Experimental And Clinical Study On The Mechanism Of Jianpi Tiaogan Decoction In Preventing And Treating Obesity Based On The Regulation Of MTOR Signal Pathway On Nesfatin-1

Objective(1)To investigate the regulatory effect of Jianpi Tiaogan Decoction on gastrointestinal hormone nesfatin-1 and its effect on glucose and lipid metabolism in obese mice based on mammalian rapamycin target protein(mTOR)signal pathway,and to study the mechanism of traditional Chinese medicine in the prevention and treatment of obesity;(2)Observing the clinical efficacy and safety of Jianpi Tiaogan Decoction in patients with simple obesity with liver depression and spleen deficiency syndrome.Methods(1)Experimental study:40 healthy male C57BL/6J mice were randomly divided into blank group(n=6)and model group(n=34).After modeling,the successful mice were randomly divided into model group,TCM group,TCM+RPM group and RPM group.The blank group,model group and TCM group were given the corresponding drugs by gavage.The TCM+RPM group was given the same amount of traditional Chinese medicine by gavage,and rapamycin(RPM,2mg/kg,twice a week)was injected intraperitoneally.The RPM group was given rapamycin by intraperitoneal injection and the same amount of normal saline by gavage.Observing the general signs of mice,and the weight,body length and food intake were monitored every week,Recording the Lee’s index,abdominal fat wet weight and FPG of mice after the experiment,To detect the TC,TG,LDL-C,HDL-C by automatic biochemical analyzer;The serum nesfatin-1 was detected with ELISA;RT-PCR and Western Blot to detect the nesfatin-1,mTOR and p70S6K expression in the small intestine tissue.(2)Clinical study:60 cases metting the inclusion criteria were randomly divided into control group and treatment group,with 30 cases in each group.The control group was given general comprehensive treatment,such as diet control and exercise control.The treatment group was treated with Jianpi Tiaogan Decoction on the basis of the control group,for 8 weeks.The changes of body weight,body mass index(BMI),waist circumference,waist hip ratio(WHR),fasting blood glucose(FPG),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),TCM syndrome score and total therapeutic effect of the two groups were observed before and after treatment.Results(1)Experimental study:①Jianpi Tiaogan decoction could reduce the weight growth rate of mice,Lee’s index and abdominal fat wet weight(P<0.05).There were significant differences between the TCM group and other groups in reducing FPG,TC,LDL-C,and improving HDL-C(P<0.05).②The content of nesfatin-1 in blood of mice in TCM group increased significantly(P<0.05).③RT-PCR showed that the mRNA expressions of nesfatin-1,mTOR and P70S6K were as follows:blank group>TCM group>TCM+RPM group>model group>RPM group.④Western blot results showed that the expression levels of nesfatin-1,mTOR and P70S6K were as follows:blank group>TCM group>TCM+RPM group>model group>RPM group.(2)Clinical study:Compared with the control group,the treatment group had significant effects in reducing body weight,WHR,TC,increasing HDL-C and improving clinical symptoms of traditional Chinese medicine(P<0.05),but there was no significant difference between the two groups in reducing BMI,waist circumference,FPG,TG and LDL-C(P>0.05);Both groups could reduce weight,but the treatment group was better than the control group(P<0.05).It indicated that Jianpi Tiaogan decoction had better efficacy in reducing body weight,regulating the disorder of glucose and lipid metabolism and reducing clinical symptoms.Conclusion(1)Jianpi Tiaogan decoction may achieve the effect of treating simple obesity by activating mTOR signal pathway in small intestine and up regulating the expression of gastrointestinal hormone nesfatin-1.(2)Clinical trials show that Jianpi Tiaogan decoction has a significant effect on improving the clinical symptoms and glucose and lipid metabolism of obese patients,and can improve the quality of life of patients.