石斛治疗糖尿病脑内微小病变的临床研究及药效学验证OA

Objective To evaluate the therapeutic efficacy of the traditional Chinese medicine Dendrobium for diabetic cerebral microangiopathy and preliminarily explore its underlying mechanisms through clinical studies in patients with diabetic cerebral microangiopathy and pharmacodynamic validation in rat model.Methods A total of 121 patients with diabetic cerebral microangiopathy were enrolled in the clinical study,including 62 in study group and 59 in control group.Both groups received as-pirin enteric-coated tablets as the baseline treatment;the study group additionally received Dendrobi-um granules,while the control group received a placebo of Dendrobium granules.Clinical efficacy rates,lipid metabolism profiles,glucose metabolism parameters and inflammatory cytokine levels were compared between the two groups before and after treatment.For the animal experiment,a rat model of diabetic cerebral microangiopathy was established,and 40 Wistar rats were randomly divid-ed into normal control group,hyperglycemic injury group,aspirin injury group and Dendrobium pol-ysaccharide group.Changes in cerebral microangiopathy in diabetic rats were assessed using bio-chemical assays,cerebral histopathological examinations,and cranial MRI.Results In the clinical study,the post-treatment clinical efficacy rate in the study group was 77.4％,which was signifi-cantly higher than 57.6％in the control group(P＜0.05).After treatment,the study group exhibi-ted significantly greater reductions in total cholesterol(TC),triglycerides(TG),low-density lipo-protein cholesterol(LDL-C)and apolipoprotein B,as well as reductions in glycated hemoglobin(HbA1c),fasting blood glucose(FBG)and 2-hour postprandial blood glucose(2 h PG),com-pared with the control group(P＜0.05).The study group also showed a significantly greater in-crease in superoxide dismutase(SOD)level and greater reductions in interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels compared with the control group(P＜0.05).In the animal experiment,compared with the hyperglycemic injury group,the aspirin injury and Dendrobium poly-saccharide groups exhibited significantly lower nuclear factor-kappa B(NF-κB)levels(P＜0.05).The hyperglycemic injury group had significantly higher vascular endothelial growth factor(VEGF)levels than the normal control group(P＜0.05).Hematoxylin-eosin(HE)staining revealed a marked reduction in neuronal count and significant glial cell proliferation in the hyperglycemic injury group compared with the normal control group.The aspirin injury group showed neuronal loss and glial pro-liferation,while the Dendrobium polysaccharide group exhibited only mild neuronal reduction and glial proliferation.Cranial MRI demonstrated that Dendrobium polysaccharide significantly reduced the number of cerebral microangiopathic lesions in diabetic rats(P＜0.05).Conclusion Dendrobium effectively reduces the number of cerebral microangiopathic lesions and regulates blood glucose and lipid levels in patients with diabetic cerebral microangiopathy.