| 引用本文:陈元史，黎传宝.养经煎协定方联合甲钴胺片改善阳虚寒凝、络脉瘀阻型糖尿病周围神经病变患者神经电生理的临床效果和作用机制[J].世界中医药,2019,(07):. |
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| 养经煎协定方联合甲钴胺片改善阳虚寒凝、络脉瘀阻型糖尿病周围神经病变患者神经电生理的临床效果和作用机制 |
| Exploration on Clinical Efficacy and Mechanism of the Combination of Empirical Formula of Yangjing Decoction and Mecobalamine Tablets in the Improvement of Neuroelectrophysiology in Patients with Diabetic Peripheral Neuropathy of Yang Deficiency,Cold Coagulation and Collaterals Stasis |
| 投稿时间：2018-11-07 |
| DOI：10.3969/j.issn.1673-7202.2019.07.030 |
| 中文关键词: 养经煎协定方 甲钴胺片 糖尿病周围神经病变 临床研究 |
| English Keywords:Empirical formula of Yangjing Decoction Mecobalamine tablets Diabetic peripheral neuropathy Clinical research |
| 基金项目:海南省自然科学基金项目（807092） |
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| 中文摘要: |
| 目的：观察用养经煎协定方联合甲钴胺片改善阳虚寒凝、络脉瘀阻型糖尿病周围神经病变患者神经电生理的临床效果，探讨其治疗糖尿病周围神经病变的作用机制。方法：选取2017年2月至2018年2月琼海市中医院收治的糖尿病周围神经病变患者110例作为研究对象，随机分为对照组与观察组，每组55例，对照组给予甲钴胺片口服，观察组在对照组基础上给予养经煎协定方口服治疗，连续治疗1个月。比较2组患者治疗前后的临床疗效及多伦多临床评分系统（TCSS）评分，观察治疗前后2组患者神经传导速度的改善情况，监测血清中缺氧诱导因子-1α（HIF-1α）、可溶性血管细胞黏附分子-1（s VCAM-1）、髓鞘碱性蛋白（MBP）水平。结果：观察组有效率90.90%明显高于对照组的76.36%，差异有统计学意义（P<0.05）；治疗后，2组患者的神经传导速度较治疗前均有所改善，观察组患者的正中神经、腓总神经的神经传导速度SNCV、MNCV均明显高于对照组，差异有统计学意义（P<0.05）；2组患者的TCSS评分较治疗前显著降低，观察组患者的TCSS评分（4.02±1.80）分,明显低于对照组的（7.28±1.42）分，差异有统计学意义（P<0.05）；2组患者的外周血HIF-1α、sVCAM-1、MBP水平较治疗前显著降低，观察组患者的上述因子水平显著低于对照组，差异有统计学意义（P<0.05）。结论：养经煎协定方利于提高阳虚寒凝、络脉瘀阻证糖尿病周围神经病变患者的神经传导速度，在改善症状方面优势明显，可能是通过干预外周血HIF-1α、sVCAM-1、MBP水平以减轻神经微血管的内皮细胞损伤而保护神经实现的。 |
| English Summary: |
| To observe the clinical efficacy of an empirical formula of Yangjing Decoction combined with ecobalamine tablets to improve the neuroelectrophysiology in patients with diabetic peripheral neuropathy of yang deficiency,cold coagulation and collateral stasis,and to explore the mechanism of the treatment of diabetic peripheral neuropathy.Methods：A total of 110 cases of diabetic peripheral neuropathy admitted in Qionghai Hospital of Traditional Chinese Medicine from February 2017 to February 2018 were selected as research subjects and treated,and they were randomly divided into control group and obserbation group,with 55 cases in each group.The control group was given oral mecobalamine tablets.On the treatment basis of the control group,the observation group was given the empirical formula of Yangjing Decoction orally.The treatment course lasted for a month.Clinical efficacy of the 2 groups of patients and Toronto clinical scoring system(TCSS）scores before and after the treatment were compared.Improvements of nerve conduction velocity in the 2 groups of patients before and after the treatment were observed.Levels of hypoxia-inducible factor-1α(HIF-1α),soluble vascular cell adhesion molecule-1(sVCAM-1）and myelin basic protein(MBP）were monitored.Results：The effective rate of the observation group was 90.90%,significantly higher than 76.36% in the control group(P<0.05).After the treatment,the nerve conduction velocity of the 2 groups of patients was improved compared with that before the treatment.In the observation group,the nerve conduction velocity of the median nerve and the nerve conduction velocity of common peroneal nerve,SNCV and MNCV,were significantly higher than those of the control group(P<0.05).The TCSS scores of the 2 groups were significantly lower than those before the treatment,and the TCSS score(4.02±1.80）of the observation group was significantly lower than that of the control group(7.28±1.42)(P<0.05).Peripheral blood HIF-1,sVCAM-1,MBP levels of the 2 groups were significantly lower than those of the control group(P<0.05).Conclusion：The empirical formula of Yangjing Decoction can improve the nerve conduction velocity of patients with diabetic peripheral neuropathy of yang deficiency,cold coagulation and collaterals stasis,and has prominent advantages in improving symptoms.Its efficacy may be related to that it can protect the nerve by intervening the levels of HIF-1α,sVCAM-1 and MBP in peripheral blood to reduce the lesions of endothelial cells in nerve microvessels. |
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