Study On The Tonifying Kidney, Tonifying Spleen And Ativating Blood Circulation Method On The Expression Of Insulin Signaling Pathway Related Factors IGF-1, IRS-1, IRS-2in Bodys With Diabetes Osteoporosis

Objective To observe the intervention effect of Qizhen Jiangtang Granules(QJG)which has the efficiency of tonifying kidney, tonifying spleen and ativating bloodcirculation on insulin signal pathway related factors IGF-1,IRS-1and IRS-2mRNAexpression of diabetes osteoporosis.Discuss its mechanism and clinical significance ofpreventing, treating and how to delay diabetes combined with bone metabolic diseasefrom holistic treatment theory of Chinese medicine and the level of molecular biology,to provide clinical data and theoretical basis for preventing and treating diabetesosteoporosis with Chinese medicine.Methods1. clinical research1.1Study Object：Divided60patients diagnosed with diabetes osteoporosis of spleenand kidney deficiency and blood stasis into the treatment group and control groupranDOPmly, two groups were both given conventional western medicine metforminhydrochloride and glimepiride.The control group was added alendronate on the basictreatment.And the treatment group was added QJG.The course of the treatment was12months.1.2Study Methods：Calculated Chinese medicine syndrome integral and assessed theclinical therapeutic effect of two groups before and after the treatmentrespectively.Tested the level of FPG,2hPG, HbAlc, FINS, IRI, Ca, P,BMD and serumIGF-1, IRS-1, and IRS-2.2Animal experiments2.1Study Object：After adaptive feeding a week,divided60female SD rats into fivegroups ranDOPmly: blank group(10rats), model group(11rats), QJG high dosegroup(14rats), QJG low dose group(14rats) and alendronate group(11rats). Except blank group, each rat of other four groups was intraperitoneal injected small-dosestreptozotocin(STZ) after fed with high-calorie diet for four weeks to estalish rat modelof type2diabetes.Divided42rats that match the diagnosis into four groups randomlyagain: model group(10rats), QJG high dose group(11rats), QJG low dose group(11rats)and alendronate group(10rats).Rats of blank group and model group were given NSintragastric administration, the alendronate group was given alendronate and metforminhydrochloride intragastric administration, QJG high and low dose group were givenQizhen Jiangtang Granules and metformin hydrochloride intragastricadministration.Each group was given medicine for8weeks continuously.2.2Study Methods: Observed general situation include behavior, body weight of eachgroup before and after experiments respectively, and examined fasting blood glucose,fasting insulin levels of the rats.The rats were killed after8weeks and their kidneyswere taken for genetic monitoring. Tested the expression level of IGF-1, IRS-1andIRS-2mRNAby RT-PCR method.Results：1. Clinical Study(1)Clinical research shows that after12months’ treatment, the total effective rate of thetreatment group and the control group was83.3%and56.6%respectively, the efficiencyof the treatment group was superior to the control group(P<0.05).After thetreatment,Chinese medicine syndrome integrals of two groups were risen and obviouslysuperior to itself before the treatment(P<0.01). And compared with the control group,the integrals of the treatment group had statistical significance(P<0.05).(2)After thetreatment, the levels of FPG,2hPG, FINS, IRI, HbAlc and BMD of two groups wereobviously improved than itself before the treatment(P<0.01).The levels of FINS and IRIof the treatment group were obviously improved than the control group’slevels(P<0.01).And the level of BMD of the treatment group had statistical significancecompared with the control group(P<0.05).(3)After the treatment, the levels of serum IGF-1, IRS-1and IRS-2were improved significantly(P<0.01). And those levels of thetreatment group had statistical significance compared with the control group’slevels(P<0.05).2. Animal experiments(1)Animal experiments shows that after4weeks’ treatment, the weight of model group,alendronate group, QJG high and low dose group were obviously loewer than blankgroup(P<0.01). After8weeks, except blank group and model group, the weight of othergroups were increased than before, but still lower than blank group and higher modelgroup(P<0.01).(2)After the treatment, the level of FPG and FINS of alendronate group,QJG high and low dose group were obviously lower than model group(P<0.01) andhigher than blank group(P<0.01). The expression levels of IGF-1, IRS-1, IRS-2mRNAin kidneys of model group, alendronate group, QJG high and low dose group werelower than blank group(P<0.05or P<0.01). Those levels of alendronate group, QJGhigh and low dose group were higher than model group (P<0.05or P<0.01).And thoselevels of QJG high and low dose group were higher than alendronate group’slevels(P<0.05or P<0.01).Conclusion: Qizhen Jiangtang Granules could not only improve Chinese medicineclinical symptoms of diabetes osteoporosis patients significantly, reduce blood sugarand glycosylated hemoglobin, lower fasting insulin level and insulin resistance index,and increase the level of IGF-1, IRS-1, IRS-2, but also could improve the expressionlevel of IGF-1, IRS-1, IRS-2mRNA of diabetes osteoporosis rats.The result reveals thatits mechanism may be related to the expression of IR in renal tissue, to alleviate theimpairment of insulin signal transduction of receptor link and improve insulin resistanceby improving the sensitivity to insulin,so as to prevent and treat diabetes osteoporosiseffectively.