Clinical efficacy of Jiangtang Mixture on diabetic peripheral Neuropathy
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摘要: 目的 评价降糖合剂治疗糖尿病周围神经病变(DPN)的临床疗效,并初步探讨其作用机制。 方法 60例DNP患者随机分为两组:治疗组和对照组,每组30例。在饮食控制和常规降糖治疗的基础上,对照组给予甲钴胺片0.5 mg,po,tid;治疗组在对照组基础上给予降糖合剂50 ml,po,tid。两组疗程均为4周。治疗前后观察临床症状和体征,进行外周血空腹血糖(FPG)、餐后2 h血糖(PPG2h)、糖化血红蛋白(HbA1C)、血浆黏度(PV)、内皮素(ET)、一氧化氮(NO)和神经传导速度(NCV)测定。 结果 治疗组临床有效率(86.67%)明显高于对照组(63.33%)(P<0.05),NCV、FPG、PPG2h、HbA1C、PV、ET、NO等检测指标治疗组治疗前后比较,均有明显改善(P<0.05);与对照组相比,治疗组治疗后NCV 、PV、ET和NO均有显著差异(P<0.05)。观察期内未发现降糖合剂的不良反应。 结论 降糖合剂联合甲钴胺治疗DPN安全有效,其作用机制可能与保护血管内皮细胞、改善血液流变性、扩张外周微血管,增加滋养神经的微血管的血供和氧供,阻止或逆转DPN受损的外周神经纤维有关。Abstract: Objective To evaluate the efficacy and explore the mechanism of Jiangtang Mixture in treatment of diabetic peripheral neuropathy (DPN). Methods 60 cases of DPN patients were randomly divided into treatment group and control group with 30 cases in each group. Two groups were all treated with a diet control, routine hypoglycemic therapy, the control group was treated with Methylcobalamin Tablet 0.5 mg, po, tid. While the treatment group was treated with Jiangtang Mixture 50 ml, po, tid, on the basis of the control group. The course of treatment was 4 weeks in each group. Before and after treatment, clinical signs and symptoms were observed and determined, including fasting plasma glucose (FPG), the 2 hours postprandial blood glucose (PPG2h), glycated hemoglobin (HbA1C), plasma viscosity (PV), endothelin (ET), nitric oxide (NO), and nerve conduction velocity (NCV). Results The total effective rate of the treatment group (86.67%) was significantly higher than that of the control group (63.33%)(P<0.05). There were significant differences in levels of the indexes, such as NCV、FPG、PPG2h、HbA1C、PV、ET and NO in the treatment group before and after treatment (P<0.05), but only in the four indexes, such as NCV、PV、ET and NO, the treatment group compared with the control group showed significantly differences after treatment (P<0.05). Adverse reactions of Jiangtang Mixture did not find in the observation period. Conclusion Jiangtang Mixture combined with Mecobalamine to treat DPN was safe and effective. The mechanism could be related to protect vascular endothelial cell, improve blood rheology, expand the peripheral microvascular, nourish the nerve with blood and oxygen supply, prevent or reverse impaired peripheral nerve fibers of DPN.
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Key words:
- Jiangtang Mixture /
- diabetic peripheral neuropathy /
- clinical efficacy
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[1] 中国医师协会内分泌代谢医师分会.糖尿病周围神经病变诊疗规范(征求意见稿) [J].中国糖尿病杂志,2009,17(8):638. [2] 中华中医药学会.糖尿病周围神经病变中医防治指南[J].中国中医药现代远程教育,2009,9(22):119. [3] 王 琪,胡良平,毛 玮,等.如何把握实验设计的随机原则[J].药学服务与研究,2010,10(3):171. [4] 管晓峰,陈智绍,黄淑玉,等.参生系列方剂在2型糖尿病慢性并发症中的临床应用[J].临床内科杂志,2002,19(增刊):142. [5] 黄秋明,李 艳,胡红艳,等.降糖合剂的薄层色谱鉴别[J].中国药师,2009,12(8):1166. [6] 李 庆,叶 真,倪海祥.糖尿病周围神经病变的临床评估和诊断进展[J].浙江临床医学,2008,10(10):1388. [7] 张先淑,胡先明.茯苓三萜化合物的药理作用及临床应用研究进展[J].重庆工贸职业技术学院学报,2011,24(4):46. [8] 孙晓生,谢 波.山药药理作用的研究进展[J].中药新药与临床药理,2011, 22 (3):353. [9] 刘 朵,章丹丹,卞 卡.地黄药理药化及配伍研究[J].时珍国医国药,2012,23 (3):748. [10] 邬浩杰.丹参的药理作用研究[J].浙江中医药大学学报,2008,32 (5):694. [11] 罗丹冬,张会平,王沛坚,等.桂枝甘草汤提取物抗血栓形成的药效及机理的初步研究[J].新中医,2010,42 (7):109. [12] Mather KJ, Lteif A, Steinberg HO, et al. Interactions between endothelin and nitric oxide in the regulation of vascular tone in obesity and diabetes[J]. Diabetes,2004,53(8):2060. [13] 柴伟栋,陈家伟,沈 捷,等.葡萄糖、胰岛素对内皮细胞一氧化氮和内皮素1分泌影响的对比研究[J].中华内分泌代谢杂志,2004,20(2):170. [14] 王春梅,刘 艳,王 艳,等.内皮素、一氧化氮与糖尿病周围神经病变关系的研究[J].医学新知杂志,2002,12(1):10.
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