ABSTRACT
Objective To investigate the effects of angelica lactone combined with Xiaoke pill on blood glucose regulation, renal protection and vascular endothelial growth factor signal pathway in diabetic nephropathy rats. Methods Totally 75 rats were randomly divided into control group, model group, Xiaoke pill group, angelica lactone group and angelica lactone combined with Xiaoke pill group, with 15 rats in each group. Except for the control group, the rest of the rats established diabetic nephropathy model. Rats in Xiaoke pill group, angelica lactone group and angelica lactone combined with Xiaoke pill group were given Xiaoke pill (0.8 g/kg), angelica lactone (20 mg/kg), Xiaoke pill (0.8 g/kg) combined with angelica lactone (20 mg/kg), respectively, once for 8 weeks. The levels of 24-hour urinary protein, fasting and postprandial blood glucose, glycosylated serum albumin and glycosylated hemoglobin, fasting insulin and insulin sensitivity index, serum creatinine (SCr) and urea nitrogen (BUN) were measured. The levels of insulin (INS) and glucose-6-phosphatase (G6Pase) mRNA in islet tissue were measured by Real-time PCR. Renal histopathological changes were detected by HE staining. The levels of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor 2 (VEGFR2) in rat kidney were detected by Western blotting and immunohistochemistry. Results Compared with the model group, 24-hour urinary protein, fasting and postprandial blood glucose, glycosylated serum albumin and glycosylated hemoglobin, fasting insulin, SCr and BUN, VEGF and VEGFR2 protein levels and relative integral absorbance of kidney tissue in angelica lactone combined with Xiaoke pill group were significantly lower than those in model group(P<0.05). The insulin sensitivity index, the levels of INS and G6Pase mRNA in islet tissue were significantly increased (P < 0.05), and the renal histopathology of diabetic nephropathy rats was significantly improved. Conclusion Angelica lactone combined with Xiaoke pill can reduce blood glucose level, increase insulin sensitivity index, and its mechanism may be related to the regulation of VEGF signal pathway.
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OBJECTIVE: To explore the synergistic molecular network mechanism of Chinese medicine ingredients and glibenclamide from Xiaoke pill for the treatment of diabetes mellitus. METHODS: After obtained diabetic-related genes of Xiaoke pill, STRING software was used to construct biomolecular network, DAVID software was used to identify KEGG pathways, Cytoscape software was used to construct the network for Xiaoke pill ingredients-key target-disease related pathway. RESULTS: The results showed that Xiaoke pill targeted 123 diabetic-related genes. Glibenclamide mainly affected pathways involved in type 2 diabetes, whereas Chinese medicine ingredients from Xiaoke pill was associated with inflammatory-related pathways such as TNF, Jak-STAT, NF-kB and cytokine pathway, islet β cell-related pathways such as PI3K/Akt, mTOR and MAPK pathway, AGE-RAGE and metabolic pathways. By combining Chinese medicine ingredients and glibenclamide, Xiaoke pill widely targeted diabetic-related pathways. CONCLUSION: It indicates that Xiaoke pill, a combination of traditional Chinese and Western medicine, can prevente diabetes and diabetic syndrome possibly by improving insulin resistance and protecting β cells and inhibiting inflammatory response.
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OBJECTIVE:To systematically review the efficacy and safety of Xiaoke pill versus glibenclamide in the treatment of type 2 diabetes mellitus,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Medline, PubMed,EMBase,Cochrane Library,CBM,CJFD,Wanfang Database and VIP Database,randomized controlled trials (RCT) about the Xiaoke pill(test group)versus glibenclamide(control group)in the treatment of type 2 diabetes mellitus were enrolled. Meta-analysis was performed by using Rev Man 5.2 software after document selection,data extract and quality assessment by Co-chrane systematical evaluation. RESULTS:A total of 15 RCT were included,involving 3 319 patients. Results of Meta-analysis showed the hemoglobin A1c (HbA1c) level [MD=-0.39,95%CI(-0.75,-0.02),P=0.04],fasting plasma glucose (FPG) level [MD=-0.70,95%CI(-1.27,-0.12),P=0.02],2 h PG[MD=-0.87,95%CI(-1.55,-0.20),P=0.01],incidence of thirst with desire for drinks [RR=3.35,95%CI(1.92,5.85),P<0.001],incidence of tiredness and debilitation[RR=5.74,95%CI(3.52, 9.36),P<0.001] and incidence of hypoglycemia [RR=0.67,95%CI(0.49,0.91),P=0.01] in test group were significantly lower than control group,the differences were statistically significant. CONCLUSIONS:Xiaoke pill has better efficacy and safety than glibenclamide in the treatment of type 2 diabetes mellitus,can obviously improve the HbA1c,FPG,2 h PG tevel and TCM symp-toms.
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Objective To further assess the therapeutic effect and safety of Xiaoke Pill (XP) in treating type 2 diabetes mellitus with qi and yin deficiency. Methods A multicentre randomized controlled trial was adopted. Three hundred and four cases were treated with XP and one hundred and one cases treated with glibenclamide troche served as control. Results In XP treatment group, the remarkably effective rate in relieving symptoms was 45. 07 % and the effective rate was 48. 68 % , the differences being significant as compared with that in the control group ( P