基于“脾胰同源”应用养阴益气活血法减少血糖波动干预糖尿病大血管病变的研究

目的探讨基于"脾胰同源"应用养阴益气活血法观察参芪复方对糖尿病血糖波动的影响。方法建立由高脂饲料喂养的糖尿病大血管并发症大鼠模型,实验分为空白组,模型组,参芪复方组,西药西格列汀组,各组灌胃8周。实验期间观察动物一般状况,在灌胃的第4周每周1次测定1日内5个时间点的血糖情况,并计算MBG、SDBG、LABG值。灌胃8周后处死GK大鼠,检测各组血脂水平、CRP、血清胰岛素、血清胰高血糖素、血清GLP-1,对腹主动脉及胰腺组织进行HE染色后进行病理形态学观察。结果参芪组一般状况优于模型组,血糖波动方面,每日平均血糖标准差(SDBG)和最大血糖波动幅度(LAGE)值优于模型组。甘油三酯(TG)、胆固醇(TC)以及C反应蛋白(CRP)较模型组降低,但与西药组无统计学意义。胰岛素(INS)与胰高血糖素(GC)与模型组相比,无统计学意义;而GLP-1较模型组有显著的差异(P<0.01)。病理方面,参芪组腹主动脉和胰腺切片优于模型组和西药组。结论应用参芪复方可以改善糖尿病大血管病变GK大鼠的一般状态,提高GLP-1的浓度,控制血糖的波动幅度;且可以改善脂代谢紊乱,降低CRP,减轻模型GK大鼠血管内皮损伤,延缓糖尿病大血管病变的进展。

Study on Decreasing Glucose Fluctuation of Diabetic Macroangiopathy by Tonifying Qi and Yin and Promoting Blood Circlulation Method Based on "Homogeny of Spleen and Pancreas"

Objective To explore the effect of Shenqi Compound Recipe by tonifying Qi and Yin and promoting blood circlulation method on blood glucose fluctuation based on "spleen-pancreas homology". Methods The rats with diabetic macrovascular complications were fed with high fat diet. The rats were divided into blank group, model group, Shenqi Compound Recipe group and Western medicine Sigliding group. Each group was given intragastric administration for 8 weeks. During the experiment, the general condition of the animals was observed, and the blood glucose was measured once a week at 5 time points in a day in the 4 th week and the values of MBG, SDBG and LABG were calculated. GK rats were sacrificed 8 weeks after intragastric administration. The levels of serum lipids, CRP, insulin, glucagon and GLP-1 were measured. The abdominal aorta and pancreas tissues were stained with HE. Results The general condition of Shenqi Compound Recipe group was better than that of the model group. The average blood glucose standard deviation(SDBG) and the maximum blood sugar fluctuation range(LAGE) of blood glucose fluctuation were better than those of the model group. Triglyceride(TG), cholesterol(TC) and C reactive protein(CRP) were lower than those in the model group, but no statistical significance was found in the Western medicine group. There was no significant difference in insulin(INS) and glucagon(GC) compared with those of the model group, but GLP-1 was significantly different from that in the model group(P<0.01). In pathology, the thoracic and abdominal aorta slices of Shenqi Compound Recipe group showed complete smooth endometrium, middle membrane elastic fibers, and cell nuclei arranged regularly. No islets were found in the pancreas slices, most of the nuclei were pyknosis and apoptosis, and there was no abnormal change in the size or shape of the islets. Conclusion Shenqi Compound Recipe can improve the vascular lesion in GK diabetic rats, increase GLP-1 concentration, control the fluctuation of blood glucose and can improve lipid metabolism, decrease CRP and alleviate vascular endothelial injury in rats model of GK, and delay the progress of diabetic macrovascular disease.