Approach On TCM Law Of Syndrome About Metabolic Syndrome And The Intervention Mechanism Of Jia Wei Tao He Cheng Qi Tang

1.Objective:To Approach on TCM law of syndrome about metabolic syndrome as well as the function and mechanism of classical prescription in typhoid theory. In order to provide evidence on metabolic syndrome which is treated by TCM diagnosis proposal. This article uses the method of clinical epidemiology investigating and frequency-analyzing to study the pathogenesis grouping characteristics of metabolic syndrome. At the same time ,we compare the differentiation of symptoms and signs for classification of syndrome between metabolic syndrome and diabetes, approach the difference between them. On the basis of clinical and laboratorial researches on Jia Wei Tao He Cheng Qi Tang, we observe the influence of Jia Wei Tao He Cheng Qi Tang on the leptin of Model rat and thus discuss the efficacy and intervention mechanism to prevent and treat metabolic syndrome.2.Content, Method and Result2.1 Research on the theory and literatureThrough the review of the documents, we do a further research on the occurence, pathogeny, pathological mechanism, diagnosis and treatment of metabolic syndrome on the basis of metabolic syndrome in TCM, the general research situation of TCM to prevent and treat metabolic syndrome and its fuctions in insulin-resistant animal experiments.According to the documents we've got so far, many scholars have done a great deal for the prevention and treatment of metabolic syndrome and really have made some progress.however there are stll many problems to be solved:(1) ununified diagnostic criteria: As diagnosis standard is not the same, that leads to the observed objectives different which brings obstacles for academic exchange and clinical research. (2) Lack of unified received standard for syndrome differentiation.Now there are many sorts of syndrome differentiation with a lot of subjective opinions but in great disorder which is not good for standardization and objective.(3) No animal model with metabolic syndrome so far. We should prepare the animal model with metabolic syndrome as soon as possible, and draw conclusion of clinical guidance which benefits human metabolic syndrome research through the experiment and research on animals of large samples. (4) On the basis of achieved research achievements, how to indicate the function mechanism of TCM to metabolic syndrome combining the latest research results oftechnology and exerting the technology advantages of cell biology and molecular biology, is a problem requiring urgent settlement in the process of deepening the research of metabolic syndrome in TCM. 2.2 Clinical researchThis research accepts the method of clinical epidemiology investigating and frequency-analyzing etc. We make an investigation on the clinical pulse condition of 117 cases of metabolic syndrome patients to reveal the features of differentiating syndrome by pathogenesis of metabolic syndrome and the difference about the differentiation of syndrome between metabolic syndrome and diabetes.The results shows: The deficient syndromes mainly include qi deficiency , yin deficiency and yang deficiency , among which qi deficiency is the most common. The sthenia syndromes mainly include accumulated heat of gastrointestine, damp-heat, phlegm dampness and blood stasis, among which the accumulated heat of gastrointestine is the most common.From the viewpoint of the combined syndromes frequency distribution, we can tell that the deficiency syndrome of both qi and yin is the most common, and in turn, the damp-heat syndrome with blood stasis, qi-deficiency syndrome with phlegm, qi-deficiency syndrome with blood stasis, deficiency syndrome of both yin and yang, among which the combined syndromes of deficiency syndrome of both qi and yin, damp-heat syndrome with blood stasis and qi-deficiency syndrome with phlegm occupies 70%, and the damp-heat syndrome with blood stasis has a higher body weight index than that of deficiency syndrome of both qi and yin. Syndrome type is not obviously relevant to the insulin level in empty stomach.The features about the diabetes TCM symptoms are that analyzing from body of the tongue the ad rat. between red tongue and pale tongue is 52.7%:47.3%, the rat of dark tongue is 33%;analyzing from coat of the tongue, yellow and yellowish greasy tongue occupy 52.2%, greasy tongue(yellowish greasy and whitish greasy tongue) occupy 24.5%, display that the pathogenetic condition is coldheat complex, blood stasis, dampness and heat are the main causative agents and patho-productions;Analyzing from the pulse tracings, the frequent pulse and the excessive pulse almost have the same frequency, display the pathogenetic condition is excess and deficiency complex.Analyzing from the TCM differentiation of symptoms and signs, the deficiency syndrome of both qi and yin occupies 99.9%, it is still the main syndrome in the diabetes longer course;deficiency both yin and yang is only less than it;the syndrome both deficiency yin and dryness-heat is little in the patients in hospital, this type is often appear the early stage of diabetes, the course is short, the patients condition is light, so it is not the main syndrome in the patients in hospital.Comparison of the difference between metabolic syndrome and diabetes display that their TCM differentiation of symptoms and signs is nearly the same. In the single syndromes, the frequency occurrence of blood stasis and deficiency yin is higher indiabetes patients than metabolic syndrome patients. But the frequency occurrence of damp-heat and phlegmatic hygrosis is on the contrary. In the type of combined syndrome, deficiency both qi and yin is their mutual main syndrome, but the frequency occurrence is more higher in diabetes than in metabolic syndrome.Accord to this research result, we find that the metabolic syndrome is based on deficiency qi, and the damp-heat, phlegmatic hygrosis and blood stasis are superficially. Its character is asthenia in origin and asthenia in superficiality. The deficiency both qi and yin is the main syndrome in its progress course and the key point of the pathogenesis transition. The syndrome of deficiency both qi and yin is controlled, the syndrome can transfer to the deficiency qi or deficiency yin, the disease condition will be better, on the contrary, it well be worse.This research shows that in all kinds of combined syndomes, the deficiency syndrome of qi and yin, damp-heat syndrome with blood stasis and qi-deficiency syndrome with phlegm are the most common. In the author's opinion, those three syndromes can act as standard syndrome in syndrome differentiation of metabolic syndrome and offer an referrence for making the solution furtherly of diagnosis and treatment of metabolic syndrome. 2.3 Experiment researchOn the basis of clinical and laboratory research on Jia Wei Tao He Cheng Qi Tang, we select Jia Wei Tao He Cheng Qi Tang as the main prescription with the function of supplementing qi and nourishing yin and purging heat and expelling stasis, the leptin is relevant to the pathological process of metabolic syndrome as the observing index, injecting streptozotocin into abdominal cavity and feeding fat and sweet food (with high calories)sucessively as the method to foster the animal model, to observe the influence of Jia Wei Tao He Cheng Qi Tang on the leptin level of model rat and approach the efficacy and intervention mechanism of it.It shows that Compared with the normal rat group, the leptin level of model rat group rises up obviously(P<0.01) which indicates that the leptin level of rat can rise up after fostering the model. The leptin levels of high dosage group and low dosage groups decline obviously(P<0.01) comparing to the model group which indicates the priscription can lower down the leptin level in rat serum.The mechanism of Jia Wei Tao He Cheng Qi Tang to reduce the leptin level of rat isn't clear yet. Maybe it's relevant to the improvement of resistance to leptin. As to the function place or segment of this prescription to improve resistance to leptin, we need to make a further research in future. 3. Prospectation3.1 In order to reveal the features of differentiating syndorme by pathogenesis of metabolic syndrome and the basis for standardization as well as the treatment, it's necessary to apply the method of Evidence Based Medicine to do the prospective and polycentric research on large samples and conduct the systematic research from segments of syndrome feature,standard of syndrome differentiation, application of medicine and priscription and function mechanism etc, to exert the advantage of sleeting treatment by differentiating syndromes in TCM and open an new era of preventing and treating metabolic syndrome.3.2 To strengthen the research of metabolic syndrome in TCM. The Syndrome is the high generalization of pathogeny, pathogenesis and lesion location and it has inversion and evolution tendency in the process of disease, which determines the complexity and versatility of syndrome. Meanwhile, as metabolic syndrome involvesMany metabolic diseases with complicated clinical syndromes and variable indexes, we should strengthen the observation of the index of metabolic syndrome and externalization research of syndrome in TCM.3.3 To conduct the research on the resistance of Jia Wei Tao He Cheng Qi Tang to leptin step by step.As leptin is involved in the pathological process of obesity, diabetesll, hyperlipemia, hypertension, atherosclerosis and coronary heart disease and closely related with metabolic syndrome, the research on the resistance of leptin will be more and more important. In furture, we should conduct further research on the influence of Ji Wei Tao He Cheng Qi Tang on leptin acceptor and the situation after that and try to discuss the function mechanism of Jia Wei Tao He Cheng Qi Tang to intervene metabolic syndrome furtherly.