温阳活血法内外合治对2型糖尿病周围神经病变患者TNF-α、IL-10的影响

Efficacy of the Wenyang Huoxue therapy on TNF-α and IL-10 in type 2 diabetic peripheral neuropathy

目的:评价温阳活血法内外合治对2型糖尿病周围神经病变患者TNF-α、IL-10的影响。方法:将80例阳虚血瘀型2型糖尿病周围神经病变患者随机分成两组,两组均常规给予口服药物或胰岛素控制血糖,观察组给予温阳活血法内外合治(归龙丸方内服、中药硬膏热贴敷双涌泉、三阴交),对照组给予甲钴胺分散片口服,疗程8周。观察治疗前后两组中医证候评分、震动感觉阈值、肿瘤坏死因子-α(Tumor Necrosis Factor,TNF-α)、白介素(Interleukin,IL)-10等指标的变化。结果:①治疗后两组中医证候评分均有下降,观察组下降明显,差异有统计学意义(P<0.05)。②治疗后两组双下肢震动感觉阈值(Vibration Perception Threshold,VPT)均有下降,观察组下降明显,差异有统计学意义(P<0.05)。③治疗后两组TNF-α水平均有下降,IL-10水平均有上升(P<0.05),观察组更明显,差异有统计学意义(P<0.05)。结论:温阳活血法内外合治能有效改善阳虚血瘀型糖尿病周围神经病变患者中医证候评分,降低震动感觉阈值,其机制可能与降低血清TNF-α、升高IL-10从而减轻炎症反应有关。

Objective:To evaluate efficacy of the Wenyang Huoxue therapy(温阳活血法)on TNF-αand IL-10 in patients with type 2 diabetic peripheral neuropathy.Methods:80 patients were randomly divided into two groups.The two groups were routinely given oral medication or insulin to control blood glucose.The observation group was given internal and external treatment by the Wenyang Huoxue therapy.The control group was given oral dispersion of mecobalamin for 8 weeks.Results:After treatment,the TCM syndrome scores in both groups were decreased,and those in the observation group were more decreased(P<0.05).The vibration perception threshold in both lower limbs were decreased,and that in the observation group were more decreased(P<0.05).TNF-αwas decreased and IL-10 was increased after treatment in two groups(P<0.05),and that in the observation group was better(P<0.05).Conclusion:The internal and external treatment accoring to the Wenyang Huoxue therapy can effectively improve the TCM syndrome,and reduce the threshold of vibrational sensation.The mechanism may be related to reducing inflammation by lowering serum TNF-αand increasing IL-10.