桑皮饮对糖尿病周围神经病变(阴虚燥热证)患者神经震动感觉阈值,血清IGF-1、TNF-α表达的影响

Effects of Sangpi Drink on Sensory Threshold of Nerve Vibration and Expression of Serum IGF-1 and TNF-αof Diabetic Peripheral Neuropathy(Yin Deficiency and Dryness Heat Syndrome)Patients

目的:观察桑皮饮对糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)(阴虚燥热证)患者神经震动感觉阈值,血清胰岛素样生长因子-1(insulin like growth factor-1,IGF-1)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)表达的影响。方法:60例DPN(阴虚燥热证)患者按照随机数字表法分为观察组与对照组各30例。对照组给予西药治疗,观察组在对照组治疗基础上给予桑皮饮治疗。比较两组患者临床疗效,治疗前后IGF-1、白细胞介素-6(interleukin-6,IL-6)、血清游离脂肪酸(free fatty acid,FFA)、人髓磷脂碱性蛋白(myelin basic protein,MBP)、TNF-α水平,两侧下肢神经震动感觉阈值(nerve vibration sensory threshold,VPT)、神经传导速度[感觉传导速度(sensory conduction velocity,SNCV)、运动传导速度(motor conduction velocity,MNCV)]及不良反应。结果:①观察组有效率为93.33%(28/30),对照组为73.33%(22/30),两组比较,差异有统计学意义(P<0.05)。②治疗后,两组患者下肢VPT值均低于本组治疗前;观察组左侧下肢VPT值为(16.04±2.19)V,右侧下肢VPT值为(15.77±2.30)V,均低于同期对照组(P<0.05)。③治疗后,两组患者腓总神经传导速度、正中神经传导速速均显著升高;观察组腓总神经MNCV为(43.48±2.18)m·s^(-1)、SNCV为(47.39±2.22)m·s^(-1),正中神经MNCV为(46.78±4.21)m·s^(-1)、SNCV为(45.04±3.14)m·s^(-1),均高于同期对照组(P<0.05)。④治疗后,两组患者FFA、MBP水平显著低于治疗前,IGF-1水平显著高于治疗前;观察组血清FFA水平为(409.64±21.18)μmol·L^(-1)、MBP水平为(1.69±0.38)ng·L^(-1),均低于同期对照组,血清IGF-1水平为(164.18±11.64)ng·L^(-1),高于同期对照组(P<0.05)。⑤治疗后,两组患者血清IL-6、TNF-α水平均显著低于治疗前;观察组血清IL-6水平为(29.31±15.53)ng·L^(-1)、TNF-α水平为(26.40±11.39)ng·L^(-1),均低于同期对照组(P<0.05)。⑥两组不良反应比较,差异无统计学意义(P>0.05)。结论:桑皮饮治疗DPN(阴虚燥热证)患者疗效显著,能有效降低患者下肢神经震动感觉阈值,提高神经传导速度,减轻机体氧化应激损伤,降低炎症因子水平。

Objective:To observe the effect of Sangpi Drink on nerve vibration sensory threshold,serum insulin like growth factor-1(IGF-1)and tumor necrosis factor-α(TNF-α)expression in patients with diabetic peripheral neuropathy(DPN)(Yin deficiency and Dryness Heat syndrome).Methods:60 patients with DPN(yin deficiency and dryness heat syndrome)were divided into observation group and control group according to random number table method,30 cases in each group.The control group was given western medicine treatment,and the observation group was given to the Sangpi Drink on the basis of the treatment of the control group.The clinical efficacy of the two groups of patients was compared,IGF-1,interleukin-6(IL-6),serum free fatty acid(FFA),human myelin basic protein(MBP),TNF-αlevels,lower extremity nerve vibration sensory threshold(VPT)on both sides,nerve conduction velocity[sensory conduction velocity(SNCV),motor conduction velocity(MNCV)]and adverse reactions.Results:①The effective rate was 93.33%(28/30)in the observation group and 73.33%(22/30)in the control group,and the difference was statistically significant(P<0.05).②After treatment,the VPT values of the lower extremities of the two groups were lower than those before treatment;the VPT value of the left lower extremity of the observation group was(16.04±2.19)V,and the VPT value of the right lower extremity was(15.77±2.30)V,both lower compared with the control group at the same period(P<0.05).③After treatment,the nerve conduction velocity and median nerve conduction velocity of the common peroneal nerve in the two groups were significantly increased.The MNCV of the common peroneal nerve in the observation group was(43.48±2.18)m·s^(-1) and the SNCV of that was(47.39±2.22)m·s^(-1),while the median nerve MNCV was(46.78±4.21)m·s^(-1) and SNCV was(45.04±3.14)m·s^(-1),which were higher than those in the control group(P<0.05).④After treatment,the levels of FFA and MBP in the two groups were significantly lower than those before treatment,and the level of IGF-1 was significantly higher than that before treatment;the serum FFA level of the observation group was(409.64±21.18)μmol·L^(-1),and the MBP level was(1.69±0.38)ng·L^(-1),which were lower than the control group at the same period,and the serum IGF-1 level was(164.18±11.64)ng·L^(-1),which was higher than that of the control group at the same period(P<0.05).⑤After treatment,the levels of serum IL-6 and TNF-αin the two groups were significantly lower than those before treatment;(26.40±11.39)ng·L^(-1),all lower than the control group(P<0.05).⑥There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Sangpi Drink has significant curative effect in the treatment of DPN(Yin deficiency and Dryness Heat syndrome)patients;it can effectively reduce the lower limb nerve vibration sensory threshold,increase nerve conduction velocity,reduce the body′s oxidative stress damage,and reduce the level of inflammatory factors.