半夏泻心汤调节2型糖尿病人GLP-1和β细胞功能的分子机制

肠促胰岛素和胰岛β细胞功能紊乱，以及肠道菌群失调是2型糖尿病病因学新热点，而调和胃肠法一直是中医治疗糖尿病的传统法则。本研究在前期研究的基础上，以2型糖尿病人为研究对象，将符合胃气不和证患者随机分为半夏泻心汤（BXXXT）组、GLP-1类似物组、格列美脲组和安慰剂组，于入组、4周、8周、16周，动态采集血浆和血清，检测GLP-1、Fins、HOMA-IR、Resistin等指标，证实BXXXT能提高患者体内GLP-1水平，增加胰岛β细胞量，从而达到降低血糖的目的。检测血浆脂多糖等反应人类2型糖尿病肠道菌群因素的关键指标，证明BXXXT提高血浆GLP-1水平是通过调节肠道菌群实现的。同时进行BXXXT对人胰岛β细胞凋亡的研究，通过凋亡蛋白Caspase-3及抗凋亡因子bcl-2的表达，证实其提高GLP-1、抗凋亡的作用。

Incretin, dysfunction of pancreatic islet beta cell, and intestinal flora imbalance are all hot topics in the etiology of type 2 diabetes, while the method of modulating gastrointestine has been the traditional therapy for diabetes in TCM. On the basis of previous research, this study, with newly diagnosed type 2 diabetes patients with syndrome of disorder of stomach qi as subjects, which were randomly divided into four groups, i.e. Ban-Xia-Xie-Xin-Tang decoction(BXXXT) group, the GLP-1 analogue group, Glimepiride group and the placebo group, and with dynamic acquisition of plasma and serum in the day of initially enlisting, 4th week, 8th week, and 16th weeks, to detect indices such as GLP-1, Fins, HOMA IR, Resistin, etc., was designed to confirm that BXXXT can elevate GLP-1 levels and increase the amount of islet beta cells in the patients, so as to achieve the purpose of lowering blood sugar. By detection of key indicators reflecting human intestinal flora in type 2 diabetes, such as plasma lipopolysaccharide, etc., this study confirmed that the therapeutic effect of elevating GLP-1 levels of BXXXT is achieved by regulating intestinal flora. At the same time, by detecting the apoptosis of human islet beta cells, this study also confirmed that the effects of BXXXT in elevating GLP-1 and anti-apoptosis are by modulating the expression of apoptosis protein Caspase -3 and antiapoptotic factor BCL-2.