【摘要】：目的:采取祛胰抵方治療糖尿病周圍神經(jīng)病變(DPN),觀察其臨床療效及對胰島素樣生長因子(IGF-1)的影響,探討其治療DPN的可能機制。方法:選取70名符合氣陰兩虛、痰瘀阻絡(luò)型DPN患者,采用隨機數(shù)字表法分為兩組,患者均采用降糖治療,如血壓、血脂異常者,合并降壓、調(diào)脂等治療,對照組(n=35)應(yīng)用甲鈷胺片口服500 ug,3次/日;治療組(n=35)在對照組基礎(chǔ)上聯(lián)用祛胰抵方,水煎300ml,150ml/袋,早晚各1袋,溫服,共12周。觀察治療前和治療后兩組的療效指標的變化,包括神經(jīng)傳導(dǎo)速度雙側(cè)腓淺神經(jīng)MCV、雙側(cè)腓總神經(jīng)SCV)、10g尼龍絲檢查、中醫(yī)證候積分、血脂及血清IGF-1的變化。結(jié)果:1、治療后,兩組患者的中醫(yī)證候積分與治療前相比均有所改善(P0.05),且治療組的中醫(yī)證候積分改善情況優(yōu)于對照組(P0.05)。單項中醫(yī)癥狀評分改善方面,兩組分別與治療前比較(P0.05),差異有統(tǒng)計學(xué)意義;治療后,肢體麻木、口干口渴、乏力、氣短懶言、自汗盜汗、五心煩熱等癥狀組間比較(P0.05),差異有統(tǒng)計學(xué)意義;2、治療后,兩組患者的神經(jīng)傳導(dǎo)速度與治療前相比均有所改善(P0.05),治療組改善腓淺神經(jīng)MCV、腓總神經(jīng)SCV的情況優(yōu)于對照組(P0.05);兩組患者壓力覺檢查情況與治療前相比均有所改善(P0.05),且治療組優(yōu)于對照組(P0.05)。3、治療組血脂改善情況優(yōu)于對照組(P0.05)。4、治療后,兩組患者血清IGF-1均高與治療前(P0.05),治療組IGF-1水平上調(diào)的情況優(yōu)于對照組(P0.05)。結(jié)論:埅胰抵方可有效改善DPN患者氣陰兩虛、痰瘀阻絡(luò)中醫(yī)證候積分及中醫(yī)臨床癥狀,尤其在肢體麻木、口干口渴、乏力、五心煩熱、氣短懶言、自汗盜汗等癥;埅胰抵方可有效改善患者神經(jīng)傳導(dǎo)速度、壓力覺;埅胰抵方通過降低TG、TC、LDL-C,升高HDL-C調(diào)節(jié)血脂紊亂;埅胰抵方可升高DPN患者IFG-1的水平;埅胰抵方對DPN患者癥狀、體征的改善,其機制可能與血清IGF-1的上調(diào)有關(guān)。
[Abstract]:Objective: to observe the clinical effect of Quyi decoction in the treatment of diabetic peripheral neuropathy (DPN),) and its effect on insulin-like growth factor (IGF-1), and to explore the possible mechanism of the treatment of DPN. Methods: 70 DPN patients with Qi and Yin deficiency and phlegm stasis obstruction were divided into two groups by random digital table. All patients were treated with hypoglycemic therapy, such as blood pressure, abnormal blood lipid, combined hypotension, lipid regulation and so on. The control group (NQ35) was treated with methylcobalamin tablets (500 ug,3 / d) and the treatment group (NN35) was treated with QUYJI recipe on the basis of the control group, decoction 300ml / bag, 1 bag in the morning and evening, 1 bag in the morning and evening, warm for 12 weeks. To observe the changes of curative effect indexes before and after treatment, including nerve conduction velocity (NV) of bilateral superficial peroneal nerve (MCV,) and bilateral common peroneal nerve (SCV) 10 g Nilon examination, TCM syndromes integral, blood lipid and serum IGF-1. Results: after treatment, the TCM syndrome scores of the two groups were improved (P0.05), and the improvement of TCM syndromes in the treatment group was better than that in the control group (P0.05). Single TCM symptom score improvement, the two groups were compared with before treatment (P0.05), the difference was statistically significant; after treatment, limb numbness, dry mouth thirst, fatigue, shortness of breath, lazy speech, self-sweat night sweat, There was a significant difference between the five upset heat groups (P0.05). After treatment, The nerve conduction velocity of the two groups was improved compared with that before treatment (P0.05). The improvement of SCV of the common peroneal nerve of MCV, in the treatment group was better than that of the control group (P0.05). The treatment group was superior to the control group (P0.05). 3. The improvement of blood lipid in the treatment group was better than that in the control group (P0.05) .4.After treatment, Serum IGF-1 in both groups was higher than that before treatment (P0.05). The up-regulation of IGF-1 in the treatment group was better than that in the control group (P0.05). Conclusion: Qi-Yin deficiency, phlegm and stasis obstruction of collaterals and clinical symptoms of TCM were effectively improved in patients with DPN, especially in limb numbness, dry mouth thirst, fatigue, five upset heat, short breath and lazy speech, self-sweating and night sweating, etc. It can effectively improve the nerve conduction velocity and pressure sense of the patients; Qianyaifang adjusts the disorder of blood lipids by reducing TG,TC,LDL-C, and increasing HDL-C; the Yanyi Jiefang can increase the level of IFG-1 in patients with DPN; the symptoms and signs of patients with DPN are improved by Qianyan Ji Fang, and the symptoms and signs of the patients with DPN are improved. The mechanism may be related to the upregulation of serum IGF-1.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R587.2

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