祛胰抵方治疗DPN的临床疗效观察及对血清IGF-1的影响

发布时间：2018-09-08 08:57

【摘要】：目的:采取祛胰抵方治疗糖尿病周围神经病变(DPN),观察其临床疗效及对胰岛素样生长因子(IGF-1)的影响,探讨其治疗DPN的可能机制。方法:选取70名符合气阴两虚、痰瘀阻络型DPN患者,采用随机数字表法分为两组,患者均采用降糖治疗,如血压、血脂异常者,合并降压、调脂等治疗,对照组(n=35)应用甲钴胺片口服500 ug,3次/日;治疗组(n=35)在对照组基础上联用祛胰抵方,水煎300ml,150ml/袋,早晚各1袋,温服,共12周。观察治疗前和治疗后两组的疗效指标的变化,包括神经传导速度双侧腓浅神经MCV、双侧腓总神经SCV)、10g尼龙丝检查、中医证候积分、血脂及血清IGF-1的变化。结果:1、治疗后,两组患者的中医证候积分与治疗前相比均有所改善(P0.05),且治疗组的中医证候积分改善情况优于对照组(P0.05)。单项中医症状评分改善方面,两组分别与治疗前比较(P0.05),差异有统计学意义;治疗后,肢体麻木、口干口渴、乏力、气短懒言、自汗盗汗、五心烦热等症状组间比较(P0.05),差异有统计学意义;2、治疗后,两组患者的神经传导速度与治疗前相比均有所改善(P0.05),治疗组改善腓浅神经MCV、腓总神经SCV的情况优于对照组(P0.05);两组患者压力觉检查情况与治疗前相比均有所改善(P0.05),且治疗组优于对照组(P0.05)。3、治疗组血脂改善情况优于对照组(P0.05)。4、治疗后,两组患者血清IGF-1均高与治疗前(P0.05),治疗组IGF-1水平上调的情况优于对照组(P0.05)。结论:埅胰抵方可有效改善DPN患者气阴两虚、痰瘀阻络中医证候积分及中医临床症状,尤其在肢体麻木、口干口渴、乏力、五心烦热、气短懒言、自汗盗汗等症;埅胰抵方可有效改善患者神经传导速度、压力觉;埅胰抵方通过降低TG、TC、LDL-C,升高HDL-C调节血脂紊乱;埅胰抵方可升高DPN患者IFG-1的水平;埅胰抵方对DPN患者症状、体征的改善,其机制可能与血清IGF-1的上调有关。
[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.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2

【相似文献】