【摘要】：目的:建立一種病證結(jié)合的脾虛痰濕型肥胖糖尿病胰島素抵抗大鼠模型。方法:60只SD大鼠按體質(zhì)量隨機(jī)分為正常對(duì)照(A)組和模型組,模型組又分為肥胖糖尿病(B)組、脾虛痰濕型肥胖糖尿病(C)組和脾虛痰濕肥胖糖尿病加中藥健脾化濕方治療(D)組。模型組復(fù)制肥胖糖尿病胰島素抵抗大鼠疾病模型,C組和D組復(fù)制脾虛痰濕型肥胖糖尿病胰島素抵抗大鼠模型,D組給予健脾化濕方干預(yù)4周。觀察各組大鼠的一般行為學(xué)變化、毛色,大便、體質(zhì)量、攝食量、飲水量、肛溫、游泳耐力、計(jì)算脾虛積分;測(cè)定大鼠的空腹血糖(FPG)、空腹胰島素(Fins),計(jì)算胰島素抵抗指數(shù)(HOMA-IR)、胰島素敏感指數(shù)(ISI);口服葡萄糖耐量試驗(yàn)(OGTT)、總膽固醇(TC)、甘油三脂(TG)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、游離脂肪酸(FFA);觀察肝臟病理變化。并采用健脾化濕方進(jìn)行反證。結(jié)果:高脂飼料喂養(yǎng)8周后,模型組平均體質(zhì)量超過(guò)A組(P0.05);STZ注射72h后,模型組大鼠FPG、Fins、HOMA-IR明顯高于A組(P0.05),ISI明顯低于A組(P0.01);模型組大鼠OGTT各點(diǎn)血糖值均高于A組(P0.05)。經(jīng)過(guò)4周脾虛痰濕階段造模后,大鼠表現(xiàn)為體質(zhì)量下降、飲食量、飲水量明顯減少,游泳耐力顯著下降,被毛油膩,倦怠,懶動(dòng),蜷縮扎堆,大便溏,脾虛積分顯著增加(P0.05,P0.01),肛溫?zé)o明顯變化;TC、LDL-C、FFA升高(P0.05,P0.01)。經(jīng)過(guò)中藥健脾化濕方干預(yù)后,大鼠出現(xiàn)體質(zhì)量下降,飲食量、飲水量下降,游泳耐力增加,倦怠、乏力,大便溏癥狀緩解,脾虛積分下降(P0.05,P0.01);大鼠FPG、Fins、HOMA-IR、ISI明顯改善(P0.05,P0.01);血脂中TC、TG、LDL-C、FFA降低(P0.05,P0.01);肝臟病理結(jié)果顯示,B、C組伴有不同程度的脂肪肝,D組脂肪肝程度減輕。結(jié)論:采用高脂飲食聯(lián)合小劑量STZ可復(fù)制出肥胖糖尿病胰島素抵抗大鼠疾病模型,采用飲食不節(jié)+勞倦過(guò)度+苦寒攻下復(fù)合法可成功建立脾虛痰濕型大鼠證候模型。
[Abstract]:Objective: to establish a model of insulin resistance in obese diabetic rats with spleen deficiency and phlegm dampness combined with disease and syndrome. Methods Sixty Sprague-Dawley rats were randomly divided into normal control (A) group and model group according to their body weight. The model group was divided into obese diabetic (B) group, spleen deficiency phlegm dampness type obesity diabetes (C) group and spleen deficiency phlegm dampness obesity diabetes mellitus plus traditional Chinese medicine Jianpi Hua Shen Fang treatment (D) group. The model group (group C) and group D (group D) were treated with Jianpi Huazheng recipe for 4 weeks. The changes of general behavior, hair color, stool, body weight, food intake, drinking water, anus temperature, swimming endurance and spleen deficiency score were observed. Insulin resistance index (HOMA-IR), insulin sensitivity index (ISI);), total cholesterol (OGTT), triglyceride (TC), (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein (LDL) were measured in rats with fasting blood glucose (FPG),) and fasting insulin (Fins),). Insulin sensitivity index (ISI);) was measured by oral glucose tolerance test (ISI);). LDL-C and free fatty acid (FFA); were used to observe the pathological changes of liver. And the use of invigorating spleen and dampness prescription to counter the evidence. Results: after feeding with high fat diet for 8 weeks, the average body mass of model group was higher than that of group A (P0.05) 72 hours after injection of STZ, the HOMA-IR of model group was significantly higher than that of group A (P0.05) and the blood glucose level of OGTT of model group was higher than that of group A (P0.05). After 4 weeks of spleen deficiency and phlegm dampness stage, the rats showed decreased body mass, decreased diet, drinking water, decreased swimming stamina, wool greasy, burnout, laziness, curling up and loose stools. The spleen deficiency score increased significantly (P0.05U P0.01), but the anal temperature did not change significantly (P0.05U P0.01). After the intervention of traditional Chinese medicine to invigorate spleen and remove dampness, the rats appeared body weight decline, diet quantity, drinking water decreased, swimming stamina increased, fatigue, loose stool symptoms alleviated. The scores of spleen deficiency (P0.05), HOMA-IRISI (P0.05 + P0.01), LDL-CfFA (P0.05P0.01) and liver pathological results showed that the degree of fatty liver was decreased in group D with different degrees of fatty liver. Conclusion: high fat diet combined with low dose STZ can reproduce the model of insulin resistance in obese diabetic rats, and the syndrome model of spleen deficiency and phlegm dampness type can be successfully established by the combination of diet, fatigue, excessive bitterness and cold attack.
【作者單位】： 中山大學(xué)附屬第一醫(yī)院中醫(yī)科;南方醫(yī)科大學(xué)珠江醫(yī)院中醫(yī)科;
【基金】：國(guó)家自然科學(xué)基金項(xiàng)目(No.81302877) 廣東省科技計(jì)劃項(xiàng)目(No.2014A020212056) 廣東省中醫(yī)藥局基金項(xiàng)目(No.20141057)~~
【分類(lèi)號(hào)】：R259;R-332

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