目的 观察痛泻要方合四逆散对2 型糖尿病KK-Ay小鼠脂代谢以及肝脏AMPK/SREBP1c/Fas通路的影响.方法 将24 只SPF级雄性KK-Ay小鼠建立2 型糖尿病模型,采用随机表数字法分为模型组、痛泻药方合四逆散中药低、中、高剂量组,每组各6 只,另取6 只雄性C57BL/6J小鼠作为正常对照组.干预 4 周后,检测小鼠血脂[高密度脂蛋白(High density lipoprotein,HDL)、低密度脂蛋白(Low density lipoprotein,LDL)、甘油三酯(Triglyceride,TG)]以及脂联素的表达水平,并通过RT-PCR,Western blot检测小鼠肝脏中AMPK、SREBP1 c、Fas蛋白以及基因的表达情况.结果 痛泻药方合四逆散可明显上调KK-Ay小鼠的血清HDL和脂联素水平,下调TG和LDL表达水平,差异有统计学意义(P＜0.05),且呈现剂量依赖性;另外,中药高剂量组可以增加小鼠肝脏中AMPK基因和磷酸化蛋白表达水平,降低SREBP1 c和Fas的基因和蛋白表达水平,差异有统计学意义(P＜0.05).结论 痛泻药方合四逆散能通过调控 AMPK/SREBP1c/Fas 信号通路而改善 2 型糖尿病 KK-Ay 小鼠脂代谢紊乱.

Objective To observe the therapeutic effect and mechanism of Tongxie Yaofang combined with Sini powder on diabetes mellitus.Methods 24 KK-Ay mice were randomly divided into model group and low, medium and high dose Chinese medicine treatment groups respectively of 6 mice in each group, and another 6 C57BL/6J mice were taken as blank control group. The low,middle and high dose groups were given the crude dosage of Chinese medicine 1. 84, 3. 68 and 5. 52 g/（kg d） respectively, while the blank group and model group were given the same volume of distilled water once a day for 4 weeks. The changes of body mass,fasting blood glucose（FBG）, insulin（INS）, insulin resistance index（HOMA-IR） and corticosterone（CORT） in each group were compared. The expression levels of 11β hydroxysteroid dehydrogenase ⅰ （HSD1） and glucocorticoid receptor（GR）in hippocampus were detected by Western blotting.Results Compared with the blank group, the body mass of the model group was higher at the 0,1,2,3 and 4 weeks of intervention（P＜0. 05）. Compared with the model group, the body weight of the low,medium and high dose groups was lower in the first and second weeks of intervention（P＞0. 05）. At the 3rd and 4th week, the body weight of the low, middle and high dose groups was low（P＜0. 05）. Compared with the blank group, the FBG in the model group was higher at the 0,1,2,3 and 4 weeks of intervention（P＜0. 05）. Compared with the model group, the level of FBG in the low, middle and high dose groups was lower at the 0, 1, 2 and 3 weeks of intervention（P＞0. 05）. At the 4th week, the level of FBG in the high dose group was low（P＜0. 05）. Compared with the blank group, the INS level and HOMA-IR in the model group were higher（P＜0. 05）. Compared with the model group, the INS level and HOMA-IR in the low-dose group were lower,with no statistical significance（P＞0. 05）. The levels of INS and HOMA-IR in middle and high dose groups were lower, and the difference was statistically significant（P＜0. 05）. Compared with the model group, the CORT level in the low-dose group was lower, and the difference was not statistically significant（P＞0. 05）. CORT in middle and high dose groups was lower, and the difference was statistically significant（P＜0. 05）. Compared with the blank group, the expression of 11β-HSD1 protein in hippocampus of model group was higher, while the expression of GR protein was lower, with statistical significance（P＜0. 05）.Compared with the model group, the expression of 11β-HSD1 protein in hippocampus of the low-dose group was lower, while the expression of GR protein was higher, with no statistical significance（P＞0. 05）. The expression of 11β-HSD1 protein in hippocampus was low and GR protein was high in middle and high dose groups, and the difference was statistically significant（P＜0. 05）.Conclusion Tongxie Yaofang combined with Sini Powder can decrease the level of FBG and improve insulin resistance in type 2 diabetes mice, and its mechanism may be related to the reduction of corticosterone content and the regulation of 11β-HSD1and GR protein expression.

目的 观察固肾降浊法联合西医常规疗法对于糖尿病肾病患者临床疗效的影响.方法 选择糖尿病肾病患者196例,依照治疗方式不同分成观察组101例与对照组95例,2组均采用西医常规治疗,观察组在对照组基础上加服固肾降浊法中药方,12周后对比2组临床疗效、中医证候积分、尿蛋白定量、肾功能指标、糖化血红蛋白、血脂治疗前后差异.结果 观察组总有效率(85.1％,86/101)高于对照组(71.6％,68/95)(P<0.05);观察组中医证候积分均显著低于对照组(P<0.01),24 h UTP水平低于对照组(P<0.05),肾功能指标BUN水平较对照组低(P<0.05),HbA1c％较对照组低(P<0.01),血脂指标TC、TG水平较对照组低(P<0.05),LDL-C水平显著低于对照组(P<0.01).结论 糖尿病肾病肾虚浊毒瘀阻型患者采用固肾降浊法联合西医常规疗法可取得较好的临床效果,可使患者24 h UTP、HbA1c％、TG、LDL-C水平降低显著,对肾功能有一定的保护作用.

目的:探讨参芪地黄汤化裁方对早期糖尿病肾病(diabetic kidney disease,DKD)患者血糖及尿蛋白的影响.方法:40例气阴两虚夹瘀型早期DKD(DKDⅢ期)患者在西医治疗基础上,予参芪地黄汤化裁方汤剂口服,连服12周,观察临床疗效及治疗前后患者中医证候积分、空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2hPG)、糖化血红蛋白(glycosylated hemoglo-bin,HbA1c)、肌酐(serum creatinine,SCr)、尿素氮(blood urea nitrogen,BUN)、尿白蛋白肌酐比值(UACR)变化情况.结果:与治疗前比较,治疗后患者中医证候积分下降(P<0.01),UACR、FBG、2hPG和HbA1c水平降低(P<0.01),SCr、BUN水平变化不明显(P>0.05);临床总有效率为87.50％.结论:参芪地黄汤化裁方联合西药能改善早期DKD气阴亏虚、脉络瘀阻证患者的临床症状,降低血糖、UACR水平及减少血糖和UACR对肾脏的损害,控制早期DKD进展,保护肾功能.

目的 观察益肾通络法联合西医常规疗法治疗糖尿病肾病患者的临床疗效.方法 将193例糖尿病肾病患者根据治疗方法分为观察组123例和对照组70例,2组均给予西医常规疗法,观察组在对照组基础上联合益肾通络法治疗,连续治疗12周后观察2组临床疗效、中医证候积分、尿蛋白定量、肾功能指标、糖化血红蛋白、血脂变化情况.结果 治疗后,观察组总有效率(86.99％,107/123)优于对照组(68.57％,48/70)(P<0.05);观察组尿浊、腰酸乏力、眼睑浮肿、肢体麻木及中医证候总积分均低于对照组(P<0.01),UTP水平低于对照组(P<0.05),肾功能指标BUN、Cys-C水平低于对照组(P<0.01),HbA1c％低于对照组(P<0.01),血脂指标TC、TG、LDL-C水平低于对照组(P<0.01).结论 益肾通络法可改善糖尿病肾病肾虚络脉瘀阻型患者的临床症状、降低UTP、HbA1c％、TC、TG、LDL-C水平,保护患者肾功能.

目的 探讨医学在线考试系统在中西医结合临床教学中的应用效果.方法 选取在北京中医药大学第三附属医院进行临床转科学习的60名实习医师作为研究对象,按照实习层次的不同,分为本科生组、研究生组和规培生组,每组20名.3组实习医生通过医学在线考试系统进行入科考试,临床专家对该学生考试情况进行点评,提出培养建议,制定临床带教方案,实习结束后进行出科考试.比较3组实习生各自的出、入科考试成绩.结果 研究生组的入科考试平均分和及格率在3组中最高,本科生组入科考试平均分和及格率在3组中最低.各组出科考试平均分均＞ 70分,各组及格率均≥85％.本科生组、研究生组及规培生组的出科成绩均高于本组的入科成绩,差异有统计学意义(P＜0.05).结论 在入科考试中引入医学在线考试系统,临床专家能对该学生的考试情况进行点评,提出培养建议,制定临床带教方案,提高出科考试成绩,值得在临床实习中推广应用.

目的:观察参芪地黄汤化裁方对Ⅳ期糖尿病肾病(diabetic nephropathy,DN)患者尿蛋白、同型半胱氨酸(homocysteine,HCY)、超氧化物歧化酶(superoxide dismutase,SOD)及临床进展的影响.方法:回顾性纳入气阴两虚夹瘀型Ⅳ期DN患者68例,对照组给予基础性治疗,治疗组在对照组基础上加用参芪地黄汤化裁方治疗,两组患者疗程均为1年.观察两组治疗前后的血糖指标[空腹血糖(fasting plasma glucose,FPG)、餐后2小时血糖(2-hour postprandial glucose,2hPG)、糖化血红蛋白(glycosylated Hemoglobin,HbA1c)]、血压[收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)]、生化指标[血浆白蛋白(plasma albumin,ALB)、血尿酸(uric acid,UA)、胆固醇(cholesterol,CHO)、三酰甘油(triglyceride,TG)、尿素氮(boold urea nitrogen,BUN)、血肌酐(serum creatinine,SCr)、尿蛋白定量(urine total protein quantity,UTP)]、HCY、SOD,估算肾小球滤过率(estimated Glomerular Filtration Rate,eGFR)的变化情况以及发展为慢性肾功能衰竭的情况,并评价中医证候积分及临床疗效.结果:治疗组患者治疗1年后,有效率为84.4％ (27/32),对照组为61.1％(22/36),两组比较差异有统计学意义(P＜0.05);治疗组腰膝酸软、倦怠乏力、双下肢浮肿、尿浊及证候总积分较对照组降低,差异有统计学意义(P＜0.01);治疗组2hPG、HbA1c水平低于对照组,差异有统计学意义(P＜0.01或P＜0.05);治疗组ALB水平优于对照组,差异有统计学意义(P＜0.05);治疗组较对照组BUN、SCr升高的幅度降低,差异有统计学意义(P＜0.05);治疗组较对照组eGFR下降的幅度降低,差异有统计学意义(P＜0.01);治疗组HCY、SOD水平均优于对照组,差异有统计学意义(P＜0.01);治疗组UTP水平优于对照组,差异有统计学意义(P＜0.05);同时治疗组较对照组进入慢性肾功能衰竭的患者明显减少,差异有统计学意义(P＜0.05).结论:参芪地黄汤化裁方辅助治疗能有效改善Ⅳ期DN气阴两虚夹瘀证患者中医证候积分、降低24hUTP、HCY水平,升高SOD的含量,保护肾脏,延缓DN进展.

Objective:To observe the clinical efficacy of Shenqi-Dihuang Decoction combined with conventional western medicine in the treatment of stage Ⅳ Diabetic Nephropathy (DN). Methods:Made a retrospective analysis of 80 patients of stage Ⅳ DN with the syndrome of qi and yin deficiency combined with blood stasis from June 2017 to June 2018, from Beijing Hospital of Traditional Chinese Medicine and The Third Affiliated Hospital of Beijing University of Chinese Medicine. The 80 patients were divided into treatment group and control group, 40 in each group. The control group was given the conventional western treatment. The treatment group was given Shenqi-Dihuang Decoction on the basic of the control group. Both of the treatments for the two groups lasted for 12 weeks. Before and after the treatment, the changes of TCM syndrome scores were observed in each group. The automatic biochemical analyzer was used to detect the level of fasting plasma glucose, 2-hour postprandial glucose (2 hPG), Boold Urea Nitrogen (BUN), Serum Creatinine (SCr), Plasma Albumin (Alb), Total Cholesterol (TC), Triglyceride (TG), Uric Acid (UA), Superoxide Dismutase (SOD), Homocysteine (HCY) before and after treatment. The Glycosylated Hemoglobin Alc were measured by high performance liquid chromatographic (HPLC), 24-hour urine total protein quantity (24 hUTP) were measured by immunoturbidimetric assay before and after treatment, and then Glomerular Filtration Rate (eGFR) was estimated to evaluate clinical effect. Results:After the treatment, the total effective rate in the treatment group was 87.5% (35/40), and the control group was 67.5% (27/40) and the difference was statistically significant ( χ2=4.557, P=0.033). After the treatment, the scores of urine turbid, weakness of waist and knees, fatigue, edema of both lower limbs were decreased in both groups, and the treatment group was significantly better than those of the control group ( t value were -2.178, -1.675, -3.667, -1.904, -4.835, respectively, all Ps<0.01). After the treatment, the level of FPG and HbA1c were significantly lower than those of the control group ( t value were-3.781, -8.557, respectively, all Ps<0.01); the systolic blood pressure was significantly lower than that of the control group ( t=-2.883, P=0.005); the level of TC was significantly lower than that of the control group ( t=-3.321, P=0.008); the level of Alb was significantly higher than that of the control group ( t=1.510, P=0.367); the level of 24 hUTP was significantly lower than that of the control group ( t=-2.819, P=0.008); the level of HCY were significantly lower than that of the control group ( t=-2.053, P=0.043); the level of SOD was significantly higher than that of the control group ( t=2.849, P=0.018). Conclusions:Shenqi-Dihuang Decoction combined with conventional western medicine can reduce 24 hUTP quantity of Ⅳ DN patients with the syndrome of qi and yin deficiency combined with blood stasis, reduce kidney damage, delay the development of Ⅳ DN, improve clinical effect and protect the kidney function.

目的 观察参芪地黄汤化裁方治疗早期糖尿病肾脏疾病(diabetic kidney disease,DKD)的临床疗效并评价其安全性.方法 回顾性纳入气阴亏虚、脉络瘀阻证的早期糖尿病肾病患者66例,治疗组及对照组各33例,对照组给予常规的糖尿病肾病基础治疗,治疗组在对照组基础上给予参芪地黄汤化裁方口服,连续给药12周,观察2组的临床疗效、中医证候积分、空腹血糖(FPG)、餐后2h血糖(2 hPBG)水平、糖化血红蛋白(HbA1c)、血压、血脂(TC、TG)、尿素氮(BUN)、血肌酐(Scr)、尿白蛋白肌酐比值(UACR)、同型半胱氨酸(HCY)及超氧化物歧化酶(SOD)改变.结果 治疗后,治疗组患者临床疗效、中医证候总积分、血糖、血脂、血压、SOD均较治疗前有显著改善(P＜0.05,P＜0.01);治疗组中医证候总积分、2 h PBG、HbA1c、UACR优于对照组,差异有统计学意义(P ＜0.05,P＜0.01).结论 参芪地黄汤化裁方联合基础治疗能够改善气阴亏虚、脉络瘀阻证早期DKD患者的临床症状,控制肾脏疾病进展,为中医药治疗早期糖尿病肾病提供新思路.

目的 观察参芪地黄汤化裁方对Ⅲ期糖尿病肾病患者尿微量白蛋白尿/肌酐比值、24 h尿蛋白定量等指标及其对疾病进展的影响.方法 回顾性纳入73例气阴两虚夹瘀型Ⅲ期糖尿病肾病患者,根据当时用药情况分为对照组35例,给予常规西医治疗,治疗组38例,在西医治疗基础上联合参芪地黄汤化裁方,治疗12个月后,比较2组临床治疗效果,观察2组中医证候积分变化,并测定临床指标以及进入Mogensen Ⅳ期病例数.结果 治疗12个月后,治疗组临床疗效总有效率为86.8％,优于对照组的65.7％ (P＜0.05);与治疗前比较,治疗后2组血糖、血脂、UA、HCY及SOD较治疗前均有不同程度的改善(P＜0.05或P＜0.01),部分治疗组优于对照组,差异有统计学意义(P＜ 0.05或P＜0.01);治疗组治疗后UACR及UTP较治疗前降低,且组间比较,差异有统计学意义(P＜ 0.01或P＜0.05),治疗组2例患者(5.2％)进入糖尿病肾病Ⅳ期,与对照组8例(22.9％)比较,差异有统计学意义(P＜0.05).结论 参芪地黄汤化裁方能有效改善Ⅲ期糖尿病肾病气阴两虚夹瘀型患者症状积分、降低其UACR、UTP、HCY水平及升高SOD的含量,保护肾脏,延缓疾病进一步进展.

目的 从"治未病"角度探索疏肝健脾法预防和治疗2型糖尿病的作用机制,选方四逆散及痛泻要方合剂,通过对患者胰岛素相关指标等水平的测定,探索疏肝健脾法对2型糖尿病及胰岛素抵抗的调控作用.方法 选取7周龄KK-Ay小鼠随机分成模型组、二甲双胍组、中药高剂量组、中药低剂量组.C57BL/6J小鼠作为正常组.连续给药4周,检测空腹血糖、OGTT、空腹血清胰岛素水平.结果 与正常组比较,模型组空腹血糖、AUC、空腹血清胰岛素水平升高(P<0.01),胰岛素敏感指数降低(P<0.01),二甲双胍组与模型组比较,空腹血糖(P<0.05)、AUC(P<0.01)、空腹血清胰岛素水平降低(P<0.01),胰岛素敏感指数升高(P<0.01);中药高剂量组较模型组比较,也可降低空腹血糖、AUC、空腹血清胰岛素水平升高(P<0.01),胰岛素敏感指数升高(P<0.05).结论 疏肝健脾法四逆散及痛泻要方合剂能够降低糖尿病小鼠血糖,改善糖耐量异常,提高胰岛素敏感性,从而进一步减轻减缓胰岛素抵抗.

目的 观察柴胡桂枝干姜化裁方治疗2型糖尿病(T2DM)患者血糖控制不佳的临床疗效,并评价其安全性.方法 回顾性分析2017年3月-2019年7月在首都医科大学附属北京中医医院肾内科、北京中医药大学第三附属医院门诊及病房就诊的中医辨证为肝胆郁热、脾肾阳虚之寒热错杂型T2DM伴血糖控制不佳者90例,分为2组,各45例.对照组在糖尿病健康教育等非药物治疗基础上,选用皮下注射胰岛素或口服磺脲类等降糖药物控制血糖;观察组在对照组常规T2DM治疗的基础上加柴胡桂枝干姜汤化裁方口服,均连续给药12周.比较2组临床疗效及治疗前后中医证候积分、血糖(FBG、2hPBG、HbA1c)、胰岛素抵抗指数(HOMA-IR)、胰岛素β细胞功能指数(HOMA-β)、血脂(CHO、TG、LDL-C、HDL-C)、尿微量白蛋白/肌酐比值(UACR)及血尿酸(UA)情况,统计治疗期间发生的不良反应.结果 观察组总有效率高于对照组(P＜0.01).2组治疗后口苦、口干、倦怠乏力及证候总积分均较治疗前降低(P＜0.01);治疗后2组腰膝酸软证候积分较治疗前明显改善,观察组优于对照组,差异有统计学意义(P＜0.01);治疗后2组FBG、2 hPBG及HbA1c均较治疗前降低(P＜0.01),且观察组低于对照组(P＜0.01).观察组治疗后HOMA-β较治疗前升高、HOMA-IR较治疗前降低,差异有统计学意义(P＜0.01);对照组治疗前后HOMA-β、HOMA-IR比较,差异均无统计学意义(P＞0.05).2组治疗后CHO、TG较治疗前降低,且观察组低于对照组(P＜0.05);2组治疗后LDL-C均较治疗前升高(P＜0.01).2组治疗后UA较治疗前降低(P＜0.01),且观察组低于对照组(P＜0.01);2组治疗前后UACR比较差异均无统计学意义(P＞0.05).结论 柴胡桂枝干姜化裁方可显著改善T2DM患者血糖控制,抑制胰岛素抵抗及增加胰岛素分泌,且无不良反应.

Objective:To observe the effects of traditional Chinese medicine compound Tang Bikang on the expressions of Bax and JNK protein and Bax mRNA in sciatic nerve of diabetic rats.Methods:A total of 60 SD male rats were randomly divided into the control group,metheycobal group and low,medium and high dose of Tang Bikang groups,10 rats per group.The high fat diet coupled with the injection of small dose of streptozotocin (STZ) was used to induce the rat model of type 2 diabetes.The corresponding drugs were respectively given each group.After 16-week experiment,the rats were sacrificed and the unilateral sciatic nerves were harvested.The expressions of Bax protein were detected using immunohistochemical method.The expressions of JNK and p-JNK,and the mRNA expression of Bax were detected by Western blot and RT-PCR,respectively.Results:Compared with the control group,the expressions of Bax protein and mRNA were decreased significantly and the protein expressions of p-JNK and JNK were significantly increased in the model group (P＜0.05,P＜0.01).Compared with the model group,the expressions of Bax protein and mRNA were decreased significantly in medium dose of Tang Bikang group (P＜0.01,P＜0.05),the Bax mRNA expressions were significantly reduced in the low dose of Tang Bikang group (P＜0.05),and the Bax protein expressions were significantly reduced in the methycobal group (P＜0.01).Although the treatment of methycobal or the high dose of Tang Bikang reduced the protein and gene expressions of Bax,correspondingly,there were no statistical differences between the treatment groups and the model group.The treatments of methycobal and the low and high dose of Tang Bikang reduced the expressions of JNK protein (P＜0.01),and the treatments of methycobal and the middle and high dose of Tang Bikang decreased the expressions of p-JNK protein (P＜0.01).There were no statistical differences in the expressions of JNK and p-JNK protein between the model group and the treatment groups including the methycobal group and the high dose of Tang Bikang group.Conclusion:Traditional Chinese medicine compound Tang Bikang could suppress the transcription of Bax mRNA and protein,down-regulate the protein expression of p-JNK and JNK in sciatic nerve of diabetic peripheral neuropathy rats,which could be one of the targets of Tang Bikang exerting the nerve protective and analgesic effects.

目的:观察中药复方糖痹康对糖尿病大鼠坐骨神经神经组织营养因子-3(NT-3)蛋白,c-jun蛋白及NT-3 mRNA表达的影响.方法:采用高脂饲料和小剂量链脲佐菌素(STZ)诱发2型糖尿病大鼠动物模型,用不同剂量的糖痹康灌胃,并与甲钴胺对照,16周后取大鼠一侧坐骨神经,用免疫组化法检测坐骨神经中NT-3蛋白的表达,Western blot法检测大鼠大鼠坐骨神经c-jun的表达及采用RT-PCR方法检测坐骨神经组织中NT-3 mRNA的表达.结果:与正常组比较,模型组NT-3蛋白及mRNA表达显著降低,c-jun蛋白表达显著升高(P＜0.01);与模型组比较,各用药组NT-3蛋白及NT-3 mRNA表达升高(P＜0.01),c-jun蛋白表达降低(P＜0.01).结论:中药复方糖痹康能够促进糖尿病周围神经病变(DPN)大鼠坐骨神经NT-3 mRNA的转录和蛋白的表达,下调DPN大鼠坐骨神经c-jun蛋白表达,可能是其DPN神经保护及镇痛作用靶点之一.

目的:观察中药复方糖痹康对糖尿病周围神经病变(DPN)大鼠脂代谢和坐骨神经超微结构的影响.方法:采用高脂饲料和小剂量链脲佐菌素(STZ)诱发2型糖尿病大鼠动物模型,用不同剂量的糖痹康灌胃,并与甲钴胺对照,16周后腹主动脉取血及大鼠一侧坐骨神经,用电镜观察其超微结构,采用酶法测定大鼠血清总胆固醇(TC)和甘油三酯(TG);免疫比浊法测定大鼠血清高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);铜试纸显色法检测大鼠血清游离脂肪酸(NEFA).结果:与正常组比较,模型组HDL-C含量均显著降低(P＜0.01),TG、TC、LDL-C、NEFA均显著升高(P＜0.01).与模型组比较,糖痹康及甲钴胺组HDL-C的含量均显著升高(P＜0.01),TG、TC、LDL-C、NEFA含量均显著降低(P＜0.01).电镜结果显示,正常组大鼠坐骨神经横切面髓鞘结构完整、致密、均匀;模型组大鼠坐骨神经横切面髓鞘的板层结构发生严重分离,各层间排列紊乱,出现大量空泡及裂隙;各给药组坐骨神经中空泡及裂隙均显著降低,但髓鞘仍未恢复板层状结构,线粒体及粗面内质网结构正常,出现结构完整的雪旺细胞.结论:糖痹康能改善DPN大鼠血脂及降低其血清NEFA水平,同时其对坐骨神经髓鞘、轴索等具有修复作用.

目的:观察中药复方糖痹康对糖尿病大鼠坐骨神经AKT、P-AKT、P13K-P85、P-P13KP85表达的影响.方法:SD雄性大鼠60只,随机选取10只为正常组,其余大鼠采用高脂饲料和小剂量链脲佐菌素(STZ)诱发2型糖尿病大鼠动物模型.造模成功后随机分为模型组,甲钴胺组,糖痹康低、中、高剂量组,每组10只.各组采取相应干预.16周后取大鼠一侧坐骨神经,采用Western blot法检测大鼠坐骨神经AKT、P-AKT、P13K-Pg5、P-P13KP85的表达.结果:与正常组比较,模型组大鼠坐骨神经组织AKT、P-AKT、P13K-P85、P-P13KP85蛋白表达显著升高(P＜0.01);与模型组比较,甲钴胺组及糖痹康低、中、高剂量组AKT、P-AKT、P13K-P85、P-P13KP85蛋白表达显著降低(P＜0.01,P＜0.05).结论:抑制PI3K/AKT信号通路,可能是中药复方糖痹康防治DPN的作用机制之一.

目的:观察中药复方糖痹康对高糖环境下大鼠坐骨神经雪旺细胞增殖的影响.方法:通过雪旺细胞株,建立高糖环境下大鼠雪旺细胞的细胞模型;用不同剂量的含药血清和正常血清培养基刺激24、48、72和96 h后,MTT法检测高糖环境下不同剂量的糖痹康含药血清对大鼠细胞增殖的影响.结果:与空白组比较,24、48、72、96 h后,50 mM GLU与75 mM GLU组细胞增殖程度均显著降低,但50 mM GLU与75 mM GLU组间并无差异;与50 mM高糖对照组比较,24、48 h后,弥可保及糖痹康1∶1、1∶2、1∶8组均可显著增高细胞增殖能力.结论:糖痹康组可明显改善高糖培养环境下雪旺细胞增殖活性,糖痹康低剂量组优于西药(弥可保)组,其在高糖培养的环境下,中医复方糖痹康可促进大鼠坐骨神经雪旺细胞的增殖,可能是其防治DPN的机制之一.

目的:观察中药复方糖痹康对糖尿病大鼠坐骨神经锰超氧化物歧化酶(MnSOD)、铜锌超氧化物歧化酶(CuznSOD) mRNA表达的影响.方法:SD雄性大鼠60只,随机选取10只为正常组,其余大鼠采用高脂饲料和小剂量链脲佐菌素(streptozotocin,STZ)诱发2型糖尿病大鼠动物模型.造模成功后随机分为模型组,弥可保组,糖痹康低、中、高剂量组,每组10只.各组采取相应干预.16周后取大鼠一侧坐骨神经,用铜试纸显色法检测大鼠血清的SOD含量及采用RT-PCR方法检测坐骨神经组织中MnSOD及CuznSODmRNA的表达.结果:与正常组比较,模型组大鼠血清SOD的含量显著降低;与模型组相比,糖痹康剂量组大鼠血清中SOD的含量显著升高;与正常组比较,模型组大鼠坐骨神经Cuzn-SODmRNA及Mn-SODmRNA表达显著降低;与模型组比较,弥可保,糖痹康低、中和高剂量组Mn-SODmRNA的表达显著升高,同时与模型组比较,糖痹康低、中和高剂量组Cuzn-SODmRNA的表达显著升高,糖痹康低,中和高剂量组Mn-SODmRNA的表达显著升高,弥可保组Mn-SODmR-NA的表达显著升高虽也升高,但无统计学意义.结论:临床有效中药糖痹康对糖尿病周围神经病变的神经保护作用有可能与通过提高血清SOD含量及Mn-SOD及Cuzn-SOD基因表达而起到抗氧化应激作用有关.

目的:观察中药复方糖痹康对糖尿病大鼠坐骨神经TNF-α-NF-κB途径的影响.方法:采用高脂饲料和小剂量链脲佐菌素(STZ)诱发2型糖尿病大鼠动物模型,用不同剂量的糖痹康灌胃,并与甲钴胺对照,16周后取大鼠一侧坐骨神经,用免疫组化法检测坐骨神经中TNF-α蛋白的表达及采用RT-PCR方法检测坐骨神经组织中NF-κBmRNA的表达.结果:与正常组比较,模型组TNF-α蛋白及NF-κB mRNA表达显著升高(P＜0.01);与模型组比较,糖痹康组能显著降低TNF-α蛋白及NF-κB mRNA表达(P＜0.01).结论:抑制TNF-α-NF-κB途径,可能是中药复方糖痹康防治糖尿病周围神经病变的作用机制之一.