| Objective: Diabetic gastoparesis, DGP in diabetes based on theappearance of abdominal distention, nausea, vomiting, early satiety,gastrointestinal symptoms, and delayed gastric emptying significantly, ongastrointestinal dynamic anomaly. The cause of Diabetic gastrointestinalmotility disorder was complex, the mechanisms have not been fully elucidated.Previous to the pathogenesis of diabetic gastroparesis studies focus on thenerve pathological changes, changes in blood glucose concentration,microvascular disease, gastrointestinal smooth muscle lesions andgastrointestinal hormone abnormalities, but these factors can not fully explainits pathogenesis. In recent years, with ICC as the object of study ongastrointestinal smooth muscle,-ICC-neural network of particular concern.-ICC-neural network of gastrointestinal smooth muscle to form a completefunction, as the basic functional unit of gastrointestinal motility, plays animportant role in the changes of gastrointestinal motility. There are someimportant factors in gastrointestinal smooth muscle,-ICC-neural networksuch as: substance P as a non-cholinergic excitatory neurotransmitter,increased gastrointestinal motility, strongly promote contraction ofgastrointestinal smooth muscle, and played an important role in maintainingthe normal gastrointestinal motor function; neuronal nitric oxide synthaseenzyme by nerve conduction and release of neurotransmitter regulation of thedigestive tract of normal physiological function, related gastrointestinaldisease pathology, and diabetes delayed gastric emptying has important role;Cx43is the most important protein clearance connection between thegastrointestinal smooth muscle cells, play an important role in ICC to smoothmuscle the spread of activity, thus affecting the contractile activity of smooth muscle. Delayed gastric emptying in diabetic, plays an important role ingastrointestinal motor dysfunction.At present, the treatment of diabetic gastroparesis with on the basis ofblood glucose control, encourage patients to eat much food less, choose easydigest, low fat, low residue of food, also used the prokinetic agents, such ascisapride, domperidone, scholars with gastric electrical pacing and operationtreatment, but the effect is not ideal. The clinical report of traditional Chinesemedicine TCM holistic concept and treatment based on syndromedifferentiation of the principle in the treatment of diabetic gastroparesis cannot only cure or improve symptoms of gastroparesis, at the same time, it canlower blood sugar, play a dual role. Blood nourishing and promoting bloodcirculation Chinese medicine Danshen, Chuanxiong Qi and blood circulation,earthworm with dredging collaterals, chuanxiong, Salvia Hirudo andearthworm Huoxue Huayu Tongluo Prescription on diabetic gastroparesisstomach in clinical therapeutic effect is good, the study by intraperitonealinjection of streptozotocin method to establish the model of diabetic rats bypromoting blood circulation to remove blood stasis, Tongluo Chinesemedicine Salvia chuanxiong, Hirudo and earthworm to intervene in the model,through the observation of experimental animal: general condition, bloodglucose and weight, gastric emptying rate, morphological and pathologicalobservation of the stomach, gastric tissue was detected the levels of nNOS,Cx43, SP level of gastric tissue, Huoxue Huayu Tongluo Decoction ondiabetic gastroparesis. Role, provide new methods and ideas for furthertreatment of the disease.Methods: Sprague Dawley SD50rats, body weight of250±20grams,adaptive feeding for1weeks were randomly divided into normal controlgroup8, the model group12, traditional Chinese medicine Salvia Chuanxionggroup10, leech earthworm group10, Chuan Qiong Danshen and leechearth-worm Hefang group Z10. Except the normal control group, model group,Chinese medicine groups were injected with STZ sterile solution good(55mg/kg body weight), to establish the model of diabetic rats, normal control group was intraperitoneally injected equal volume of citrate buffer solution.Determined after the modeling, traditional Chinese medicine (A) group wasgiven Salvia Chuanxiong1.2g（kg.d) by gavage, traditional Chinese medicine(B) group was treated with hirudo and earthworm1.2g（kg.d) by gavage,traditional Chinese medicine (C) group was given Salvia miltiorrhizaLigustrazine and Hirudo and earthworm and1.2g（kg.d) by gavage, normalcontrol group and model group were given an equal volume of normal saline,once a day, for8weeks. In the eighth week, the rats weighing, and fasting,water deprivation16-24hours after2hours, to the rat500mg/L phenol redsolution2ml gavage,15minutes after the anesthesia by intraperitonealinjection of8%2ml/kg sodium amobarbital, opened the abdominal cavity,cardia and pylorus ligation, removal of the rat stomach, cut along the greatercurvature of the stomach, rinse the stomach contents with distilled water,constant volume of20ml, used for measuring gastric emptying rate. Take partin stomach tissue, placed in4%paraformaldehyde, pathological changes ofrats in each group were used to observe the gastric HE staining; the expressionof Cx43and SP in gastric tissue by immunohistochemical method in. Takepart in gastric tissue quick-frozen in liquid nitrogen in the low temperature of-80DEG C refrigerators, reverse transcription polymerase chain reactionmethod was used to detect mRNA content in gastric tissue.Result：1Compared with the general condition of ratsSignificant increase in weight of rats in normal control group, in goodspirits, fur luster, sensitive reaction, ease, food intake, water intake and urinevolume of normal, no significant change during the whole experiment;injection of STZ into rat appeared gradually polyphagia, polydipsia, polyuria,significantly reduced, unresponsive, color dull dull.2Comparison of blood glucose and body weight of ratsThe rats body weight show: compared with the normal control group,model group, Chinese medicine group rats were obviously lower than thenormal weight group rats (P <0.05)；compared with the model group, Chinese medicine group rats were no significant difference； traditional Chinesemedicine group compared to traditional Chinese medicine, there were nosignificant difference in body weight. blood glucose results show: comparedwith the normal control group, model group, Chinese medicine group ratsblood glucose was significantly higher than the normal group (P <0.05);compared with the model group, Chinese medicine group rats blood glucosewas obviously lower than the model group(P <0.05); traditional Chinesemedicine group compared to traditional Chinese medicine, ZY (C) groupblood glucose was obviously lower than ZY (A) and ZY (B) group.3Comparison of rat gastric emptying rateCompared with the normal control group, model group, Chinesemedicine group rats gastric emptying rate decreased significantly (P <0.05);compared with the model group, Chinese medicine group rats gastricemptying rate were significantly higher (P <0.05); traditional Chinesemedicine group compared to traditional Chinese medicine, ZY (C) group thanin traditional Chinese medicine ZY (A), in drug ZY (B) group and gastricemptying rate increased significantly (P <0.05)4The results of HE stainingNormal control group rat gastric mucosa, mucosa hierarchicalstructure clear, cells arranged in neat rows, and rich in blood vessels,interstitial cells; compared with the normal control group, model group of ratgastric mucosa is not complete, mucosal hierarchy is not clear, gland arrangedin disorder, vascular quantity reduction, interstitial cell decreased in number;traditional Chinese medicine groups the rat gastric mucosa is complete,mucosal structure more clearly, the glands were arranged in order, the numberof rich blood vessels, stromal cells.5Expression of gastric tissue of rats with Cx43The positive expression of Cx43in gastric tissue of rats with Buffy thenormal control, the expression of Cx43densely distributed in the gastric bodyand antrum circular muscle layer, the positive expression of Cx43expressedby the average gray value, gray value the higher the positive expression level is low, the cellular protein content lower than; with the normal control group,model group significantly reduced Cx43traditional Chinese medicine group,the positive expression of brown, the average gray of Cx43values weresignificantly higher (P<0.05); compared with the model group, Chinesemedicine group increased Cx43positive expression of brown, gray Cx43decreased (P<0.05); traditional Chinese medicine group compared totraditional Chinese medicine, ZY (C) compared with traditional Chinesemedicine ZY (A) group, ZY (B) increased in group Cx43positive expressionof brown, gray value reduced Cx43.(P<0.05)6Expression of gastric tissue of rats with SPSubstance P was mainly distributed in rat antral circular muscle layerand longitudinal muscle layer around the myenteric plexus submucosal plexus,a little distribution. Normal control group rat myenteric plexus of SPimmunoreactive material wealth, many brown clusters distributed incytoplasm, obvious stain, deeper color; compared with the normal controlgroup, the plexus SP immunoreactive substances in model group, Chinesemedicine group rats muscle decreased, part of fine granular, part brown cloudsscattered in the cytoplasm, nerve plexus of SP positive unit in antral myentericwas lower than that in normal control rats (P<0.05); compared with the modelgroup, rat myenteric nerve plexus of traditional Chinese medicine were SPimmunoreactive substances increased, antral myenteric plexus SP positiveunits higher than those in the model group rat (P<0.05); traditional Chinesemedicine group compared to traditional Chinese medicine, ZY (C) group thanin traditional Chinese medicine ZY (A) group, ZY (B) plexus SPimmunoreactive substances rats muscle increased, antral myenteric nerveplexus of SP positive units higher than that of traditional Chinese medicineZY (A) group, ZY (B) rats.(P<0.05)7Expression of gastric tissue of rats with nNOS mRNA resultsResults the expression of nNOS mRNA in gastric tissue of rats in eachgroup showed: compared with the normal control group, model group,Chinese medicine group nNOS mRNA content decreased significantly (P<0.05); compared with the model group, Chinese medicine group nNOSmRNA content were increased (P<0.05); traditional Chinese medicine groupthan in medicine, ZY (C) nNOS mRNA content is the Chinese ZY (A) group,ZY (B) nNOS with high mRNA content.(P<0.05)Conclusions:1The diabetic gastroparesis rats there are significantly delayed gastricemptying；the herbs of activating blood circulation and dissolving stasis cansignificantly improve the rats diabetic gastroparesis gastric emptying rate andblood glucose, it’s a well treatment for diabetic gastroparesis.2The herbs of activating blood circulation and dissolving stasis cansignificantly decrease the expression of Cx43, to repair the gap junctionsbetween the cells, to maintain ICC and smooth muscle action potentialconduction, promote smooth muscle contraction, maybe this is one of methodsto cure diabetic gastroparesis delayed gastric emptying.3The herbs of activating blood circulation and dissolving stasis can signi-ficantly improve the expression of SP, by promoting SP to adjusted the ICC’spacemaker currents, affect the activities of the ICC, increase smooth musclecontraction, maybe this is one of methods to improve the diabetic gastroparesisdelayed gastric emptying.4The herbs of activating blood circulation and dissolving stasis can signi-ficantly improve the expression of nNOS mRNA, to promote nNOS release ofneurotransmitters, then regulation and control smooth muscle contraction, toimprove gastric emptying dysfunction of diabetic gastroparesis. |
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