祛胰抵方治疗DPN的临床疗效观察及对Hcy的影响
发布时间：2018-08-12 19:10
【摘要】：目的:探究中医中药于糖尿病周围神经病变(Diabetic peripheral neuropathy,DPN)的认识。通过随机对照法,进一步考证祛胰抵方对本病的疗效并通过检测患者血同型半胱氨酸(homocysteine,Hcy)含量,探其机理,评价其安全性,为日后运用祛胰抵方医治气阴两虚兼痰瘀阻络型DPN论述新的证据。方法:募集气阴两虚、痰瘀阻络型DPN确诊患者70例,按照随机对照原则分为治疗组(n=35)和对照组(n=35)。两组患者基础治疗方案一致。其中治疗组服用祛胰抵方300ml日一剂,水煎早晚各150ml温服,并加服甲钴胺片,0.5毫克,3次/日;对照组服用甲钴胺片,0.5毫克,3次/日。两组连续治疗12周。试验前后分别察看患者的神经传导速度以及血同型半胱氨酸。结果:①治疗后,两组受试患者糖化血红蛋白(HbA1c)值均较入组前明显下降(P0.05),且治疗组患者指标结果的改善较对照组更加明显(P0.05)。②治疗后,两组受试患者中医证候积分均下降(P0.05),且治疗组症候改善优于对照组。治疗组及对照组总有效率分别为94.3%,71.4%,说明祛胰抵方疗效优于西药治疗。③治疗后,两组患者双侧腓浅神经感觉神经传导速度(SCV)、双侧腓总神经运动神经传导速度(MCV)均有提高(P0.05),治疗组改善优于对照组。④治疗后,两组患者TG、TC、LDL-C均下降,差异具有统计学意义(P0.05);HDL-C明显升高,差异明显,具有统计学意义(P0.05)且治疗组优于对照组。⑤治疗后,两组患者血同型半胱氨酸含量均有下降,说明治疗组的血同型半胱氨酸的下降优于对照组(P0.05)。结论:①祛胰抵方可改善气阴两虚、痰瘀阻络型DPN患者的中医证候。②祛胰抵方可有效缓解患者肢体麻木、口干口渴、乏力、五心烦热、气短懒言、自汗盗汗等症症状。③祛胰抵方可有效改善患者双侧腓总神经MCV运动神经传导速度、腓浅神经SCV感觉神经传导速度;④ 祛胰抵方降低患者TG、TC、LDL-C,升高HDL-C水平、降低血糖水平。⑤祛胰抵方能够降低DPN患者血同型半胱氨酸含量,其治疗DPN的机制可能是通过减少血同型半胱氨酸而成。
[Abstract]:Objective: to explore the knowledge of (Diabetic peripheral neuropathy in diabetic peripheral neuropathy. By means of randomized controlled method, the curative effect of QYJI recipe on this disease was further studied, and its mechanism was investigated by detecting the content of homocysteine (Hcy) in blood of the patients, and its safety was evaluated. In order to treat Qi and Yin deficiency and phlegm stasis collaterals type DPN, the new evidence is discussed. Methods: 70 DPN patients with deficiency of qi and yin and phlegm and blood stasis were recruited and divided into two groups according to the principle of random control: the treatment group (n = 35) and the control group (n = 35). The two groups had the same basic treatment plan. The treatment group took one dose of Quyi decoction 300ml, the morning and evening of decoction of 150ml were taken warm, and the control group took mecobalamin tablet 0.5 mg / d, and the control group took mecobalamin tablet 0.5 mg / d. The control group was treated with mekobalamin tablet 0.5 mg / d, and the control group was given Mecobalamin tablet (0.5 mg / d). The two groups were treated continuously for 12 weeks. Nerve conduction velocity and homocysteine were examined before and after the trial. Results the glycosylated hemoglobin (HbA1c) values of the two groups were significantly lower than those of the control group (P0.05), and the improvement of the index of the patients in the treatment group was more obvious than that in the control group (P0.05). The scores of TCM syndromes in both groups were decreased (P0.05), and the improvement of symptoms in the treatment group was better than that in the control group. The total effective rates of the treatment group and the control group were 94.3 and 71.4, respectively. The sensory nerve conduction velocity (SCV),) of bilateral superficial peroneal nerve (SCV),) and the motor nerve conduction velocity (MCV) of bilateral common peroneal nerve were increased in both groups (P0.05). The improvement in treatment group was better than that in control group (P < 0.05). The difference was statistically significant (P0.05), HDL-C was significantly increased, there was significant difference (P0.05) and the treatment group was better than the control group after 5 treatment, the two groups of patients' blood homocysteine content decreased, The decrease of homocysteine in the treatment group was better than that in the control group (P0.05). Conclusion the TCM syndrome of Qi-Yin deficiency and deficiency of Qi and Yin, phlegm and stasis obstructing collaterals in patients with DPN can be effectively alleviated by "1: 1" Quyi decoction, which can effectively relieve the numbness of limbs, dry mouth thirst, fatigue, five upset and heat, and short and lazy talk of qi. Self-sweating and night sweating symptom 3.Quyi decoction can effectively improve the motor nerve conduction velocity of bilateral common peroneal nerve (MCV) and the sensory nerve conduction velocity of superficial peroneal nerve (SCV) Quyi decoction can reduce the level of TGG TCLDL-C and increase the level of HDL-C. Lowering blood glucose level of 5. 5 Quyi decoction can reduce the content of homocysteine in patients with DPN. The mechanism of treatment of DPN may be by reducing the level of blood homocysteine.
【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】：R259
[Abstract]:Objective: to explore the knowledge of (Diabetic peripheral neuropathy in diabetic peripheral neuropathy. By means of randomized controlled method, the curative effect of QYJI recipe on this disease was further studied, and its mechanism was investigated by detecting the content of homocysteine (Hcy) in blood of the patients, and its safety was evaluated. In order to treat Qi and Yin deficiency and phlegm stasis collaterals type DPN, the new evidence is discussed. Methods: 70 DPN patients with deficiency of qi and yin and phlegm and blood stasis were recruited and divided into two groups according to the principle of random control: the treatment group (n = 35) and the control group (n = 35). The two groups had the same basic treatment plan. The treatment group took one dose of Quyi decoction 300ml, the morning and evening of decoction of 150ml were taken warm, and the control group took mecobalamin tablet 0.5 mg / d, and the control group took mecobalamin tablet 0.5 mg / d. The control group was treated with mekobalamin tablet 0.5 mg / d, and the control group was given Mecobalamin tablet (0.5 mg / d). The two groups were treated continuously for 12 weeks. Nerve conduction velocity and homocysteine were examined before and after the trial. Results the glycosylated hemoglobin (HbA1c) values of the two groups were significantly lower than those of the control group (P0.05), and the improvement of the index of the patients in the treatment group was more obvious than that in the control group (P0.05). The scores of TCM syndromes in both groups were decreased (P0.05), and the improvement of symptoms in the treatment group was better than that in the control group. The total effective rates of the treatment group and the control group were 94.3 and 71.4, respectively. The sensory nerve conduction velocity (SCV),) of bilateral superficial peroneal nerve (SCV),) and the motor nerve conduction velocity (MCV) of bilateral common peroneal nerve were increased in both groups (P0.05). The improvement in treatment group was better than that in control group (P < 0.05). The difference was statistically significant (P0.05), HDL-C was significantly increased, there was significant difference (P0.05) and the treatment group was better than the control group after 5 treatment, the two groups of patients' blood homocysteine content decreased, The decrease of homocysteine in the treatment group was better than that in the control group (P0.05). Conclusion the TCM syndrome of Qi-Yin deficiency and deficiency of Qi and Yin, phlegm and stasis obstructing collaterals in patients with DPN can be effectively alleviated by "1: 1" Quyi decoction, which can effectively relieve the numbness of limbs, dry mouth thirst, fatigue, five upset and heat, and short and lazy talk of qi. Self-sweating and night sweating symptom 3.Quyi decoction can effectively improve the motor nerve conduction velocity of bilateral common peroneal nerve (MCV) and the sensory nerve conduction velocity of superficial peroneal nerve (SCV) Quyi decoction can reduce the level of TGG TCLDL-C and increase the level of HDL-C. Lowering blood glucose level of 5. 5 Quyi decoction can reduce the content of homocysteine in patients with DPN. The mechanism of treatment of DPN may be by reducing the level of blood homocysteine.
【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】：R259
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