| Objective: To observe the effect of Danzhijiangtang Capsule(DJC) with Yiqi Yangyin Huoxue effectiveness on atherosclerosis in T2 DM patients with macroangiopathy and the influence on the expression of p22 phox m RNA and p47 phox m RNA in thoracic aorta of diabetic atherosclerosis model of rats, thus to explore DJC’s mechanism to prevent and treat macroangiopathy in T2 DM.Methods: 1.Clinical Research: 136 T2 DM patients with carotid atherosclerosis who were in deficiency of both Qi and Yin and blood stasis syndrome were randomly divided into control group and treatment group, and each group has 68 cases. All patients were given western medicines which were hypoglycemic and lipid-lowering, combined with life style intervention as foundation treatment. Treatment group were given DJC based on the foundation treatment,and control group were given DJC simulated agent.The treatment lasted for 1 years. To observe TCM syndrome integral,detect the levels of blood glucose,blood lipids,ET-1,NO,SOD,GSH-px,check the changes of CIMT and plaque area and calculate efficiency in both two groups before and after treatment.2.Experiment: 60 SD healthy and clean-class rats with weight(210.45±4.26) g,were fed 1 week for adaption.10 rats were randomly divided into blank group with 10 rats and other 50 rats for molding.Rats in blank group were given common forage. The remaining 50 rats were fed with high fat diet,and at the same time, given Vitamin D3 orally, a total of 700000 IU/kg in 3 days to induce atherosclerosis models. 4 weeks later, with 35mg/kg STZ intraperitoneal injection, rats were induced diabetic AS models. The ultimate success of the models were 39 rats, witch were randomly divided into 4 groups: model group, low,middle and high doses of Chinese medicine groups, and the respective number of them was 9, 10, 10, 10. Blank group and model group were administeredsaline, and low,middle and high doses of Chinese medicine groups were treated with different dose of DJC orally, The treatment lasted for 12 weeks. Rats in each group were observed the changes of behavior and weight,detected the levels of FPG, blood lipids, SOD, GSH- px, ET, NO and the expressions of p22 phox m RNA and p47 phox m RNA in thoracic aorta.Results: 1.Clinical Research: After treatment, the total efficiency of the control group the treatment group was 73.33% and 84.38% respectively,and the treatment group was superior to the control group(P<0.05).Chinese medicine syndrome integrals of the two groups decreased after treatment(P<0.05 or P<0.01),and the treatment group was lower than the control group(P<0.05).The levels of FPG, 2h PG and Hb A1 c of two groups decreased significantly(P<0.01), and the levels of 2h PG and Hb A1 c of the treatment group were lower than the control group(P<0.05).The levels of TC,TG,LDL-C of two groups decreased significantly(P<0.01),and the level of HDL-C rose(P<0.05).The levels of TG,LDL-C of the treatment group were lower than the control group(P<0.05). The level of ET-1 decreased significantly and the level of NO rose significantly in the treatment group(P<0.01),and the treatment group was superior to the control group(P<0.05).The levels of SOD and GSH-px in two groups significantly elevated(P<0.01),and those of the treatment group were higher than the control group(P<0.05 or P<0.01).The levels of CIMT and plaque area in two groups decreased(P<0.05 or P<0.01),and the level of CIMT in treatment group was lower than the control group(P<0.05).2.Experiments: At the end of the experiment,the weight of rats in low,middle and high doses of Chinese medicine groups was higher than the model group(P<0.05).The level of FPG of rats in middle and high doses of Chinese medicine groups decreased significantly(P<0.01), and the level of FPG of rats in middle and high doses ofChinese medicine groups was lower than the model group and the low dose of Chinese medicine group.The level of TG of rats in high dose of Chinese medicine group was lower than the model group,low,middle doses of Chinese medicine groups(P<0.05).The level of ET of rats in model group were significantly higher than the blank group,low,middle and high doses of Chinese medicine groups(P<0.01).The level of NO of rats in the blank group and middle and high doses of Chinese medicine groups were significantly higher than the model and low dose of Chinese medicine group(P<0.01).The level of SOD of rats in the model group,low,middle and high doses of Chinese medicine groups was significantly higher than the blank group(P<0.01),and that in the middle and high doses of Chinese medicine groups was higher than the model group and low dose of Chinese medicine group(P<0.05).The The level of GSH-px of rats in the middle and high doses of Chinese medicine groups was higher than the blank group,model group and low dose of Chinese medicine group(P<0.05 or P<0.01). The expression of thoracic aortic p22 phox m RNA, p47 phox m RNA in the model group,low,middle and high doses of Chinese medicine groups were significantly higher than the blank group(P<0.01),and those in low,middle and high doses of Chinese medicine groups were significantly lower than model group(P<0.01),and those in middle and high doses of Chinese medicine groups were significantly lower than low dose of Chinese medicine group(P<0.01).Conclusion: The DJC with Yiqi Yangyin Huoxue effectiveness can improve the symptoms of T2 DM patients with macroangiopathy with deficiency of both Qi and Yin and blood stasis syndrome and the degree of atherosclerosis.The mechanism may be: to reduce glucose and lipid, improve the levels of SOD and GSH-px,reduce the expression of p22 phox m RNA and p47 phox m RNA,improve endothelial function and decrease CIMT and plaque area. |
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