脉管复康片联合糖痹外洗方对糖尿病血管病变的疗效及其机制  

Effects and mechanism of Maiguan Fukang Tablets combined with Tangbi Waixi Prescription on diabetic angiopathy

作　　者：申永叶 李颖 宋紫腾 李烨玲 赵怡楠 张涵 郭远强[2] SHEN Yong-ye;LI Ying;SONG Zi-teng(Tianjin University of Traditional Chinese Medicine,Tianjin(301617),China;不详)

机构地区：[1]天津中医药大学,天津301617 [2]南开大学药学院,天津300350

出　　处：《中国中西医结合外科杂志》2023年第4期440-444,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：国家重点研发计划“中医药现代化研究”重点专项项目“糖尿病足中西医结合防治方案的循证评价及疗效机制研究”(2019YFC1709300)子课题:糖尿病足防治关键环节的中医药疗效机制研究(2019YFC1709305)。

摘　　要：目的:建立糖尿病大鼠下肢缺血模型,研究脉管复康片联合糖痹外洗方对糖尿病大鼠血管内皮损伤的疗效及其作用机制。方法:选取50只大鼠中的8只为正常对照组,余下大鼠采用高脂饮食联合腹腔注射链脲佐菌素法建立大鼠糖尿病模型,结扎大鼠左后肢股动脉,建立下肢缺血模型。取造模成功的32只大鼠,随机分为模型组和高、中、低剂量给药组,每组8只。给药21 d后处死大鼠,取其血样及左后肢腓肠肌组织,检测血清中血栓素A2(TXA2)、内皮素(ET)-1、一氧化氮(NO)、内皮型一氧化氮合成酶(eNOS)、血管内皮生长因子(VEGF)、血管细胞黏附分子-1(sVCAM-1)、C反应蛋白(CRP)含量;HE染色观察缺血后肢肌细胞形态;CD31免疫组织化学染色检测术侧腓肠肌微血管形成数量。结果:经给药治疗后,大鼠腓肠肌组织HE染色未见明显萎缩坏死,血管内皮功能趋于正常。与模型组相比,脉管复康片高、中、低剂量组大鼠血清中TXA2水平均显著降低(P<0.01);eNOS水平均显著升高(P<0.001);ET-1水平均有下降,高剂量组最显著(P<0.001);高剂量组NO水平显著上升(P<0.001);高、中剂量组VEGF水平明显上升(P<0.01);免疫组化结果显示,相比于模型组大鼠,脉管复康片高剂量组腓肠肌微血管形成数量显著增加(P<0.01)。结论:脉管复康片联合糖痹外洗方主要通过调节TXA2、ET-1、NO水平,维持血管内皮功能,并增加VEGF的表达,促进微血管新生,最终改善糖尿病后肢缺血。Objective To establish the hind limb ischemia model in diabetic rats and explore the effects of Maiguan Fukang tablets combined with Tangbi Waixi Prescription on vascular endothelial injury in diabetic rats and its role in promoting angiogenesis.Methods The rat diabetes model was established by high fat diet and intraperitoneal injection of streptozotocin.Based on the measurement of blood glucose levels,the successfully modeled rats were ligated with the left hind limb femoral artery to establish the lower limb ischemia model of diabetic rats.After modeling,the model rats were randomly divided into the model group,Tangbi Waixi Prescription combined with Maiguan Fukang tablets high,medium,and low dose group.After 21 days of administration,the rats were sacrificed and blood samples and left hind limb gastrocnemius muscle tissues were taken.The levels of TXA2,ET-1,NO,eNOS,VEGF,sVCAM-1,and CRP were detected by ELISA.HE staining was used to observe the morphology of muscle cells.The expression of the CD31 marked microvascular density was determined by immunohistochemical staining.Results After treatment with Maiguan Fukang Tablets combined with Tangbi Waixi Prescription,no obvious atrophy and necrosis were found in the gastrocnemius muscle tissue of rats by HE staining,and the vascular endothelial function tended to be normal.When compared with the model group,the changes of relevant indicators were as follows.The TXA2 levels in the serum of rats in the high-,medium-,and low-dose groups were significantly reduced(P<0.01).The levels of eNOS significantly increased(P<0.001).The levels of ET-1 all decreased,with the highest dose group being the most significant(P<0.001).The NO levels in the high-dose group significantly increased(P<0.001).There was a significant increase in VEGF levels in the high-and medium-dose groups(P<0.01).The immunohistochemical results showed that the high-dose group showed a significant increase in number of microvasculature formation(P<0.01).Conclusion Maiguan Fukang Tablets combined with Tangbi

关 键 词：糖尿病 下肢缺血模型 血管内皮功能 血管新生 脉管复康片 糖痹外洗方 

分 类 号：R285.5[医药卫生—中药学] R654.4[医药卫生—中医学]