健脾疏肝方对非酒精性脂肪性肝炎大鼠胰岛素抵抗的影响

Effect of Jianpi Shugan Decoction on insulin resistance in rats with nonalcoholic steatohepatitis

目的:观察健脾疏肝方对非酒精性脂肪性肝炎(NASH)大鼠胰岛素抵抗的影响,并探讨其作用机制。方法:40只SD雄性大鼠中随机选择34只给予高脂饲料建立NASH模型,其余6只大鼠作为正常组喂食普通饲料。将NASH造模成功后的大鼠随机分为模型组、健脾疏肝方低、中、高剂量组、多烯磷脂酰胆碱(易善复)组。模型组和正常组给予去离子水灌胃,中药各实验组给予健脾疏肝方低、中、高剂量颗粒剂灌胃,易善复组给予易善复混悬液灌胃,1次/d,连续干预4周。测定各组大鼠给药后的体重、血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、血清甘油三脂(TG)、血清胆固醇(TC)水平,测定血清脂联素(ADPN)、空腹血糖(FPG)、血清胰岛素(FINS)水平,计算胰岛素抵抗指数(HOMA-IR),计算肝脏指数(肝湿重/总体重×100%),苏木精-伊红染色和油红O染色观察肝脏组织病理变化。结果:正常组及各实验组大鼠的体重均低于模型组,差异有统计学意义(P<0.05)。健脾疏肝方中、高剂量组及易善复组血清ALT、AST水平较模型组显著降低,健脾疏肝方低、中剂量组血清TC水平较模型组显著降低,健脾疏肝方高剂量组血清TG水平较模型组显著降低,差异有统计学意义(P<0.05)。健脾疏肝方中、高剂量组及易善复组ADPN水平均高于模型组,差异有统计学意义(P<0.05)。健脾疏肝方中、高剂量组FPG、FINS、HOMA-IR均高于正常组,低于模型组,健脾疏肝方低剂量组HOMA-IR低于模型组,易善复组FINS、HOMA-IR低于模型组,均差异有统计学意义(P<0.05)。结论:健脾疏肝方能有效改善NASH大鼠的肝酶、肝脂、FPG、FINS,降低HOMA-IR,升高ADPN,从而起到调节脂质代谢,减轻胰岛素抵抗的作用。

Objective: To observe the effect of Jianpi Shugan Decoction on insulin resistance in rats with nonalcoholic steatohepatitis(NASH) and explore its mechanism. Methods: Thirty four male SD rats were randomly selected and fed with high-fat diet to establish NASH model, and the other 6 rats were fed with normal diet as normal group. The rats were randomly divided into model group, Jianpi Shugan Decoction low, medium and high dose groups, polyene phosphatidylcholine(yishanfu) group. The model group and normal group were given deionized water by gavage, the experimental groups of Traditional Chinese Medicine were given Jianpi Shugan Decoction low, medium and high dose granules, and the yishanfu group was given yishanfu suspension by gavage, once a day for 4 weeks. The body weight, serum alanine aminotransferase(ALT), aspartate aminotransferase(AST), serum triglyceride(TG), serum cholesterol(TC), adiponectin(ADPN), fasting plasma glucose(FPG), serum insulin(FINS) were measured, and the insulin resistance index(HOMA) was calculated assessment for insulin resistance(HOMA-IR), liver index(liver wet weight/total weight × 100%), HE and oil red O staining were used to observe the pathological changes of liver tissue. Results: The body weight of normal group and each experimental group was lower than that of model group(P<0.05). The serum levels of ALT and AST in the middle and high dose groups of Jianpi Shugan Decoction and yishanfu group were significantly lower than those of the model group, the serum TC level of the low and middle-dose groups of Jianpi Shugan Decoction was significantly lower than that of the model group, and the serum TG level of the high-dose Jianpi Shugan Decoction group was significantly lower than that of the model group(P<0.05). The average ADPN level of Jianpi Shugan Decoction group was higher than that of model group(P<0.05). The levels of FPG, FINS and HOMA-IR in the middle and high dose groups of Jianpi Shugan Decoction were higher than those in the normal group and lower than those in the model group. The levels of HOMA-IR in the low-dose Jianpi Shugan Decoction group were lower than those in the model group, and the levels of fins and HOMA-IR in the yishanfu group were lower than those in the model group(P<0.05). Conclusion: Jianpi Shugan Decoction can effectively improve liver enzymes, liver fat, FPG, FINS, reduce HOMA-IR and increase ADPN, thus regulating lipid metabolism and reducing insulin resistance.