2型糖尿病肾病db/db小鼠的中医证候演变分析  

Evolution of Tradtional Chinese Medicine Syndrome of db/db Mice with Type 2 Diabetic Nephropathy

作　　者：冯慧 朱晓云[2] 付守强 朱莉莉 刘喜明[2] FENG Hui;ZHU Xiaoyun;FU Shouqiang;ZHU Lili;LIU Ximing(College of Chinese Medicine,College of Integrated Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of Laboratory of Diabetes,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;College of Life Sciences,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]南京中医药大学中医学院·中西医结合学院,江苏南京210023 [2]中国中医科学院广安门医院糖尿病实验室,北京100053 [3]北京中医药大学生命科学学院,北京100029

出　　处：《山东中医药大学学报》2022年第2期242-251,共10页Journal of Shandong University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年项目(编号:81804085);虞山医派中医经典传承奖励基金资助项目。

摘　　要：目的:分析2型糖尿病肾病(T2DN)db/db小鼠的中医证候演变规律,为db/db小鼠在中医药干预T2DN研究中的应用提供依据。方法:建立中医证候表征体系,采集并分析8~20周龄db/db小鼠及同窝野生型小鼠的中医证候表征信息,包括形体、活动、二便、舌色、进食、体质量、空腹血糖(FBG)、血脂、24 h尿量、尿微量白蛋白排泄等。结果:8~14周龄db/db小鼠形体肥胖,大便秘结,活动少,力量小,进食量、体质量、FBG、24 h尿量及尿微量白蛋白排泄逐渐增加,舌质红,符合消渴病早期阳明热盛的证候特点,兼有痰湿、气虚证表现;14~16周龄db/db小鼠纳食减少,体质量、尿微量白蛋白排泄增加,符合脾气亏虚、痰湿蕴阻的证候特点;16~20周龄db/db小鼠进食量、体质量、24 h尿量下降,FBG及尿微量白蛋白排泄持续增加,血脂水平高,部分小鼠出现精神萎靡、蜷缩喜卧等表现,符合消渴病中后期脾肾亏虚、气阴两虚的证候特点,兼有肾阳虚、痰湿证表现。结论:本实验中,8~20周龄db/db小鼠T2DN的中医证候演变符合“实则阳明,虚则太阴,久病及肾”的病机转变特点。其中,8~14周龄db/db小鼠以阳明热盛证为主,兼有痰湿、气虚证;14~16周龄db/db小鼠以脾气亏虚、痰湿阻滞证为主;16~20周龄db/db小鼠以气阴两虚、脾肾亏虚证为主,兼有肾阳虚、痰湿证。Objective:To provide the basis for the application of db/db mice in the study of traditional Chinese medicine(TCM)intervention on type 2 diabetic nephropathy(T2DN)by analyzing TCM syndrome evolution of db/db mice with T2DN Methods:TCM syndrome representation system was established.The TCM syndrome representation information of db/db mice aged 8 to 20 weeks and wild-type mice in the same litter was collected and analyzed,including body shape,activity,defecation,tongue color,food intake,body weight,fasting blood glucose(FBG),blood lipids,24-hour urine volume,and urinary albumin excretion,etc.Results:From 8 weeks to 14 weeks of age,db/db mice behaved obesity,constipate,less activity,and less strength,the food intake,body weight,FBG,24-hour urine volume,and urine albumin excretion increased gradually,the tongue color was red,and that were consistent with the syndrome characteristic of Yangming excessive heat syndrome in the early stage of diabetes,accompanied by phlegm dampness and qi deficiency syndrome.From 14 weeks to 16 weeks of age in db/db mice,the food intake decreased,but body weight and urine protein increased,that were consistent with the syndrome characteristic of spleen qi deficiency and phlegm dampness accumulation.From 16 weeks to 20 weeks of age in db/db mice,the food intake,body weight and urine volume decreased,the FBG and urine protein excretion increased continuously,blood lipid level was high,and some mice appeared mental depression,curling up and lying down,that were consistant with the syndrome characteristic of spleen-kidney deficiency and deficiency of both qi and yin syndrome,accompanied with kidney yang deficiency and phlegm dampness.Conclusions:The TCM syndrome evolution of db/db mice aged 8 to 20 weeks was consistent with the pathogenesis change characteristic of“excess manifestation often occurring in Yangming,while deficiency in Taiyin,lasting disease involving kidney”.Among them,the TCM syndrome of db/db mice aged 8 to 14 weeks was mainly excessive heat syndrome of Yangming,accompan

关 键 词：DB/DB小鼠 2型糖尿病肾病 阳明热盛证 脾气亏虚、痰湿阻滞证 气阴两虚、脾肾亏虚证 证候演变 

分 类 号：R259[医药卫生—中西医结合]