The Experimental And Clinical Study On Influence Of Correlated Factors Curing T2DM Following The Fundamental Principle Of Tonifying Qi And Spleen, Nourishing Kidney And Activating Blood

Purpose:Directed by distinguished professor Zhang Qi's clinical thoughts, following the fundamental principle of "tonifying Qi and spleen, nourishing kidney and activating blood ", taking Tang Zhi Ping (TZP) which is a clinical experiential prescription as the representative prescription, aim of this subject is to observe the impact that Tang Zhi Ping affects insulin resistance, sebaceous metabolization, and risk factors of blood vessel pathological changes. The purpose of this subject is to offer the science gist to prevent and cure T2DM and diabetic complicating disease.Methods:Adopting the method of intraperitoneal injection of STZ as the model, a total of 105 Wistar rats were divided into seven groups randomly: blank control group, model control group,Ai Ding group, Xue Zhi Kang group,TZP granular low-dose group, TZP granular middle-dose group, TZP granular high-dose group,each group has 15 rats. We gave the rats intragastric administration by TZP or control drug respectively, used biochemistry and reverse transcription-polymerase chain reaction, to examine the index, including fasting insulin fasting blood, high density lipoprotein cholesterol, low density lipoprotein cholesterol, insulin sensitivity index, tumor necrosis factor-α, interleukin 6, nitric oxide(NO), endothelin-1(ET-1), plasminogen activator inhibitor-1(PAI-1) and the expression of glucose transporter 4 mRNA; In addition, a total of 120 obese patients with diabetes (the type of blood stasis obstructing the vessel , and phlegm and turbid urine obstructing the vessel) was studied, the test adopted methods randomized, opened, and group controled:test group(cured by TZP) 60 cases, control group (cured by diformin tablet) 60 cases. We observe different index change before and after treatment in eight weeks.Result:1. Experimental study shows that: TZP can significantly reduce the weight, body mass index of 2DM, TG,TC,LDL-C and IRI of obese rats, clearly raise ISI of obese rats, the research has significant difference in statistics (P<0.05); in respect of improving vascular endothelial function, TZP can effectively increase the level of blood serum NO, decrease the levels of serum ET-1 and PAI-1, after the statistical treatment, curative effect is better than Xue Zhi Kang group's(P <0.05); and that TZP can inhibit the expression of tumor necrosis factor -a and IL-6 expression, and it shows dose-dependent, high-dose group's function is identical with Xue Zhi Kang's;TZP could increase the expression of glucose transporter 4 mRNA in T2DM rat's skeletal muscle and fat, by contrast, in the middle and low dose group,the expression of glucose transporter 4 mRNA is significantly lower than Xue Zhi Kang group's.2. Clinical study showed that : following the principle of "tonifying Qi and spleen, nourishing kidney and activating blood", the prescription TZP could clearly alleviate the general clinical symptoms of 2DM vascular lesion, reduce FPG, FINS, HbA₁c, ISI, endothelin-1, plasminogen activator inhibitor-1, can improve blood serum -TC, LDL-C, TG, HDL-C; increase nitric oxide (NO), and can also significantly improve hemorheology parameters, reduce fibrinogen and reduced viscosity,hematocrit and hardenability value, compared with the prior treatment and the post-treatment,the research has notable significance in statistics(P<0.01). The prescription can reduce patients' blood viscosity, erythrocyte sedimentation and aggregation index.Conclusion:1. TZP can significantly improve Wistar rats blood lipid metabolism of 2DM highfat model: it can reduce blood serum TC, LDL-C, TG, raise blood serum HDL-C, and it have significant dose-effect relationship;2. TZP can reduce body mass index(BMI) of 2DM rats and patients, increaseinsulin sensitivity index(ISI), promote insulin secretion and reduce insullin resistance index(IRI);3. TZP can clearly raise blood serum-NO, reduce the levels of serum ET-1 andPAI-1 of 2DM rats and patients, and also can significantly improve vascular endothelial function, have no significant adverse reaction;4. TZP can reduce the expression of blood serum-interleukin 6 (IL-6) and tumornecrosis factorα-(TNF-α), and could increase the expression of glucose transporter 4 mRNA , accordingly it promotes metabolism of glucose and lipid to control the development and progression of DM;5. The fundamental principle of "tonifying Qi and spleen, nourishing kidney and activating blood"could significantly improve body constitution of 2DM patients, alleviate the symptoms of clinical complications, control progress of disease. So it is an effective way to cure 2DM.