芪归药对通过激活Nrf2通路干预气虚血瘀型T2DM大血管病变的临床研究
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摘要
目的:探讨芪归药对治疗气虚血瘀型T2DM大血管病变的临床疗效和机理,评估芪归药对对于Nrf2系统的干预作用。方法:选择70例气虚血瘀型T2DM大血管病变患者,随机分组,将其中20例予原有的治疗方案加用黄芪27 g,当归18 g,水煎400 mL,日1剂(芪归3∶2组),20例予原有的治疗方案加用黄芪37.5 g,当归7.5 g,水煎400 mL,日1剂(芪归5∶1组),30例予原有治疗方案(对照组),分别对其进行系统临床研究,着重观察治疗前后患者主要临床症状及血清Nrf2和下游细胞因子HO-1、SOD的表达。结果:芪归3∶2组总有效率为90%,芪归5∶1组有效率为85%,对照组总有效率为76.7%,前两组与对照组临床总疗效之间有显著性差异(P<0.05);芪归药对组在改善临床主要症状方面优于对照组(P<0.05)。结论:芪归药对对于气虚血瘀型T2DM大血管病变的患者有良好的治疗效果。
Objective: To discuss the clinical efficacy and mechanism to treat Qi deficiency and blood stasis type of diabetic macrovascular disease after taking Huangqi(Astragalus membranaceus) combined with Danggui(Angelica sinensis) and evaluate the interventional effectof Huangqi(Astragalus membranaceus) combined with Danggui(Angelica sinensis) on Nrf2 System.Methods: We selected 70 cases of Qi deficiency and blood stasis type of T2 DM patients with macrovascular disease and randomly divided them into 3 groups: 20 cases besides the original treatment addedHuangqi(Astragalus membranaceus)27 g, Danggui(Angelica sinensis)18 g, decoction 400 mL, once dose a day(Qigui 3∶2 group), 20 cases besides the original treatment addedHuangqi(Astragalus membranaceus) 37.5 g, Danggui(Angelica sinensis)7.5 g, decoction 400 mL, one dose a day(5∶1 group). The remaining 30 cases used the original treatment(the original treatment group). We observed the main clinical symptoms and expression sof serum Nrf2 and downstream cytokine HO-1 and SOD before and after treatment.Results: The total efficiency of Qigui 3∶2 group was 90% and that of Qigui 5∶1 group was 85%,and the total efficiency of control group was 76.7%. There was a significant difference between the first two groups and the control group's total clinical efficacy(P<0.05).The first two groups were better than the control group in improving the main clinical symptoms(P<0.05).Conclusion:Huangqi(Astragalus membranaceus) combined with Danggui(Angelica sinensis) for Qi deficiency and blood stasis type of T2 DM patients with macrovascular disease has a good therapeutic effect.
Objective: To discuss the clinical efficacy and mechanism to treat Qi deficiency and blood stasis type of diabetic macrovascular disease after taking Huangqi(Astragalus membranaceus) combined with Danggui(Angelica sinensis) and evaluate the interventional effectof Huangqi(Astragalus membranaceus) combined with Danggui(Angelica sinensis) on Nrf2 System.Methods: We selected 70 cases of Qi deficiency and blood stasis type of T2 DM patients with macrovascular disease and randomly divided them into 3 groups: 20 cases besides the original treatment addedHuangqi(Astragalus membranaceus)27 g, Danggui(Angelica sinensis)18 g, decoction 400 mL, once dose a day(Qigui 3∶2 group), 20 cases besides the original treatment addedHuangqi(Astragalus membranaceus) 37.5 g, Danggui(Angelica sinensis)7.5 g, decoction 400 mL, one dose a day(5∶1 group). The remaining 30 cases used the original treatment(the original treatment group). We observed the main clinical symptoms and expression sof serum Nrf2 and downstream cytokine HO-1 and SOD before and after treatment.Results: The total efficiency of Qigui 3∶2 group was 90% and that of Qigui 5∶1 group was 85%,and the total efficiency of control group was 76.7%. There was a significant difference between the first two groups and the control group's total clinical efficacy(P<0.05).The first two groups were better than the control group in improving the main clinical symptoms(P<0.05).Conclusion:Huangqi(Astragalus membranaceus) combined with Danggui(Angelica sinensis) for Qi deficiency and blood stasis type of T2 DM patients with macrovascular disease has a good therapeutic effect.
引文
[1] Standl E,Schnell O.A look at the heart in diabetes mellitus:from ailing to failing[J].Diabetolia,2000,43(12):1435-1469.
[2] Lebovitz HE.Insulin resistance:definition and consequences[J].Exp Clin Endocrinol Diabetes,2001,109[Suppl 2]:S135-148.
[3] 陈莉明.糖尿病心血管病变的研究现状[J].国外医学内分泌学分册,2003,23(1):59-61.
[4] 任小旦,张莹雯,王秀萍,等.当归补血汤对高糖条件下系膜细胞Nrf2表达及T-SOD、MDA的影响[J].现代中西医结合杂志,2015,24(26):2855-2858.
[5] Osende JI,Badimon JJ,Fuster V,et al.Blood thrombogenicity in type 2 diabetes mellitus patients is associated with glycemic control[J].J Am Coll Cardiol,2001,38(5):1307-1312.
[6] 李程,万沁.Nrf2/ARE通路与糖尿病及并发症的关系[J].西南军医,2013,15(1):45-48.
[7] Wang X,Hai CX.ROS acts as a double-edged sword in the pathogenesis of type 2 diabetes mellitus:is Nrf2 a potential target for the treat ment[J].MiniRev Med Chem,2011,11(12):1082-1092.
[8] 阴永辉,孔畅,张丽君,等.黄芪当归不同配比对糖尿病模型大鼠MCP-1、TNF-α、IL-6的影响[J].山东中医药大学学报,2014,38(4):375-377.
[9] 郭良清,张丽君,孔畅,等.不同配比黄芪当归对糖尿病大鼠血管内皮损伤的早期干预比较[J].山东中医杂志,2014,33(7):576-577.
[10] 黄丽萍,陈耀辉,吴素芬,等.当归补血汤含药血清对血虚小鼠骨髓造血功能的影响[J].中药药理与临床,2014,30(2):18-20.
[11] 王书乐,张志斌.血管内皮细胞凋亡研究进展[J].辽宁中医药大学学报,2011,13(3):50-53.
[12] 刘坚,邹丰,欧阳静萍.黄芪多糖通过活化AMPK促进L6细胞葡萄糖摄取的实验研究[J].中国病理生理杂志,2010,26(10):2058.
[13] 周云枫,吴勇,欧阳静萍.黄芪多糖对2型糖尿病大鼠肾组织胰岛素信号转导的影响[J].武汉大学学报:医学版,2005,26(2):139-142.
[14] 高卫真,康毅,娄建石,等.黄芪苷Ⅳ对心肌细胞氧化损伤的保护作用[J].中国心血管杂志,2005,10(3):166-169.
[15] 季亢挺,唐疾飞,柴俊德.黄芪甲苷对内皮祖细胞氧化损伤的保护作用[C]//浙江省心电生理与起搏学术年会论文汇编,2011.
[16] 高卫真,康毅,娄建石,等.黄芪苷Ⅳ对心肌细胞氧化损伤的保护作用[J].中国心血管杂志,2005,6(3):166-169.
[17] 江红,匡洪宇,马丽丽,等.不同质量浓度的黄芪总黄酮对高糖培养下牛视网膜血管周细胞氧化应激的影响[J].中国中医急症,2011,20(7):1105-1133.
[18] 陈立新,朱海燕,朱陵群,等.黄芪多糖对人心脏微血管内皮细胞增殖及再灌注后内皮细胞与中性粒细胞黏附的影响[J].中囯组织工程研究与临床康复,2007,11(27):5382-5386.
[19] 李自成,李庚山,黄从新,等.当归提取液对培养的兔主动脉平滑肌细胞增殖的影响[J].中药药理与临床,1998,14(1):28-32.
[2] Lebovitz HE.Insulin resistance:definition and consequences[J].Exp Clin Endocrinol Diabetes,2001,109[Suppl 2]:S135-148.
[3] 陈莉明.糖尿病心血管病变的研究现状[J].国外医学内分泌学分册,2003,23(1):59-61.
[4] 任小旦,张莹雯,王秀萍,等.当归补血汤对高糖条件下系膜细胞Nrf2表达及T-SOD、MDA的影响[J].现代中西医结合杂志,2015,24(26):2855-2858.
[5] Osende JI,Badimon JJ,Fuster V,et al.Blood thrombogenicity in type 2 diabetes mellitus patients is associated with glycemic control[J].J Am Coll Cardiol,2001,38(5):1307-1312.
[6] 李程,万沁.Nrf2/ARE通路与糖尿病及并发症的关系[J].西南军医,2013,15(1):45-48.
[7] Wang X,Hai CX.ROS acts as a double-edged sword in the pathogenesis of type 2 diabetes mellitus:is Nrf2 a potential target for the treat ment[J].MiniRev Med Chem,2011,11(12):1082-1092.
[8] 阴永辉,孔畅,张丽君,等.黄芪当归不同配比对糖尿病模型大鼠MCP-1、TNF-α、IL-6的影响[J].山东中医药大学学报,2014,38(4):375-377.
[9] 郭良清,张丽君,孔畅,等.不同配比黄芪当归对糖尿病大鼠血管内皮损伤的早期干预比较[J].山东中医杂志,2014,33(7):576-577.
[10] 黄丽萍,陈耀辉,吴素芬,等.当归补血汤含药血清对血虚小鼠骨髓造血功能的影响[J].中药药理与临床,2014,30(2):18-20.
[11] 王书乐,张志斌.血管内皮细胞凋亡研究进展[J].辽宁中医药大学学报,2011,13(3):50-53.
[12] 刘坚,邹丰,欧阳静萍.黄芪多糖通过活化AMPK促进L6细胞葡萄糖摄取的实验研究[J].中国病理生理杂志,2010,26(10):2058.
[13] 周云枫,吴勇,欧阳静萍.黄芪多糖对2型糖尿病大鼠肾组织胰岛素信号转导的影响[J].武汉大学学报:医学版,2005,26(2):139-142.
[14] 高卫真,康毅,娄建石,等.黄芪苷Ⅳ对心肌细胞氧化损伤的保护作用[J].中国心血管杂志,2005,10(3):166-169.
[15] 季亢挺,唐疾飞,柴俊德.黄芪甲苷对内皮祖细胞氧化损伤的保护作用[C]//浙江省心电生理与起搏学术年会论文汇编,2011.
[16] 高卫真,康毅,娄建石,等.黄芪苷Ⅳ对心肌细胞氧化损伤的保护作用[J].中国心血管杂志,2005,6(3):166-169.
[17] 江红,匡洪宇,马丽丽,等.不同质量浓度的黄芪总黄酮对高糖培养下牛视网膜血管周细胞氧化应激的影响[J].中国中医急症,2011,20(7):1105-1133.
[18] 陈立新,朱海燕,朱陵群,等.黄芪多糖对人心脏微血管内皮细胞增殖及再灌注后内皮细胞与中性粒细胞黏附的影响[J].中囯组织工程研究与临床康复,2007,11(27):5382-5386.
[19] 李自成,李庚山,黄从新,等.当归提取液对培养的兔主动脉平滑肌细胞增殖的影响[J].中药药理与临床,1998,14(1):28-32.