Study Of Initial Pathogenesis And Six-channel Syndrome Differentiation Thought Of Diabetes And Effect Of Intervening The IGR Rats By Curing Shaoyin, Taiyin Also Jueyin Disease

Objective1. To investigate the distributive feature of TCM Syndrome in patients with impaired glucose regulation and diabetes through the information collection of four diagnostic methods. Using of statistical methods to compare the two syndromes. Thus discuss the TCM pathogenesis characteristic from IGR developing to DM. To further explore the primary pathogenesis as well as nail down the location and nature of the disease.2. Probing into the distributive feature of six-channel syndrome differentiation of DM. Discussing the idea of six-channel syndrome differentiation of the disease.3. Observing the therapeutic effect based on Taiyin, Shaoyin and Jueyin syndrome differentiation. Investigating the effects of the method of strengthen yang and protect yin, circumrotate shuji(SPC) on the disorder of sugar and fat metabolism as well as Oxidative Stress of IGR rats .Discussing the therapeutic mechanism of the treating method to pre-diabetes.Methods1. Clinical research: Collecting the information of four diagnostic methods of 50 cases of pure pre-diabetic patients and 60 cases of pure diabetes whose course of disease is less than one year in Guangzhou from the end of 2006 to the end of 2007.. The frequency statistics and Analysis of the two clinical symptoms, the tongue, the pulse and the syndromes distribution were performed separately. Summarizing the distribution rule and the characteristic, and analyzing the nature and the location of the disease. To their syndromes, including deficiency of qi, blood, yin and yang and deficiency of zang-fu organs as well as excess made X2 test. To early diabetes going along six-channel syndrome differentiation.2. In the experimental study, SPF female SD rats were selected. The IGR rats were made by 4 weeks high fat feeding and injecting small dose STZ. The rats were randomly assigned to four groups: normal group, model group, western medicine(MHT) group with dosage (0. 0225g·kg-1·d-1 by gavage) and TCM group with APC complex prescription (19. 17g·kg-1·d-1 by gavage) . The course of treatment lasted 4 weeks. Observing the effects on blood glucose, blood fat, FFA, insulin, ISI and the index of Oxidative Stress, for example SOD ,MDA, GSH-Px and so on. The effects on morphology of pancreas were analyzed by HE and observed by light microscopy.Results1. Pre-diabetic syndrome distribution were as follows , kidney deficiency (50.00%), stagnation of qi (41.30%) , phlegm and dampness syndrome(26. 09%), liver deficiency (26.09%) , spleen deficiency (23.91 %)Yang deficiency (17. 39%),blood stasis (10. 87%). Simple deficiency syndrome and simple excess syndrome were existed at the same time and the former was 1. 5 times the latter. Early DM syndrome distribution included kidney deficiency (53.45%),Yang deficiency (51. 72%),heart deficiency(37.93%) , liver deficiency (34.48%),spleen deficiency (31.03%),stagnation of qi (22. 41%),blood stasis (20. 69%),qi deficiency (13. 79 %) .deficiency syndrome was 2.87 times the excess syndrome. The excess syndrome existed always with deficiency syndrome in one case. Compared with pre-diabetes, yang deficiency and heart deficiency syndrome in early DM were much more obviously (P<0. 01) . While stagnation of qi and phlegm and dampness syndrome were more than those in DM (P<0. 05) .2. The distribution of six-channel syndrome differentiation of early DM were as follows, shaoyin disease (55%),jueyin disease (26.67%),taiyin disease (23.33%),heat syndrome of yangming disease (23.33%),shaoyang disease (20%),cold syndrome of yangming disease (10%),taiyang disease (0%) .3. Compared with normal group, the blood glucose , TG , FFA and insulin, Homa-IR of model rats increased (P < 0.05); ISI decreased (P < 0. 05); MDA, T-AOC, GSH and NO, NOS of blood serum increased. (P < 0. 05), VC was decreased(P< 0. 05), CAT livingness of pancreas was fall (P< 0. 05)。. Pancreas islands and the plasm of cell of model rats were shrinking, and inflammation cell soakage, cell denaturalization.4. Compared with model group, the blood glucose, TG, insulin, HOMA-IR, T-AOC of TCM group rats were decreased (P < 0. 05), ISI, MDA was increased (P < 0.05), compared with MH group, there was no difference (P>0. 05) ; while FFA and NO of TCM group decreased(P< 0. 05) and the effects were significantly better than MH group (P< 0. 05). SOD,CAT,GSH-PX,VC were increased (P < 0. 05), NOS, MDA of pancreas lower (P < 0. 05), while there were no effects on those in MH group. In TCM group, pancreas islands is satiation , the plasm of cell is more abundant, inflammation cells were much more lessened, the amount of cell manifold and the effects is excelled than MH group.Conclusions1. Pre-diabetes can be caused by deficiency, also can be caused by excess. The former is more than the latter. Deficiency syndrome mainly included kidney deficiency, liver deficiency and spleen deficiency. The deficiency syndrome of qi, blood, yin and yang did not occupy the dominant position, but the deficiency of yang had revealed symptom initially. Excess syndrome mainly included stagnation of qi phlegm and dampness syndrome. DM caused by deficiency. Deficiency syndrome mainly included kidney deficiency, heart deficiency, liver deficiency and spleen deficiency. And the deficiency of yang occupied the majority.2. Diabetes' occurrence take the deficiency of five internal organs, especially the kidney weakness, the liver weakness and spleen weakness as the foundation. The aggravation of yang and heart deficiency played a very important role.3. The essence of DM by six-channel syndrome differentiation was shaoyin, jueyin and taiyin have had the pathological change. The three can be sick together. Yangming disease and shaoyang disease are the secondary of the disease.4. The method of strengthen yang and protect yin, circumrotate shuji(SPC) has a certain effect on rectifying the metabolic disorder of sugar and fat, Reducing the fat toxicity and insulin resistance. Especially on reducing fat toxicity aspect, its curative effect significantly surpasses MH. The method can ameliorate pathologic change of pancreatic tissue and relieving inflammatory cell soakage obviously, raising the amounts and cytoblastema content of islet cells.5. The method of SPC can improve oxidative stress availably. It also can eliminate ROS and RNS, reduce over-oxidation of lipid and debase the damaging degree of the free radical to organism cell. Elevating the content and activeness of anti-oxidase also enhancing organism oxidation resistance defense system' s ability . The curative effect surpasses MH and it has the western medicine incomparable superiority.