Analysis of Chinese medicine syndrome pattern in patients with type 2 diabetes mellitus and its relationship with diabetic chronic complications / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To analyze the Chinese medicine (CM) syndrome pattern of patients with type 2 diabetes mellitus (DM2) and the relationship of CM patterns with the different blood glucose levels controlled and the incidences of diabetic chronic complications.</p><p><b>METHODS</b>CM syndromes in 557 DM2 patients were sorted into 7 patterns, A: the Fei-Wei yin-deficiency with exuberant heat pattern; B: the Pi-qi deficiency pattern; C: the Shen-qi deficiency pattern; D: the Pi-Shen qi-deficiency pattern; E: the Gan-Shen yin-deficiency pattern; F: the both qi-yin deficiency pattern; and G: the both yin-yang deficiency pattern, the concurrent or accompanied excessive syndromes were not taken as the indication for sorting. The blood glucose level, duration of illness and incidence of diabetic chronic complications in patients of different patterns were compared.</p><p><b>RESULTS</b>The CM syndrome patterns commonly encountered in mostly of the 557 patients was pattern F (in 264 patients, accounting for 47.4%); the next was pattern C (95 patients, 17.1%) and E (92 patients, 16.5%). The concurrent syndromes appeared in most patients was blood stasis (501 patients, 89.9%), Gan-qi stagnation was the second (225 patients, 40.4%), and the portion of damp-heat syndrome was also rather large (180 patients, 32.3%). The duration of diabetes mellitus for patients with various patterns was significantly different (P < 0.01), the longest appeared in patients of pattern G, followed by pattern D, C, F, and E in sequence, and patients of pattern A and B had a rather shorter duration. Level of fasting blood glucose was rather higher in patients of pattern A, C, D, F, and G than in those of pattern B and E. Level of glycosylated hemoglobin in patients of pattern G was the highest and in pattern A the second, while in pattern B and E was rather lower. Incidences of diabetic chronic complications, including diabetic peripheral neuropathy, diabetic retinopathy, diabetic nephropathy, cerebral infarction, and atherosclerosis in patients of pattern A and B were lower than in those of other 5 patterns (P < 0.05); but the highest incidence of multiple chronic complications revealed in pattern D and G, and that of coronary heart disease revealed in pattern C and G, all showed significant different as compared with other patterns (P < 0.01).</p><p><b>CONCLUSION</b>The most commonly encountered CM syndrome patterns in DM2 patients of early stage are pattern A and B; and those of middle stage are pattern C, D, E and F, various diabetic chronic complications may reveal in this stage; pattern G could be found in patients accompanied with multiple chronic complications and with uncontrolled blood glucose for a long time.</p>

Effect of Tujian decoction on protein kinase C activity in renal cortex in diabetic rat / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate influence of administration of Tujian decoction (Chinese herbal medicine) on protein kinase C (PKC) activity, renal function and structure in diabetic rat kidney.</p><p><b>METHOD</b>Experimental diabetic nephropathy model was induced by nephrectomy combined with streptozotocin (STZ) injection in sprague-dawley rat. Tujian decoction (20 g x kg(-1) x d(-1)) and Valsartan (20 mg x kg(-1) x d(-1)) were orally administrated respectively for 12 weeks. PKC activity was measured by [3H]phorbol 12, 13-dibutyrate ([3H]PDBu) binding assay. 24 h urine protein excretion (Upro) and renal pathological changes were observed.</p><p><b>RESULT</b>In 12th week, diabetic nephrectomized rats developed proteinuria, glomerulosclerosis, increased membrane PKC activity (mPKC), decreased cytosol PKC (cPKC), and increased ratio of mPKC and cPKC (M/C). Administration of Tujian decoction or Valsartan led to a reduction in proteinuria, structural injury, mPKC and M/C, and a recovery in cPKC.</p><p><b>CONCLUSION</b>Tujian decoction possesses a renoprotective effect on diabetic nephrectomized rat, at least partially via the inhibition of PKC activation in renal cortex.</p>

Phenotypic modulation of mesangial cells in diabetic rats and effect of tujian mixture / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore whether there is phenotypic modulation of mesangial cells in streptozotocin (STZ) induced diabetic rats and study the effect of Tujian Mixture (TJM) on it.</p><p><b>METHODS</b>SD rats were divided into the normal control group (NC group, n = 8), the unilateral nephrectomized control group (QC group, n = 8), the STZ induced diabetes mellitus with unilateral nephrectomy model group (DM group, n = 8), the Valsartan treated group (VT group, n = 8) and the TJM treated group (ZY group, n = 9), rats in the latter two groups were modeled as in the DM group and treated with Valsartan (20 mg/kg.d) and TJM (20 g/kg.d) respectively for 12 weeks. The expression of alpha-smooth muscle actin (alpha-SMA) and transforming growth factor-beta 1 (TGF-beta 1) in rats glomeruli were observed by immunohistochemistry assay, and the ratio of alpha-SMA and TGF-beta 1 positive area/total glomerule tuft area (SMA/GT and TGF/GT) were analyzed using computer-assisted image analysis software.</p><p><b>RESULTS</b>In the NC and the QC groups, only trace of alpha-SMA positive staining was found. But there was prominant alpha-SMA positive staining in glomeruli of the DM group, with SMA/GT and TGF/GT increased significantly (P < 0.01), and marked increase of 24 hrs proteinuria excretion (P < 0.01). As compared with the DM group, the three indexes were all significantly lower in the VT and ZY groups (P < 0.01), and the lowering of proteinuria was more significant in the ZY group than that in the VT group (P < 0.01).</p><p><b>CONCLUSION</b>The expression of alpha-SMA in glomeruli in STZ induced diabetic rats with unilateral nephrectomy is pronounced, indicating that phenotypic modulation of mesangial cells involvement in the pathogenesis of diabetic nephropathy. TJM and Valsartan can reduce 24 hrs proteinuria excretion, inhibit the phenotypic modulation of mesangial cells and the expression of TGF-beta 1 in glomeruli of diabetic rats, and the effect of TJM is more potent than that of Valsartan in lowering urinary protein excretion.</p>