补肾降浊饮及其拆方改善非酒精性脂肪肝大鼠胰岛素抵抗的机制研究  

Mechanism of the Bushen Jiangzhuo decoction and its disassembled prescriptions in improving insulin resistance in rats with nonalcoholic steatohepatitis

作　　者：吕宝伟[1] 冯春青[1] 杨昊 谷万里[1] 李延辉[1] LYU Baowei

机构地区：[1]聊城市人民医院,山东聊城252000

出　　处：《中医临床研究》2023年第4期70-75,共6页Clinical Journal Of Chinese Medicine

基　　金：山东省中医药科技发展计划项目(2017-493)。

摘　　要：目的:研究补肾降浊饮及其拆方对非酒精性脂肪性肝炎(Nonalcoholic Steatohepatitis,NASH)大鼠胰岛素抵抗(Insulin Resistance,IR)的影响,探讨补肾降浊饮及其拆方对胰岛素信号通路相关细胞因子及激酶的影响。方法:将60只SD大鼠随机分为正常组、模型组、补肾组、降浊组、补肾降浊饮组及西药组,正常组予普通饲料喂养,其余各组予高脂饲料喂养并分别灌胃生理盐水或相应剂量药物干预。12周后检测对比各组大鼠血清胆固醇(Total Cholesterol,TC)、三酰甘油(Triglyceride,TG)、丙氨酸氨基转移酶(Alanine Aminotransferase,ALT)、天门冬氨酸氨基转移酶(Aspartate Aminotransferase,AST)、空腹血糖(Glucose,GLU)、胰岛素(Insulin,INS)水平、胰岛素抵抗指数(Insulin Resistance Index,IRI)、胰岛素敏感指数(Insulin Sensitivity Index,ISI)水平及血清脂联素(Adiponectin,ADP)、瘦素(Leptin,LEP)、肿瘤坏死因子(Tumor Necrosis Factor,TNF)-α、白细胞介素(Interleukin,IL)-6水平;油红O染色检测肝组织脂肪变性程度,糖原染色检测肝组织糖原含量;Western-blot法检测肝组织中c-Jun氨基端激酶1(c-Jun N-terminal Kinase 1,JNK1)、磷酸化c-Jun氨基末端激酶(Phospho-c-Jun N-terminal Kinase,p-JNK)及胰岛素受体α(Insulin Receptor alpha,IRα)、磷酸化胰岛素受体底物1(Phospho-insulin Receptor Substrate-1,p-IRS-1)表达水平。结果:中药各组均可不同程度改善大鼠血清中TC、TG、ALT、AST及GLU、INS、IRI、ISI水平(P<0.05,P<0.01),亦能不同程度影响血清ADP、LEP、TNF-α、IL-6含量及肝组织JNK1、p-JNK、IRα及p-IRS-1表达水平(P<0.05,P<0.01)。中药各组在改善GLU、INS、IRI、ISI及p-IRS-1方面均优于西药组(P<0.05,P<0.01);其中补肾组在改善TC、TG、ADP、LEP方面优于西药组(P<0.05,P<0.01);降浊组在改善ALT、AST、TNF-α、IL-6方面优于西药组(P<0.05,P<0.01);补肾降浊饮组在各方面均优于西药组(P<0.01)。结论:补肾降浊饮可明显改善NASH大鼠IR,其�Objective:To study the effects of the Bushen Jiangzhuo decoction(补肾降浊饮)and its disassembled prescriptions on IR in rats with NASH,and to investigate the effects of the Bushen Jiangzhuo decoction and its disassembled prescriptions on cytokines and kinases related to insulin signaling pathway.Methods:A total of 60 SD rats were randomly divided into the blank group,the model group,the Bushen(补肾)group,the Jiangzhuo(降浊)group,the Bushen Jiangzhuo decoction group and the western medicine group.The blank group was fed with normal diet,the other groups were fed with high fat diet and normal saline or the corresponding dose of medicine.All the rats were put to death after 12 weeks,the levels of TG,TC,ALT,AST,GLU,INS,IRI,ISI in serum and ADP,LEP,TNF-α,and IL-6 in serum were detected.Fatty degeneration of liver tissue was detected by oil red O staining,glycogen content in liver tissue was detected by glycogen staining.The expression levels of JNK1,IRα,p-JNK and p-IRS-1 were detected by Western-blot method.Results:Each group of TCM medicine can improve the level of serum TC,TG,ALT,AST and GLU,INS,IRI,ISI in varying degrees(P<0.05,P<0.01),also affect the level of ADP,LEP,TNF-α,IL-6 content and JNK1,p-JNK and p-IRS-1 expression in liver(P<0.05,P<0.01).Compared to the western medicine group,the Bushen group was superior in changing TC,TG,ADP and LEP(P<0.05,P<0.01),the Jiangzhuo group was superior in improving ALT,AST,TNF-αand IL-6(P<0.05,P<0.01),and the Bushen Jiangzhuo decoction group was superior in all aspects(P<0.01).Conclusion:The Bushen Jiangzhuo decoction can improve IR of NASH rats,it works by the Bushen group regulating the levels of ADP and LEP of adipocytes,and the Jiangzhuo group regulating the levels of TNF-α,IL-6,JNK1 and p-JNK of inflammatory factors,it enhances the activity of insulin receptor substrates and thus improve insulin signal transduction.

关 键 词：非酒精性脂肪性肝炎 胰岛素抵抗 胰岛素信号通路 补肾降浊饮 补肾组 降浊组 

分 类 号：R575.5[医药卫生—消化系统]