健脾疏肝法防治代谢综合征时机的探讨

Occasion for treating metabolic syndrome with therapy of fortifying spleen and soothing liver

目的探讨健脾疏肝法防治代谢综合征的最佳给药时机。方法采用高脂高糖高盐饮食喂养方法复制大鼠代谢综合征模型,并分为模型组、中药组、罗格列酮组和正常组。中药组给予柴芪汤,按给药时间不同分为造模开始时给药(中药1组)和造模后第9周给药(中药2组)2组,给药量均为5.71 g/(kg.d);对照组(罗格列酮组)从造模开始即给予罗格列酮,给药量为1.2 mg/(k.d)(给药剂量按大鼠的体表面积进行计算)。观察不同组别、不同时间大鼠的一般情况,实验室指标及血管组织学变化。用生化法检测血脂(TC、TG、HDC、LDC-C)、空腹血糖(FBG),放免法检测空腹胰岛素(FINS),HE染色法观察血管的病理组织学改变。结果模型组大鼠一般情况逐渐变差,第8周代谢综合征造模成功。中药1组及罗格列酮组一般情况、血脂、血糖、胰岛素敏感性和血管病理学等指标均优于模型组。中药1组与罗格列酮组相比,在改善总胆固醇、降糖及改善胰岛素敏感性方面无统计学差异,但其余指标改善情况均优。中药1组与中药2组比较,在血脂、胰岛素敏感性和血管病理学等指标均优于中药2组。结论健脾疏肝法治疗代谢综合征疗效明显,早期连续治疗对于预防并干预代谢综合征的出现和进展十分重要。

Objective To investigate the best occasion for treating metabolic syndrome with the therapy of fortifying spleen and soothing liver. Methods The rat model of metabolic syndrome was established by using feeding method of high fat, sugar and salt diet and all rats were divided into the model group, Chai Qi Tang group, rosiglitazone group and normal group. Chai Qi Tang group was given Chai Qi Tang （5.71 g/kgod） and divided into the Chai Qi Tang group 1 （after modeling） and Chai Qi Tang group 2 （9 weeks after modeling ） according to the different time points of medicinal administration. The rosiglitazone group was given rosiglitazone （ 1.2 mg/kgod ） at the beginning of modeling. The general condition was observed in rats of different groups at different time points. The levels of blood fat and fasting plasma glucose were detected by using biochemistry assay, fasting insulin was detected by using radioimmunoassay, and the changes of vascular pathohistology was observed by using HE staining. Results The general condition of rat became poor gradually in the model group, and the model of metabolic syndrome was established successfully on the 8th week. The indexes of general condition, blood fat, fasting plasma glucose, insulin sensitivity and vascular pathohistology were all better in the Chai Qi Tang group 1 and rosiglitazone group than those in the model group, lne lmprovcu,c cholesterol （TC）, plasma glucose and insulin sensitivity compared between the Chai Qi Tang group 1 and rosiglitazone group had no statistical difference, but other indexes were better in the Chai Qi Tang group 1 than those in the rosiglitazone group. The indexes of blood fat, insulin sensitivity and vascular pathohistology were all better in the the Chai Qi Tang group 1 than those in the Chai Qi Tang group 2. Conclusion The application of the therapy of fortifying spleen and soothing liver is important to preventing and intervening the progress of metabolic syndrome before its occurrence.