetes Chinese medicine selecting by the pathogenesis theory of traditional Chinese medicine, some good signs are found, which is worth going deep into discussion, summing up constantly to establish a new traditional Chinese medicine drug selecting and research and development pattern.
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