消麻止痛颗粒治疗气阴两虚夹瘀证糖尿病周围神经病变的疗效观察及机制探讨
发布时间：2019-01-01 13:31
【摘要】：目的：观察消麻止痛颗粒对气阴两虚夹瘀型糖尿病周围神经病变患者血中AR、N0和SOD活性及神经传导速度的影响,探讨其作用机制。 方法：将我院2013年1月～2014年5月期间收治的102例气阴两虚夹瘀型糖尿病周围神经病变(DPN)患者纳入研究对象,随机分为对照组50例和治疗组52例。对照组口服甲钴胺片500mg和安慰剂,3次/d；治疗组口服甲钴胺片500mg,3次/d和消麻止痛颗粒15g,3次/d,连续治疗4周为1疗程。3个疗程后评价疗效。采用Srivastava法[1]检测红细胞醛糖还原酶(AR)活性,血清一氧化氮(NO)水平采用Gress重氮化反应法测定,通过酶联免疫吸附法(ELISA)检测血清超氧化物歧化酶(SOD)水平。应用肌电图仪测量患者正中神经、腓总神经的运动神经传导速度(MNCV)和感觉神经传导速度SNCV)的变化。通过多伦多临床评分系统(TCSS)症状评分和视觉模拟评分法(VAS)疼痛评分对病情进行评估。 结果： 1.治疗前后疗效比较,治疗组总有效率明显优于对照组(P0.05)。 2.经治疗后,两组正中神经、腓总神经MNCV及SNCV较治疗前均有提高。与对照组比较,治疗组神经传导速度提升较明显,其中正中神经的传导速度与对照组相比差异有统计学意义(P0.05)。 3.经治疗3个疗程后,两组神经病变症状均有明显改善(P0.05),VAS评分明显降低(P0.05),且治疗组TCSS和VAS疼痛评分低于对照组(P0.05)。 4.治疗3个疗程后,治疗组及对照组AR含量均有下降,与治疗前对比,差异有统计学意义(P0.05)。治疗组对AR的作用明显优于对照组(P0.05)。 5.治疗3个疗程后,两组患者NO、SOD含量较治疗前均有上升(P0.05)；与对照组比较,治疗组可显著提高MO、SOD的含量,差异具有统计学意义(P0.05)。结论： 消麻止痛颗粒联合甲钴胺片可明显抑制AR的表达,提高体内NO. SOD的含量,改善DPN患者的神经传导速度,这可能是消麻止痛颗粒发挥神经保护作用的机制之一。
[Abstract]:Objective: to observe the effect of Xiaomaxitong granule on the activities of AR,N0 and SOD and nerve conduction velocity in patients with diabetic peripheral neuropathy with Qi and Yin deficiency and stasis. Methods: from January 2013 to May 2014, 102 patients with (DPN) of diabetes mellitus with deficiency of Qi and Yin and blood stasis were randomly divided into control group (n = 50) and treatment group (n = 52). The control group was given megalobalamin tablets 500mg and placebo 3 times a day, the treatment group was treated with megalobalamin tablet 500 mg / d 3 times a day and Xiaomaodong granule 15 g / d for 4 weeks as a course of treatment, and the curative effect was evaluated after 3 courses of treatment. The activity of Aldose reductase (AR) in erythrocytes was detected by Srivastava assay, the level of serum nitric oxide (NO) was determined by Gress diazotization reaction, and the level of serum superoxide dismutase (SOD) was detected by enzyme-linked immunosorbent assay (ELISA). The motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of median nerve and common peroneal nerve were measured by electromyography. The symptoms of the disease were evaluated by the Toronto Clinical scoring system (TCSS) and the Visual Analog scale (VAS). Results: 1. Before and after treatment, the total effective rate of the treatment group was significantly better than that of the control group (P0.05). 2. After treatment, MNCV and SNCV of median nerve, common peroneal nerve and peroneal nerve in both groups were higher than those before treatment. Compared with the control group, the nerve conduction velocity in the treatment group was significantly increased, and the median nerve conduction velocity was significantly higher than that in the control group (P0.05). 3. After three courses of treatment, the symptoms of neuropathy in both groups were significantly improved (P0.05), VAS score significantly decreased (P0.05), and the treatment group TCSS and VAS pain score was lower than the control group (P0.05). 4. After three courses of treatment, the content of AR in treatment group and control group were decreased, compared with before treatment, the difference was statistically significant (P0.05). The effect of AR in the treatment group was significantly better than that in the control group (P0.05). 5. After three courses of treatment, the content of NO,SOD in the two groups was higher than that before treatment (P0.05); compared with the control group, the treatment group could significantly increase the content of MO,SOD, the difference was statistically significant (P0.05). Conclusion: Xiaomaxitong granule combined with mecobalamin tablets can significantly inhibit the expression of AR and increase NO. in vivo. The content of SOD and the improvement of nerve conduction velocity in patients with DPN may be one of the mechanisms by which Xiaomaxitong granule plays a neuroprotective role.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2
本文编号：2397638
[Abstract]:Objective: to observe the effect of Xiaomaxitong granule on the activities of AR,N0 and SOD and nerve conduction velocity in patients with diabetic peripheral neuropathy with Qi and Yin deficiency and stasis. Methods: from January 2013 to May 2014, 102 patients with (DPN) of diabetes mellitus with deficiency of Qi and Yin and blood stasis were randomly divided into control group (n = 50) and treatment group (n = 52). The control group was given megalobalamin tablets 500mg and placebo 3 times a day, the treatment group was treated with megalobalamin tablet 500 mg / d 3 times a day and Xiaomaodong granule 15 g / d for 4 weeks as a course of treatment, and the curative effect was evaluated after 3 courses of treatment. The activity of Aldose reductase (AR) in erythrocytes was detected by Srivastava assay, the level of serum nitric oxide (NO) was determined by Gress diazotization reaction, and the level of serum superoxide dismutase (SOD) was detected by enzyme-linked immunosorbent assay (ELISA). The motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of median nerve and common peroneal nerve were measured by electromyography. The symptoms of the disease were evaluated by the Toronto Clinical scoring system (TCSS) and the Visual Analog scale (VAS). Results: 1. Before and after treatment, the total effective rate of the treatment group was significantly better than that of the control group (P0.05). 2. After treatment, MNCV and SNCV of median nerve, common peroneal nerve and peroneal nerve in both groups were higher than those before treatment. Compared with the control group, the nerve conduction velocity in the treatment group was significantly increased, and the median nerve conduction velocity was significantly higher than that in the control group (P0.05). 3. After three courses of treatment, the symptoms of neuropathy in both groups were significantly improved (P0.05), VAS score significantly decreased (P0.05), and the treatment group TCSS and VAS pain score was lower than the control group (P0.05). 4. After three courses of treatment, the content of AR in treatment group and control group were decreased, compared with before treatment, the difference was statistically significant (P0.05). The effect of AR in the treatment group was significantly better than that in the control group (P0.05). 5. After three courses of treatment, the content of NO,SOD in the two groups was higher than that before treatment (P0.05); compared with the control group, the treatment group could significantly increase the content of MO,SOD, the difference was statistically significant (P0.05). Conclusion: Xiaomaxitong granule combined with mecobalamin tablets can significantly inhibit the expression of AR and increase NO. in vivo. The content of SOD and the improvement of nerve conduction velocity in patients with DPN may be one of the mechanisms by which Xiaomaxitong granule plays a neuroprotective role.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2
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