| Objective: The symptom complex of diabetic gastroparesis(DGP)typically associated with low motility of stomach, such as anepithymia,fullness, nausea, vomitting, abdominal distention, abdominal pain and so on, itwas one of the most common chronic complications of diabetic melliutus(DM), and gastroparesis seriously affects the quality of life, then it isimportant to study the pathogenesis of DGP and look for effective methods toprevent and treat DGP. DGP was resulted from synthetic action of multiplefactors with characteristics of complicated pathological mechanism. Scholarsboth at home and abroad continue to explore pathological mechanism andeffective treatment. However until now, the pathogenesis is not clear yet.Favorable treatment and medicines are less. Treatment of DGP by traditionalChinese medicine (TCM) is typified with a multitude of ways, multi-targetlow adverse reactions. In recent years, good effect with TCM was acquired tocure DGP, showing greater potential and potential applications.Uprightdeficient was defined as basic pathogeny of DGP. Promoting blood circulationand removing the stasis were the main therapy methods of curing DGP.Prescription was a traditional chinese medicine compound containing Salviamiltiorrhiza, Rhizoma ligustici wallichii, leech and earthworm with features ofpromoting blood circulation and removing the stasis. The prescription showedgood effect to cure DM and DGP. Then the study was designed to verify thetherapeutic effect and probe into the possible mechanism. The prescriptionwas used to treat DGP animal model of gastric motility disorders observingthe therapeutic effect, and testing the expression of Ghrelin in stomach. Theinfluence of this prescription in gastric enteric nervous system such as5-HT,Nissol body, MAO-A mRNA and gastric neurotransmitter such as5-HT of gastric myenteric nerve plexus was detected, and identify the site of action，link and molecule mechanism which the prescription treated DGP. It wasdesigned to probe into the possible mechanism and to provide experimentalevidence in clinical therapy of DGP.Methods:50SD male rats were randomly divided into5groups: controlgroup, model group, low dose treated group, middle dose treated group andhigh dose treated group. After1week adaptable feed, others groups except forcontrol were injected streptozotocin (STZ) solution (55mg/kg) into abdominalcavities.72h later, blood glucose (BG)≥16.7mmol/L were taken as thestandard model. The rats in traditional Chinese medicine groups were treatedby intragastric administration with the Herbs of Supplement Qi and NourishYin Resolve Masses and Dredge Meridians respectivelyone time per day for6weeks. The rats in control group and model group were given by intragastricadministration with the saline water for6weeks. After cardia and pylorusligation, phenol red was administered to test gastric emptying function (GEF).The comparison of Nissol body in gastric enteric nervous system wasexamined by toluidine blue staining. The comparison of Ghrelin and5-HTwas examined by immunohistochemistry, and the comparison of MOA-AmRNA in gastric enteric nervous system was examined by RT-PCR.Results:1The comparison of gastric emptying rates among5group ratsCompared with normal group, the gastric emptying decreased obviouslyin the other four groups(P<0.05). Compared with model group, the gastricemptying and expression of ghrelin increased obviously in each ChineseMedicine group(P<0.05). Compared with Chinese medicine group3, thegastric emptying decreased obviously in Chinese medicine group1and2(P<0.05), no meaning to compare Chinese medicine group1with Chinesemedicine group2(P>0.05).2The comparison of Ghrelin in gastric antrum among5group ratsCompared with normal group, the expression of Ghrelin decreasedobviously in the other four groups(P<0.05).Compared with model group, the expression of Ghrelin increased obviously in each Chinese Medicinegroup(P<0.05). Compared with Chinese medicine group3, the expression ofGhrelin decreased obviously in Chinese medicine group1and2(P<0.05), nomeaning to compare Chinese medicine group1with Chinese medicine group2(P>0.05).3Changes of gastric enteric nervous system among5group rats3.1The comparison of Nissol body in gastric enteric nervous system among5group ratsCompared with normal group,the number of Nissol body in gastricenteric nervous system were obviously less in the other four groups, amountof Nissol body were also lessened and presented obviously lysis or loss;Compared with model group, the number of Nissol body increased obviouslyin each Chinese Medicine group. Compared with Chinese medicine group3,the number of Nissol body decreased obviously in Chinese medicinegroup1and2, no meaning to compare Chinese medicine group1with Chinesemedicine group2.3.2The comparison of5-HT in gastric enteric nervous system among5groupratsCompared with normal group, the expression of5-HT decreasedobviously in the other four groups(P<0.05).Compared with model group, theexpression of5-HT increased obviously in each Chinese Medicinegroup(P<0.05). Compared with Chinese medicine group3, the expression of5-HT decrease obviously in Chinese medicine group1and2(P<0.05), nomeaning to compare Chinese medicine group1with Chinese medicine group2(P>0.05).3.3The comparison of MOA-A mRNA in gastric enteric nervous systemamong5group ratsCompared with normal group, the expression of MOA-A mRNAincreased obviously in the other four groups(P<0.05). Compared with modelgroup, the expression of MOA-A mRNAdecreased. Obviously in eachChinese Medicine group(P<0.05). Compared with Chinese medicine group3, the expression of5-HT increased obviously in Chinese medicinegroup1and2(P<0.05), no meaning to compare Chinese medicine group1withChinese medicine group2(P>0.05).Conclusions:1There was disfunction of gastric emptying in DGP rats. The traditionalChinese medicine which promote blood circulate and remove the stasis couldrecover the disfunction of gastric emptying in DGP rats.2The expression of Ghrelin was decreased in stomach of DGP rats. Thetraditional Chinese medicine which promote blood circulate and remove thestasis could improve gastric emptying by iecreasing the level of the expressionof Ghrelin.3The traditional Chinese medicine which promote blood circulate andremove the stasis could improve gastric emptying by recovering thedisfunction of gastric enteric nervous system. |
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