| Purpose1.Perform in vivo experiments in TIDM-related NOD mice where imDC induced by Qikui granules interferes with initial T cells,and clarify that Qikui granules induce the production of imDC(1)to promote T cells to differentiate into Tregs and up-regulate the secretion of anti-inflammatory factor IL-10 Reduce inflammation and restore Th17/Treg balance;(2)T cell clones are incompetent and unable to secrete IL-2.Thus,the establishment of immune tolerance is the way and effective mechanism to prevent and alleviate T1DM.The clarification of Qikui granule’s immune regulation mechanism provides an objective basis for the clinical application of Qikui Granules,and provides scientific support for the application of T1DM prevention theory of TCM treatment of disease.2.Observe the characteristics of TCM syndromes in patients with type 1 diabetes and explore the correlation between TCM syndromes of type 1 diabetes and blood glucose control and complications through clinical research.3.Analyze the changes in the immune and inflammation indicators of type 1 diabetes according to clinical research.Method1 Experimental researchAfter the dendritic cells mature,the antigen presentation function is enhanced,causing imbalance of T cell differentiation,destroying immune tolerance and causing autoimmune inflammation of islet β cells,which is an important mechanism leading to the onset of type 1 diabetes.This study was based on the pathogenesis of type 1 diabetes in NOD mice.Qikui granules were used to interfere with isletitis and type 1 diabetes in NOD mice.The effects of Qikui granules on T cell immune tolerance were observed.The effects of Qikui granules on the blood glucose and pathogenesis of T1DM in NOD mice and NOD mice,the ability to regulate DC cell maturity,the ability to regulate Th17/Treg,and the ability to adjust IL-10 and IL-17 were detected.2 Clinical research1.1 A retrospective analysis of patients with type 1 diabetes who were treated in the Endocrinology Department of the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2012 to December 2019.The clinical syndromes,physical and chemical indicators of the patients were analyzed,and according to the "Traditional Chinese Medicine Diagnosis and Treatment Program for the Treatment of Thirst(Type 2 Diabetes)(2017 Edition)",the Chinese Society of Traditional Chinese Medicine "Diabetes TCM Prevention and Treatment" Refers to "Guidelines"(2007)and "Diagnosis and treatment plan for Diabetes(Type 2 Diabetes)of the Key Specialty Collaboration Group of the State Administration of Traditional Chinese Medicine in the Eleventh Five-Year Plan".TCM syndrome differentiation was performed on the collected patients,and SPSS statistical software was used to analyze the correlation between T1DM patients’ types of TCM syndrome and western medicine physical,chemical indicators and complications.Summarize the clinical significance of the distribution of TCM types and the rules.1.2 Select the diabetic patients admitted to the endocrinology department of the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2015 to December 2019 and the healthy population to be followed up in the outpatient clinic.Use SPSS statistical software to detect T cell subgroups,twelve cytokines,and five immune items in the collected T1DM cases to analyze the immune abnormalities of T1DM,so as to study the immune pathogenesis of T1DM better.Result1 Experimental research1.1 Qikui granule administration can interfere with the onset of diabetes in NOD mice,and the mechanism of decrease may be related to the protection of islet C-peptide function.1.2 Qikui granules can alleviate the symptoms of T1DM mice and protect the islet C-peptide function.1.3 Qikui granules can inhibit DC cell maturation in NOD mice and T1DM mouse models.Reduce the number of mature DC cells,increase the ability of DC cell antigen extraction,the ability of DC to stimulate T cell proliferation,and reduce the expression levels of IL-2 and IL-12.1.4 Qikui granules can increase the Treg/Th17 ratio and increase the expression level of Foxp3 in NOD mice and T1DM mouse models.1.5 Qikui granules can reduce inflammation in NOD mice and T1DM mouse models.Decreased the expression of IL-17 and increased the expression of IL-10.2 Clinical research1.1 In type 1 diabetes patients,the main syndromes of Qi and Yin deficiency are the most(88.76%),the syndromes of Yin deficiency and fire deficiency are the second(11.33%).The syndrome is the most,followed by phlegm and dampness.There were no significant differences in T1DM primary syndrome,T1DM syndrome,T1DM age,BMI,course of disease,FBG,PBG,HbAlc,and acute complications(P>0.05).In terms of chronic complications,the incidence of diabetic nephropathy was significantly higher than that of other groups(P<0.05).There was no significant difference in the incidence of DPN,DR,atherosclerosis,coronary heart disease,and cerebral infarction in the other groups of TCM syndromes(P>0.05).1.2 The levels of IL-10,IFN-y,IL-8,IL-12P70,and TNF-α in patients with type 1 diabetes are lower than those in patients with type 2 diabetes and the normal population.Compared with normal population,patients with type 1 diabetes have reduced immune function(P<0.05).Conclusion1.Animal experiments have confirmed that Qikui granules can inhibit DC maturation,up-regulate the expression of Foxp3,promote the production of Treg cells and release the anti-inflammatory cytokine IL-10 against the inflammatory response,and negatively regulate the generation and differentiation of Th17 cells,and regulate Th17/Treg cells are balanced and cause T cell cloning incompetence,which induces immune tolerance.This pathway may be the mechanism of Qikui granules in preventing and treating T1DM.2.TCM syndrome differentiation of type 1 diabetes is related to the occurrence of diabetic nephropathy,and has little correlation with other physical and chemical indicators and complications.3.Patients with type 1 diabetes have immune abnormalities,and their immunity is significantly lower than that of normal people. |
PDF Full Text Request