益气化瘀方对气虚血瘀型糖尿病神经病变患者炎性因子、胰岛B细胞功能的影响

Effect of Yiqi Huayu Prescription on Inflammatory Factors and Pancreatic IsletβCell Function in Patients with Diabetic Neuropathy

目的:观察益气化瘀方治疗气虚血瘀型糖尿病神经病变患者的临床疗效,并观察其对患者血糖、炎性因子及胰岛B细胞功能的影响。方法:98例气虚血瘀型糖尿病神经病变患者按随机数字表法平均分为对照组和观察组各49例。对照组给予西医常规治疗,观察组在对照组治疗基础上给予益气化瘀方。治疗4周后比较两组患者临床疗效,糖化血红蛋白(glycosylated hemoglobin,HbA1c)、餐后2小时血糖(2 h postprandial blood glucose,2hPBG)、空腹血糖(fasting blood-glucose,FBG)、白细胞介素-1β(interleukin-1β,IL-1β)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平,腓总神经、正中神经的感觉神经传导速度(sensory nerve conduction velocity,SNCV)、运动神经传导速度(motor nerve conduction velocity,MNCV),胰岛素分泌指数、空腹胰岛素水平,乏力、胃纳差、下肢刺痛等症状积分,不良反应发生率。结果:治疗后,观察组HbA1c、2hPBG、FBG等血糖指标水平低于对照组,差异均有统计学意义(P<0.05);观察组腓总神经、正中神经SNCV、MNCV大于对照组,差异有统计学意义(P<0.05);观察组IL-1β、TNF-α等炎症因子水平低于对照组,差异有统计学意义(P<0.05);观察组胰岛素分泌指数、空腹胰岛素水平低于对照组,差异有统计学意义(P<0.05);治疗后观察组乏力、胃纳差、下肢刺痛等症状积分均低于对照组(P<0.05);观察组有效率为93.88%(46/49),高于对照组的73.47%(36/49),差异有统计学意义(P<0.05);观察组不良反应发生率为12.24%(6/49),对照组为16.33%(8/49),差异无统计学意义(P>0.05)。结论:益气化瘀方治疗糖尿病神经病变气虚血瘀证疗效显著,可减轻患者炎症反应、改善胰岛B细胞功能、调节血糖水平。

Objective:Objective To observe the clinical efficacy of Yiqi Huayu Prescription in the treatment of diabetic neuropathy of qi deficiency and blood stasis type,and to observe its influence on blood glucose,inflammatory factors and pancreatic isletβcell function.Methods:98 cases of diabetic neuropathy of qi deficiency and blood stasis type were randomly divided into control group and observation group with 49 cases in each group.The control group was given conventional western medicine treatment,and the observation group was given Yiqi Huayu Prescription on the basis of the control group.After 4 weeks of treatment,the clinical effi-cacy of the two groups were compared,including glycosylated hemoglobin(HbA1c),2 h postprandial blood glucose(2hPBG),fasting blood-glucose(FBG),Interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)level,sensory nerve conduction velocity(SNCV)of common peroneal nerve and median nerve,motor nerve conduction velocity(MNCV),insulin secretion index,fasting insulin level,symptom scores of fatigue,gastric anorexia and lower limb tingling of common peroneal nerve and median nerve,and incidence of adverse reactions.Results:After treatment,the levels of HbA1c,2hPBG and FBG in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05);SNCV and MNCV of common peroneal nerve and median nerve in observation group were higher than those in control group,and the differences were statistically significant(P<0.05);the levels of IL-1β,TNF-αand other inflammatory factors in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05);the insulin secretion index and fasting insulin level in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05);after treatment,the symptom scores of fatigue,poor appetite and lower limb tingling in the observation group were lower than those in the control group(P<0.05);the effective rate of the observation group was 93.88%(46/49),which was higher than 73.47%(36/49)of the control group,and the difference was statistically significant(P<0.05);the incidence of adverse reactions in the observation group was 12.24%(6/49),which was 16.33%(8/49)in the control group,and the difference was not statistically significant(P>0.05).Conclusion:Yiqi Huayu Prescription has significant effect on diabetic neuropathy with qi deficiency and blood stasis syndrome,which can reduce inflammatory reaction,improve pancreatic isletβcell function and regulate blood glucose level.