| Objective: To conduct TCM syndrome differentiation in patients with Gestational diabetes mellitus(GDM),to understand the clinical common syndrome classification of gestational diabetes,and to know the proportion of gestational diabetes kidney deficiency type,which can be used to understand the six flavors.The clinical application prospect of Dihuang Pill in the treatment of gestational diabetes mellitus;through animal experiments,it is verified whether Liuwei Dihuang Pill can reduce the blood sugar of pregnant diabetic mice and improve the pregnancy outcome.If it can lower blood sugar,its hypoglycemic mechanism improves insulin resistance and repairs the pancreas.Organization related.Methods: In the first part of the clinical observation,the patients diagnosed with gestational diabetes were selected as the research object.According to their clinical manifestations,refer to the diagnostic criteria of TCM common syndrome revised by the Chinese Medicine Diagnostics Branch of Chinese Traditional Medicine Association and the Dialectical Principles of Clinical Research of New Drugs of Traditional Chinese Medicine.Classification.The second part of the animal modeled part,45 C57 mice of 6weeks old,including 15 males and 30 females.After 2 weeks of adaptive feeding,they were mated at 2:1 in the night according to the male and female,and the next morning.Those who have sputum or vaginal discharge smear see sperm as mating success,counted as the 0th day of pregnancy.Pregnant mice were randomly divided into3 groups: control group,high dose group and low dose group.After fasting for 12 hours in each group,the high-dose group was intraperitoneally injected with 50 mg/kg STZ solution;the low-dose group was given 30 mg/kg STZ solution,intraperitoneal injection for 24 hours,and co-injection 3 times;The group was intraperitoneally injected with an equal dose of citrate buffer.After 4 hours of injection,they were given normal feed and fed freely.The fasting blood glucose of the pregnant mice of each group was detected by the tail-cutting method using the automatic blood glucose meter.The fasting blood glucose of the pregnant rats on the 0th,6th,9th and 19 th days was fast.The fasting blood glucose was 5.1mmol/L.The third part of the experimental study,the same 6-week-old C57 mice 60,including 20 males and 40 females,after 2 weeks of adaptive feeding,at night,according to the male and female 2:1ratio cage,the next morning If the smear of the vaginal plug or vaginal discharge is seen as sperm,it is considered as mating success,and it is counted as the 0th day of pregnancy.Pregnancy-successful mice were randomly divided into 3 groups:normal group,model group,and Chinese medicine group.Mice in the model group and the Chinese medicine group were given STZ fresh solution 30 mg/kg,intraperitoneal injection at intervals of 24 h,and a total of 3 injections.On the 9th day of pregnancy,the Chinese medicine group began to give Liuwei Dihuang Pill for 10 consecutive days;the model group was intragastrically administered with Liuwei Dihuang Pill suspension and other physiological saline;the normal group was not given special treatment.The three groups of mice were weighed on the 0,9 and 19 days of pregnancy and tested for fasting blood glucose(fasting 10 h before the measurement).On the 19 th day of pregnancy,after the mice were anesthetized,the blood was taken from the sputum,and the supernatant was taken after centrifugation.Insulin content,insulin resistance index,islet?-cell function were calculated.The number of fetal rats,placental weight and quantity were recorded after cesarean section;pancreatic tissue was dissected,formaldehyde was fixed,paraffin-embedded,HE stained after sectioning,and pancreatic tissue morphology was observed.Cell structure.Results: The first part of clinical observation: 40 cases of gestational diabetes were collected in the past 9 months,12 cases of spleen and stomach heat syndrome,accounting for 30% of the total,9 cases of spleen and stomach qi deficiency syndrome,accounting for 22.5% of the total,kidney yin deficiency 12 patients were diagnosed,accounting for 30% of the total,and 7 patients with yin and yang deficiency syndrome,accounting for 17.5% of the total.The second part of the animal model,low-dose group(30 mg /kg STZ group)mold rate of 70%,low mortality,high blood sugar levels can be continued from the end of modeling to the end of pregnancy;high dose composition rate 50%,due to high blood sugar levels,high blood sugar fluctuations,poor tolerance of pregnant rats,high mortality.In the third part of the experimental study,on the 0th day of pregnancy,there was no significant difference in body weight between the three groups(P>0.05),and the groups were comparable.On the 9th day of pregnancy,the body weight was higher than that on the 0th day,but the three groups were There was no significant difference in body weight between the two groups(P>0.05).On the19 th day of pregnancy,the body weight of the three groups increased significantly.There was no significant difference in body weight between the three groups(P>0.05).On the 0th day of pregnancy,there was no significant difference in fasting blood glucose between the three groups(P>0.05).There was comparability between the groups.On the 9th day of pregnancy,the fasting blood glucose level of both the model group and the Chinese medicine group was significantly higher than that of the normal group.The difference was statistically significant(P>0.05).On the 19 th day of pregnancy,the fasting blood glucose level of the model group was significantly higher than that of the other two groups(P<0.01).Although the blood glucose level of the Chinese medicine group was still higher than the normal value,the difference between the fasting blood glucose level of the Chinese medicine group and the normal group blood glucose level.Not statistically significant.Compared with the normal group,the weight and placental weight of the model group were significantly increased,and the difference was statistically significant(P<0.05).Compared with the model group,the weight and placental weight of the Chinese medicine group decreased.Statistical significance(P <0.05).HE staining showed that the shape of the islets in the model group was irregular,and the exocrine glands invaded into the islets.The islet cells were disordered,and the islet cell vacuolar degeneration,individual cell hypertrophy,and islet interstitial cell proliferation;compared with the normal group,the islet periphery The nucleus is round or oval,with less cytoplasm and more lightly stained cells.The islet morphology of Liuwei Dihuang Pills group is regular,the exocrine gland invasion phenomenon is reduced;the islet cell cytoplasm is abundant,the islet cell vacuolar degeneration is occasionally seen,the islet peripheral nucleus is round or oval,the cytoplasm is less,the lightly stained cells Increased compared to the model group and moved to the central part of the islet.Compared with the normal group,the serum insulin level of the model group was significantly increased,and the insulin resistance index was also significantly increased,the difference was statistically significant(P<0.01).Compared with the model group,the serum insulin level of the mice in the traditional Chinese medicine group was significantly decreased,and the islet resistance index was also significantly decreased,and the difference was statistically significant(P<0.01).Conclusion: Patients with gestational diabetes mellitus and kidney yin deficiency account for a large proportion in clinical gestational diabetes mellitus;30mg/kg STZ solution,intraperitoneal injection every 24 hours,co-injection 3 times compared with 50mg/kg STZ disposable intraperitoneal injection The animal model of gestational diabetes is more stable and more representative;Liuwei Dihuang Pill can reduce the fasting blood glucose level of gestational diabetes mice.Reducing the weight of fetal rats,the weight of placenta,and reducing the fasting blood glucose of gestational diabetic mice may be related to repairing pancreatic tissue and improving insulin resistance. |
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