目的 探讨补肾益气方药对充血性心力衰竭大鼠胰岛素抵抗及PKB、脂联素蛋白表达的影响。方法 选用健康雄性Wistar大鼠60只，对照组10只，其余50只均用阿霉素腹腔注射，建立充血性心力衰竭大鼠模型。造模成功后将Wistar雄性大鼠随机分为模型组、卡托普利组（25 mg/kg·d）、补肾益气方药低剂量组（4 g/kg·d）、中剂量组（6 g/kg·d）、高剂量组（8 g/kg·d）。葡萄糖氧化酶法测定空腹血糖（Fasting Blood-Glucose, FBG）；放射性免疫法测定空腹胰岛素（Fasting inshulin, FIS），计算胰岛素敏感性指数（Insulin Sensitivity Index，ISI）；Western Blot 技术检测PKB、脂联素蛋白表达，RT-PCR 方法检测PKB、脂联素的mRNA表达。结果 与空白对照组相比，模型组FBG、FIS显著增加（P < 0.01），ISI显著降低（P < 0.01）；与模型组比较，补肾益气方药高剂量组FBG显著降低（P < 0.05），卡托普利组及补肾益气方药各剂量组FIS明显降低（P < 0.05），卡托普利组及补肾益气方药中高剂量组ISI显著升高（P < 0.05）。与空白对照组相比，模型组心脏、肝脏与骨骼肌组织PKB、脂联素mRNA与蛋白表达均显著下降（P < 0.01）；与模型组比较，卡托普利组及补肾益气方药各组可呈剂量依赖性显著增加PKB、脂联素mRNA与蛋白表达（P < 0.05）。结论 补肾益气方药可能通过增加PKB、脂联素基因转录与及其蛋白表达，改善充血性心衰大鼠胰岛素抵抗，保护心肌细胞，改善心功能。
Objective To investigate the effects of Bushen Yiqi Recipe on insulin resistance and expression of PKB and adiponectin in rats with congestive heart failure. MethodsSixty healthy male Wistar rats were used 10 in the control group and 50 in the other group, which be injected intraperitoneally with doxorubicin to establish the model of congestive heart failure. After successful modeling, Wistar male rats were randomly divided into model group, captopril group (25 mg/kg·d), Bushen Yiqi Recipe low-dose group (4 g/kg·d), middle-dose group (6 g/kg·d)), high-dose group (8g /kg·d). Fasting blood-Glucose (FBG) was detected by glucose oxidase method and fasting insulin (FIS) was detected by radioimmunoassay method, finally Insulin Sensitivity Index (ISI) was calculated through FBG and FIS; Western Blot and real-time quantitative PCR were used to detected PKB and adiponectin protein expression. Results Compared with the blank control group, FBG and FIS in the model group increased significantly (P < 0.01) and ISI decreased significantly (P < 0.01); compared with the model group, FBG in the high dose group of Bushen Yiqi Recipe decreased significantly (P < 0.05), FIS in the captopril group and each dose group of Bushen Yiqi Recipe decreased obviously (P < 0.05), ISI in the captopril group and the medium and high dose group of Bushen Yiqi Recipe increased significantly (P < 0.05). Compared with the blank control group, the expression of PKB and adiponectin in the heart, liver and skeletal muscle tissue of the model group decreased significantly (P < 0.01); compared with the model group, the expression of PKB and adiponectin in the captopril group and the Bushen Yiqi Recipe groups increased significantly in a dose-dependent manner (P < 0.05). Conclusion Bushen Yiqi Recipe effectively decrease insulin resistance, protect cardiomyocytes and improve cardiac function in rats with congestive heart failure by increasing the genes transcription and expression of PKB and adiponectin.