消渴痹通胶囊联合针刺治疗糖尿病周围神经病变抗氧化应激机制的临床研究

发布时间：2018-03-23 18:19

本文选题：糖尿病周围神经病变　切入点：消渴痹通胶囊　出处：《长春中医药大学》2016年硕士论文

【摘要】：目的:本研究通过临床观察消渴痹通胶囊联合针刺对糖尿病周围神经病变(DPN)患者氧化应激水平(血清超氧化物歧化酶(SOD)、丙二醛(MDA))的影响、神经传导速度的影响及对临床疗效的影响,验证消渴痹通胶囊联合针刺以及单用消渴痹通胶囊治疗DPN的临床疗效,揭示可能存在的抗氧化作用机制。方法:将90例已确诊的DPN患者,随机分为三组,硫辛酸胶囊组、消渴痹通胶囊组、针刺加消渴痹通胶囊组三组,每组各30例。三组患者基础治疗均相同。三组分别给予针刺加口服消渴痹通胶囊、口服消渴痹通胶囊及口服硫辛酸胶囊治疗,疗程均为12周,治疗前后分别观察患者的神经传导速度以及氧化应激水平血清超氧化物歧化酶(SOD)、丙二醛(MDA)的变化。结果:1治疗后,三组患者空腹血糖(FPG),餐后2小时血糖(2h PG),糖化血红蛋白(Hb A1c),均有所改善(P0.05),消渴痹通胶囊加针刺明显优于其他两组(P0.01),其他两组无明细差异。2治疗后,三组患者双侧腓总神经运动神经传导速度(MCV)、双侧腓肠神经感觉神经传导速度(SCV)均有提高(P0.05),且消渴痹通胶囊联合针刺优于其他两组(P0.01)。3治疗后,三组患者氧化应激水平血清超氧化物歧化酶(SOD)均有所上升(P0.05),且消渴痹通胶囊联合针刺优于其他两组(P0.01),其他两组无差异。丙二醛(MDA)均有所下降(P0.05),消渴痹通胶囊联合针刺优于其他两组(P0.01),其他两组无差异。消渴痹通胶囊联合针刺可以改善机体氧化应激水平。4治疗后,三组患者中医证候积分均降低(P0.05),且消渴痹通胶囊加针刺改善优于其他两组(P0.01),消渴痹通胶囊组由于硫辛酸胶囊组(P0.05)。三组总有效率分别是总有效率分别为87%、67%、60%,说明消渴痹通胶囊加针刺及消渴痹通组中医证候疗效优于硫辛酸胶囊组。结论:1消渴痹通胶囊联合针刺和单用消渴痹通胶囊可以改善DPN患者的中医证候积分和中医证候疗效。2消渴痹通胶囊联合针刺和单用消渴痹通胶囊可以提高患者双侧腓肠神经和双侧腓总神经的传导速度。3消渴痹通胶囊联合针刺消渴痹通胶囊可有效降低FPG、2h PG、Hb A1c。4消渴痹通胶囊联合针刺和单用消渴痹通胶囊可以降低血清MAD,提高SOD水平,抑制机体氧化应激。可能是抑制DPN的机制之一。5在研究及多年临床应用中,未发现与消渴痹通胶囊相关的不良反应,可见其安全性。
[Abstract]:Objective: to observe the effect of Xiaoke Bitong capsule combined with acupuncture on the levels of oxidative stress (serum superoxide dismutase (SOD), malondialdehyde (MDA) MDAA) in patients with diabetic peripheral neuropathy (DPN). The effect of nerve conduction velocity and its effect on clinical curative effect were verified. The clinical effect of Xiaokebitong capsule combined with acupuncture and single application of Xiaokebitong capsule in the treatment of DPN was verified. Methods: 90 patients with DPN were randomly divided into three groups: lipoic acid capsule group, Xiaokebitong capsule group, acupuncture plus Xiaokeitong capsule group. The three groups were treated with acupuncture plus Xiaokebitong capsule, Xiaokebitong capsule and lipoic acid capsule for 12 weeks. The changes of serum superoxide dismutase (SOD) and malondialdehyde (MDA) were observed before and after treatment. In the three groups, fasting blood glucose and FPGG, 2 h postprandial blood glucose and 2 h PGN, HbA1cX, HbA1cX, HbA1cX, HbA1C, HbA1C, HbA1C, HbA1C, HbA1C, HbA1C, HbA1C, HbA1C, HbA1C, et al, et al. The motor nerve conduction velocity (MCV) of bilateral common peroneal nerve and the sensory nerve conduction velocity (SCV) of bilateral sural nerve in the three groups were all increased (P 0.05), and the combination of Xiaokebitong capsule and acupuncture was superior to that of the other two groups. The levels of serum superoxide dismutase (SOD) in the three groups were increased to some extent, and the combination of Xiaokebitong capsule and acupuncture was better than the other two groups, but there was no difference between the other two groups. Acupuncture was superior to the other two groups (P 0.01), but there was no difference between the other two groups. Xiaokebitong capsule combined with acupuncture can improve the oxidative stress level of the body after 4. 4 treatment. The scores of TCM syndromes in all the three groups decreased P0.05N, and the improvement of Xiaoke Bitong capsule plus acupuncture was better than that of the other two groups. The total effective rate of the three groups was 87,670.The total effective rate of the three groups was about 60 points, indicating that the total effective rate of the Xiaoke Bitong capsule group was lower than that of the other two groups, and the total effective rate of the Xiaokebitong capsule group was the same as that of the lipoic acid capsule group. Conclusion the combination of Wei 1 Xiaoke Bi Tong capsule and Xiaoke Bitong capsule can improve the TCM syndromes integral and TCM syndrome treatment of DPN patients. Effect of Xiaokebitong capsule combined with acupuncture and single application of Xiaokebitong capsule can increase the conduction velocity of bilateral sural nerve and bilateral common peroneal nerve. Xiaokebitong capsule combined with acupuncture and single application of Xiaokebitong capsule can reduce serum MADand increase the level of SOD. Inhibition of oxidative stress may be one of the mechanisms of inhibiting DPN. 5. In the study and clinical application for many years, no adverse reactions related to Xiaokebitong capsule were found, so its safety can be seen.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R587.2

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