健脾理气活血方对2型糖尿病大鼠非酒精性脂肪肝病的保护作用  

Protective effects of decoction for strengthening spleen,tonifying qi,activating blood in rats with type 2 diabetes and non-alcoholic fatty liver disease

作　　者：刘梦瑶 张贺芳 牛明明 申英鸽 LIU Mengyao;ZHANG Hefang;NIU Mingming;SHEN Yingge(The First Affiliated Hospital of Hebei College of Traditional Chinese Medicine,Shijiazhuang 050013,Hebei,China;Handan Hospital of Integrated Traditional Chinese and Western Medicine,Handan 056001,Hebei,China)

机构地区：[1]河北中医学院第一附属医院,河北石家庄050013 [2]邯郸市中西医结合医院,河北邯郸056001

出　　处：《现代中西医结合杂志》2022年第23期3246-3251,3268,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药防治重大疑难疾病研究项目-中医药防治内分泌疑难疾病(2018125580)。

摘　　要：目的探讨健脾理气活血方对2型糖尿病大鼠非酒精性脂肪肝病(NAFLD)的干预作用及其机制。方法随机取10只SD雄性大鼠作为正常组,另取20只SD雄性大鼠以高脂高糖饲料联合小剂量链脲佐菌素腹腔注射方法建立2型糖尿病伴NAFLD模型。将19只造模成功大鼠随机分为模型组10只和中药组9只。中药组给予健脾理气活血方17.1 g/(kg·d)灌胃,正常组及模型组给予等量蒸馏水灌胃,均连续灌胃16周。取血检测肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)]、胰岛功能相关指标[空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)]、血脂指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)],Western blot法检测肝脏组织中葡萄糖-6-磷酸酶(G-6-Pase)、叉头转录因子O1(FoxO1)、胰岛素受体底物1(IRS1)的蛋白表达情况,HE染色和油红O染色观察肝脏病理表现。结果与正常组比较,模型组大鼠血清ALT、AST、FPG、FINS、HbAlc、HOMA-IR、TC、TG、LDL-C水平及肝脏组织中G-6-Pase、FoxO1蛋白相对表达量均明显升高(P均<0.05),血清HDL-C水平及肝脏组织中IRS1蛋白相对表达量均明显降低(P均<0.05);HE染色示模型组大鼠肝细胞核位置偏移,染色变浅或消失,胞浆中可见较多脂肪空泡与炎性浸润;油红O染色见广泛红色脂滴分布在肝细胞中。与模型组比较,中药组血清ALT、AST、FPG、FINS、HbAlc、HOMA-IR、TC、TG、LDL-C水平及肝脏组织中G-6-Pase、FoxO1蛋白相对表达量均明显降低(P均<0.05),血清HDL-C水平及肝脏组织中IRS1蛋白相对表达量均明显升高(P均<0.05);HE染色和油红O染色示中药组大鼠肝细胞形态变化、脂肪变性及炎性浸润程度均较模型组轻,胞浆内脂滴减少。结论健脾理气活血方可以改善2型糖尿病大鼠非酒精性脂肪肝病病理变化,机制可能与调控FoxO1相关通路、减轻胰岛素�Objective It is to investigate the interventional effects and mechanisms of the decoction for strengthening spleen,tonifying qi,activating blood in the rats with type 2 diabetes and nonalcoholic fatty liver disease(NAFLD).Methods Ten SD male rats were randomly selected as the normal group,and another 20 SD male rats were randomly selected to establish models of type 2 diabetes mellitus with NAFLD by high-fat and high-sugar diet combined with intraperitoneal injection of low-dose streptozotocin.The 19 successfully modeled rats were randomly divided into model group with 10 rats and Chinese medicine group with 9 rats.The Chinese medicine group was given the decoction for strengthening spleen,tonifying qi,activating blood 17.1 g/(kg·d)by gavage,and the normal group and the model group were given equal amounts of distilled water by gavage,and all groups were gavaged continuously for 16 weeks.The blood was collected to detect the liver function indicators[glutamic aminotransferase(ALT),glutamic aminotransferase(AST)],islet function-related indicators[fasting plasma glucose(FPG),fasting insulin(FINS),glycated hemoglobin(HbAlc),insulin resistance index(HOMA-IR)],lipid indicators[total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],the protein expression of glucose-6-phosphatase(G-6-Pase),forkhead transcription factor O1(FoxO1),insulin receptor substrate 1(IRS1)in liver tissues were detected by Western blot method,the liver pathological manifestations were observed by HE staining and oil red O staining.Results Compared with the normal group,the levels of serum ALT,AST,FPG,FINS,HbAlc,HOMA-IR,TC,TG,LDL-C and the relative expression of G-6-Pase and FoxO1 proteins in liver tissues of the rats of the model group were significantly increased(all P<0.05),and the levels of serum HDL-C and the relative expression of IRS1 in liver tissues were significantly decreased(all P<0.05);HE staining showed that the nuclei of hepatocytes in the model group were sh

关 键 词：2型糖尿病 非酒精性脂肪肝病 健脾理气活血方 葡萄糖-6-磷酸酶 叉头转录因子O1 胰岛素受体底物1 

分 类 号：R-332[医药卫生]