本文選題：2型糖尿病 + 丹蛭降糖膠囊　； 參考：《安徽中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:觀察具有益氣養(yǎng)陰活血功效的中藥復(fù)方丹蛭降糖膠囊(DJC)對(duì)T2DM患者血清中TIMP-2、hs-CRP的影響及對(duì)糖尿病大鼠腎臟NF-κB表達(dá)的研究,探討炎癥因子與2型糖尿病的相關(guān)性,闡述DJC對(duì)T2DM患者血管病變中炎癥指標(biāo)的影響,評(píng)價(jià)DJC防治和延緩糖尿病慢性并發(fā)癥的作用機(jī)理。方法:1臨床研究將60例2型糖尿病患者隨機(jī)分為兩組,每組各30例。單純以西醫(yī)綜合治療的為對(duì)照組,在西醫(yī)綜合治療基礎(chǔ)上加用丹蛭降糖膠囊(每次5粒,每日3次)的為治療組,兩組療程均為12周。詳細(xì)記錄患者治療前后FPG、Hb A1c、血脂、肌酐等指標(biāo),檢測(cè)TIMP-2、hs-CRP水平。另納入健康體檢者30例作為正常組。2實(shí)驗(yàn)研究將55只健康雄性大鼠適應(yīng)性喂養(yǎng)一周后,隨機(jī)抽取9只作為正常對(duì)照組,余為實(shí)驗(yàn)組,分別予以基礎(chǔ)飼料及高脂飼料喂養(yǎng),4周后按照35mg/kg的標(biāo)準(zhǔn)予以腹腔注射鏈脲佐菌素(STZ),誘發(fā)出2型糖尿病大鼠模型。剔除未成模的大鼠5只,將成模的41只的大鼠隨機(jī)分成4組:模型組11只,吡格列酮組、DJC高、低劑量組各10只。丹蛭高、低劑量組分別按1.08g/(kg·d)、0.54 g/(kg·d)灌胃,吡格列酮組按10mg/(kg·d)灌胃,正常對(duì)照組和模型組按5ml/(kg·d)給予生理鹽水灌胃,繼續(xù)給予高脂飼料喂養(yǎng)8周至實(shí)驗(yàn)結(jié)束。觀察并記錄各組大鼠的體重、飲水量、攝食量,檢測(cè)大鼠血糖、NF-κB的陽(yáng)性指數(shù)。結(jié)果:1臨床研究結(jié)果臨床結(jié)果顯示,經(jīng)丹蛭降糖膠囊治療12周后,治療組與對(duì)照組總有效率分別為81.5%、50%,治療組療效優(yōu)于對(duì)照組(P0.05)。對(duì)照組與治療組治療后中醫(yī)證候積分與同組治療前相比均改善明顯(P0.01),且治療組治療后中醫(yī)證候積分值低于對(duì)照組治療后中醫(yī)證候積分值(P0.05)。與對(duì)照組相比,治療組TIMP-2與hs-CRP的表達(dá)均明顯下調(diào)(P0.01)。與治療前相比,兩組治療后中醫(yī)證候積分、FPG、Hb A1c、甘油三酯和總膽固醇、肌酐值、尿素氮均明顯改善,差異具有統(tǒng)計(jì)學(xué)意義(P0.05或P0.01)。2實(shí)驗(yàn)研究結(jié)果動(dòng)物實(shí)驗(yàn)結(jié)果表明,造模后,各組血糖較正常組明顯升高(P0.01),治療2周后,DJC高、低劑量組血糖明顯降低(P0.01),治療4—8周后,與模型組比較,各組血糖顯著下降(P0.01)。對(duì)于大鼠腎臟NF-κB的表達(dá),研究顯示:模型組的NF-κB在腎組織中表達(dá)升高明顯,特別在腎小管及腎間質(zhì)細(xì)胞中最為明顯,呈強(qiáng)陽(yáng)性;在正常對(duì)照組腎組織中NF-κB基本不表達(dá)或呈弱陽(yáng)性表達(dá);DJC高、低劑量組NF-κB在腎組織中的表達(dá)降低,多為弱陽(yáng)性或不表達(dá),與模型組比較有顯著性差異(P0.01);NF-κB在吡格列酮組腎組織中的表達(dá)較糖尿病模型組大鼠降低,多呈弱陽(yáng)性表達(dá)。治療后,DJC高、低劑量組中NF-κB陽(yáng)性指數(shù)顯著降低,與模型組比較有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論:具有益氣養(yǎng)陰活血作用的丹蛭降糖膠囊能抑制TIMP-2、NF-κB、hs-CRP等炎癥因子的強(qiáng)反應(yīng)。其機(jī)制可能與降低血糖,減少炎癥因子的高表達(dá),調(diào)節(jié)機(jī)體免疫平衡等有關(guān)。
[Abstract]:Objective: to observe the effect of Danzhi Jiangtang capsule on the expression of TIMP-2 hs-CRP in the serum of patients with T2DM and the expression of NF- 魏 B in the kidney of diabetic rats, and to explore the correlation between inflammatory factors and type 2 diabetes mellitus. The effect of DJC on inflammatory indexes in vascular lesions of patients with T2DM was discussed, and the mechanism of DJC in preventing and delaying chronic diabetic complications was evaluated. Methods 60 patients with type 2 diabetes were randomly divided into two groups, 30 cases in each group. The control group was treated with integrated western medicine, and the treatment group was treated with Danzhi Jiangtang capsule (5 capsules per day, 3 times a day) on the basis of western comprehensive therapy. The course of treatment in both groups was 12 weeks. The serum levels of HbA1c, serum lipids, creatinine and TIMP-2 hs-CRP were recorded in detail before and after treatment. Another 30 healthy subjects were included as normal group .2 experimental study. After 55 healthy male rats were fed adaptively for one week, 9 healthy male rats were randomly selected as normal control group and the rest as experimental group. The model of type 2 diabetic rats was induced by intraperitoneal injection of streptozotocin (STZ) in accordance with the standard of 35mg/kg after feeding with basic diet and high fat diet for 4 weeks. The rats were randomly divided into 4 groups: model group (n = 11), pioglitazone group (n = 10), high DJC group (n = 10) and low dose group (n = 10). The rats in the high and low dose groups were fed with 1.08g/(kg dU 0.54 g/(kg d, the pioglitazone group 10mg/(kg d, the normal control group and the model group 5ml/(kg d respectively. The rats in the control group and the model group were fed with high fat diet for 8 weeks until the end of the experiment. The body weight, water consumption and intake of rats were observed and recorded. The positive index of NF- 魏 B was measured. Results the clinical results showed that the total effective rates of the treatment group and the control group were 81.5 and 50 respectively after treatment with Danzhi Jiangtang capsule for 12 weeks. The curative effect of the treatment group was better than that of the control group (P 0.05). The scores of TCM syndromes after treatment in control group and treatment group were significantly improved compared with those before treatment in the same group, and the integral value of TCM syndrome in treatment group was lower than that in control group after treatment (P 0.05). Compared with the control group, the expression of TIMP-2 and hs-CRP in the treatment group was significantly down-regulated (P 0.01). Compared with before treatment, the scores of TCM syndromes such as HBA1c, triglyceride, total cholesterol, creatinine and urea nitrogen were significantly improved in the two groups after treatment. The difference was statistically significant (P0.05 or P0.01.2). Compared with the normal group, the blood glucose in each group was significantly higher than that in the normal group. After 2 weeks of treatment, the level of DJC in the low dose group was higher than that in the control group. After 4-8 weeks of treatment, the blood glucose in the low dose group was significantly lower than that in the model group, and that in the low dose group was significantly lower than that in the model group. For the expression of NF- 魏 B in the kidney of rats, the expression of NF- 魏 B in the model group was significantly increased, especially in the tubules and interstitial cells. In normal control group, the expression of NF- 魏 B was almost no or weakly positive. The expression of NF- 魏 B in renal tissue of low dose group was decreased, mostly weakly positive or not. Compared with the model group, the expression of NF- 魏 B in pioglitazone group was significantly lower than that in the diabetic model group, and the expression of NF- 魏 B was weakly positive. After treatment, the positive index of NF- 魏 B in the low dose group was significantly lower than that in the model group, which was significantly higher than that in the model group (P 0.01). Conclusion: Danzhi Jiangtang capsule can inhibit the strong response of TIMP-2 NF- 魏 -hs-CRP and other inflammatory factors. The mechanism may be related to lowering blood sugar, reducing the high expression of inflammatory factors and regulating the immune balance of the body.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R259

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