| Objective:In this study, taking the core link of type2diabetes-islet β-cell dysfunction as a breakthrough point, we establish type2diabetic Sprague-Dawley (SD) rats model, mainly characteristic symptoms of hyperglycemian, hyperinsulinemia and hyperlipidemia, by feeding high-fat and high-calorie diet together with peritoneal injection of STZ, and explore the mechanism of the Jiangtang Jiaonang in improving rats pancreatic β-cell function, blood glucose and lipid metabolism to study the mechanism of the treatment of type2diabetes with traditional chinese medicine (TCM). In addition, we plan to find experimental evidence of the hypothesis that diabetes are caused by deficiency of spleen, and explore a correlation between spleen-stomach weakness and islet β-cell dysfunction, in order to initially reveal a mechanism of the treatment of invigorating qi and strengthening the spleen and thus provide an innovative way to study the role of TCM in treating type2diabetes.Methods:Literature studies:reviews include "Theory and experiment research progress in the treatment of type2diabetes with TCM" and "Modern medical research progress in type2diabetes". We make a systematic summary of pathological mechanism of type2diabetes in two aspects of TCM and western medicine, through documenting all relevant literature concerning the etiology, pathogenesis and clinical studies of type2diabetes all over the world.Experiment studies:taking SD rats as research objects, we established type2diabetic rats model by feeding high-fat and high-calorie diet together with peritoneal injection of STZ. SD rats were randomly divided into4groups:control group (NC group), model group (M group), Metformin Hydrochloride Tablets group (MH group) and Jiangtang Jiaonang group (J group) and were treated with Jiangtang Jiaonang, comparing to Metformin Hydrochloride Tablets. Then we observed the effects of the drugs on pancreatic β-cell function, blood glucose and lipid metabolism, inflammatory factors, the expression of NF-kB in pancreas of rats and oxidative stress.Results:①efore STZ injection, FIN in M group, MH group and J group totally significantly increase compared with NC group (p<0.01). At7d after STZ injection to after4weeks of administration, FBG and AUC in M group. MH group and J group totally significantly increase compared with NC group (p<0.01). In1-4weeks of administration. FBG in MH group significantly decrease compared with M group (p<0.051%或p<0.01). In3-4weeks of administration, FBG in J group significantly decrease compared with M group (p<0.05or p<0.01). In1-4weeks of administration, FBG in J group significantly increase compared with MH group (p<0.05). After4weeks of administration, AUC in MH group significantly decrease compared with M group (p<0.01). AUC in J group significantly decrease compared with M group and MH group (p<0.05or p<0.01). HbAlc in M group, MH group and J group totally significantly increase compared with NC group (p<0.01), while there is no significant differences between three groups (p>0.05). FIN in MH group and J group totally significantly decrease compared with M group (p<0.01), while there is no significant differences compared with NC group (p>0.05). C-P in MH group and J group totally significantly increase compared with NC group (p<0.05). INS in M group, MH group and J group totally significantly decrease compared with NC group (p<0.01), while INS in MH group and J group significantly increase compared with M group and MH group (p<0.05or p<0.01) and there is no significant differences between them (p>0.05). Under high power microscope, a large amount of islets with clear outline and regular shape in NC group are seen, which are dispersed with rats pancreatic acinar cells. In addition, cells in islets present distinctive boundary, regular arrangement, even distribution, clear nuclei and cytoplasm and unobvious pathological changes. Fewer Islets with obscure outline, irregular shape, structure disturbance and obvious pathological changes are observed in M group. Yet. to some extent, tissue morphology in MH group and J group are improved compared with M group.②Before STZ injection, TG and TC in M group, MH group and J group totally significantly increase compared with NC group (p<0.01). At3weeks after STZ injection to after4weeks of administration, weight in M group, MH group and J group totally significantly decrease compared with NC group (p<0.01). After4weeks of administration, five indexes of blood lipid in M group, MH group and J group totally significantly increase compared with NC group (p<0.01). TG, TC, FFA and HDL-C in MH group and J group totally significantly decrease compared with M group (p<0.05or p<0.01). LDL-C in MH group significantly decrease compared with M group (p<0.05), while LDL-C in MH group is no significant differences compared with M group (p>0.05).③After4weeks of administration, serum CRP in M group, MH group and J group totally significantly increase compared with NC group (p<0.05or p<0.01), while serum CRP in MH group and J group totally significantly decrease compared with M group (p<0.05). Expressions of NF-k B in NC group significantly decrease compared with M group (p<0.05), while there is no significant differences between M group. MH group and J group (p>0.05).④After4weeks of administration, MDA in MH group significantly decrease compared with M group (p<0.01). and SOD, GSII-PX and CAT in MH group totally significantly increase compared with M group (p<0.05or p<0.01), while CAT in MH group significantly decrease compared with NC group (p<0.05). MDA in J group significantly decrease compared with M group (p<0.01), and SOD, GSH-PX and CAT in J group significantly increase compared with M group (p<0.05). GSH-PX in J group significantly increase compared with NC group and MH group (p<0.05). CAT in J group is no significant differences compared with NC group (p>0.05), while CAT in J group significantly increase compared with MH group (p<0.05).Conclusion:Jiangtang Jiaonang, based mainly on functions of strengthening the spleen and stomach, can definitely reduce blood glucose, improving rats pancreatic β-cell function, insulin resistance, blood lipid metabolism disorder, inflammatory environment and oxidative stress, enhance anti-oxidation. This drug plays an active role in treating type2diabetes. Comparing to Metformin Hydrochloride Tablets, the drug has poor glucose-lowering effect (p<0.05), especially in two aspects of FBG and AUC, but better relaxing oxidative stress (p<0.05), respectively in two aspects of GSH-PX and CAT. Besides, there is no significant difference in other aspects (p>0.05). Therefore, comparisons of effects of treatment of type2diabetes with two drugs need further studies.Form the study, we conclude that spleen-stomach weakness is the essential cause and key pathogenesis of type2diabetes, namely, spleen and stomach in TCM are important to that disease. Thus, spleen-stomach weakness is related to islet β-cell dysfunction and the treatment of regulating spleen and stomach can improve β-cell function. Therefore, clinically, the treatment of type2diabetes should come from regulating spleen and stomach, base on invigorating qi and strengthening the spleen-dominated syndrome differentiation, and then a good outcome can usually be achieved. |
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