發(fā)布時(shí)間：2018-11-03 14:37

【摘要】：目的:通過采用內(nèi)服中藥(糖通飲)及穴位埋線的方法對糖尿病周圍神經(jīng)病變(diabetic peripheral neuropathy,DPN)大鼠進(jìn)行干預(yù),觀察比較各組大鼠空腹血糖(fasting blood glucose,FBG)、血清神經(jīng)生長因子(nerve growth factor,NGF)、血清轉(zhuǎn)化生長因子β1(transforming growth factor-β1,TGF-β1)、坐骨神經(jīng)動作電位傳導(dǎo)速度及坐骨神經(jīng)病理形態(tài)學(xué)變化,探討糖通飲及穴位埋線治療DPN可能的作用機(jī)理和途徑,為臨床治療及優(yōu)選治療方案提供理論依據(jù)。方法:將大鼠隨機(jī)分為正常組、模型組、埋線組、中藥組、中藥+埋線組(藥埋組),通過高能量飼料喂養(yǎng)聯(lián)合多次小劑量腹腔注射0.1%濃度鏈脲佐菌霉素(Streptozocin,STZ)溶液的方法誘導(dǎo)建立糖尿病周圍神經(jīng)病變大鼠模型,模型成功后根據(jù)分組進(jìn)行相應(yīng)治療。經(jīng)10周治療后,檢測大鼠FBG、坐骨神經(jīng)動作電位傳導(dǎo)速度及血清NGF、TGF-β1變化,并取大鼠坐骨神經(jīng)觀察其病理形態(tài)學(xué)變化。結(jié)果:經(jīng)干預(yù)治療后:1)各治療組大鼠FBG值較模型組降低(P0.05或P0.01),其中藥埋組下降最為明顯(P0.05),其余兩治療組間比較無差異(P0.05);2)三治療組大鼠坐骨神經(jīng)動作電位傳導(dǎo)速度較模型組均有所升高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),但各治療組間神經(jīng)動作電位傳導(dǎo)速度未見明顯差異(P0.05);3)各治療組大鼠血清NGF含量均較模型組明顯升高(P0.01),其中藥埋組血清NGF含量升高最為明顯(P0.01),中藥組與穴埋組比較無顯著差異(P0.05);4)三治療組大鼠血清TGF-β1含量均低于模型組(P0.01),其中藥埋組血清TGF-β1含量降低最為明顯(P0.01),其它兩治療組間比較無明顯差異(P0.05);5)模型組大鼠坐骨神經(jīng)形態(tài)較正常組大鼠有明顯改變,經(jīng)治療后,三治療組大鼠坐骨神經(jīng)形態(tài)較模型組大鼠有所改善。結(jié)論:中藥糖通飲和穴位埋線均能有效治療DPN,延緩DPN病情進(jìn)展,兩者合用時(shí)療效最佳,其可能的作用途徑為:通過降低血糖,改善糖代謝,增加NGF含量,降低TGF-β1含量,促進(jìn)受損神經(jīng)的修復(fù),來實(shí)現(xiàn)延緩DPN病情進(jìn)展的目的。
[Abstract]:Objective: to observe and compare the fasting blood glucose (fasting blood glucose,FBG) of diabetic peripheral neuropathy (diabetic peripheral neuropathy,DPN) rats by taking traditional Chinese medicine (Tangtong Yin) and embedding thread at acupoint. Serum nerve growth factor (nerve growth factor,NGF), serum transforming growth factor 尾 1 (transforming growth factor- 尾 1 (TGF- 尾 1), sciatic nerve action potential conduction velocity and histopathologic changes of sciatic nerve. To explore the possible mechanism and approach of Tangtong Yin and acupoint catgut embedding in the treatment of DPN, and to provide theoretical basis for clinical treatment and selective treatment. Methods: rats were randomly divided into normal group, model group, catgut embedding group and traditional Chinese medicine embedding group (drug embedding group). The rats were fed with high energy feed and intraperitoneally injected with 0.1% Streptozocin,. Rat model of diabetic peripheral neuropathy was established by STZ solution. After 10 weeks of treatment, the FBG, sciatic nerve action potential conduction velocity and serum NGF,TGF- 尾 1 were measured, and the histopathologic changes of the sciatic nerve were observed. Results: after intervention: 1) the FBG value of rats in each treatment group was lower than that in the model group (P0.05 or P0.01), and the decrease was most obvious in the traditional Chinese medicine embedding group (P0.05), but there was no difference between the other two treatment groups (P0.05). 2) the conduction velocity of sciatic nerve action potential in the three treatment groups was higher than that in the model group, the difference was statistically significant (P0.05), but there was no significant difference in the nerve action potential conduction velocity among the three treatment groups (P0.05). 3) the serum NGF content in each treatment group was significantly higher than that in the model group (P0.01), and the serum NGF content in the TCM embedding group was the most significant (P0.01), but there was no significant difference between the Chinese medicine group and the acupoint embedding group (P0.05). 4) the content of serum TGF- 尾 1 in the three treatment groups was lower than that in the model group (P0.01), and the serum TGF- 尾 1 content in the traditional Chinese medicine embedding group was the most significant (P0.01), but there was no significant difference between the other two groups (P0.05). 5) the shape of sciatic nerve in the model group was obviously changed than that in the normal group. After treatment, the shape of the sciatic nerve in the three treatment groups was improved compared with that in the model group. Conclusion: Tangtong Yin and catgut embedding at acupoints can effectively treat DPN, and delay the progression of DPN. The best therapeutic effect can be achieved when the two drugs are combined. The possible ways of their action are as follows: decreasing blood glucose, improving glucose metabolism, increasing NGF content and decreasing TGF- 尾 1 content. To promote the repair of damaged nerve to delay the progression of DPN.
【學(xué)位授予單位】：貴州醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R245

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