益肾补阳还五汤治疗糖尿病周围神经病变

Effect of Buyanghuanwu Decoction on Diabetic Peripheral Neuropathy u-Lpo and Blood Hemorrheology

目的 :对老年人糖尿病周围神经病 48例进行中医辨证规律观察 ;用益肾补阳还五汤治疗观察其临床疗效 ,并观察该方对尿过氧化脂质和血液流变学的影响。方法 :48例患者按不同中医证型分别用益肾补阳还五汤系列方治疗 ,同时控制饮食和药物控制血糖。治疗前后测定尿过氧化脂质( U- LPO)和红细胞压积 ( Ht)、纤维蛋白原 ( Fbg)及全血粘度 ( Va)、血浆粘度 ( vp)。结果 :48例中肾气阴虚血瘀证 30例 ,肾阳气虚血瘀证 1 8例。治疗后显效 2 6例 ,有效 1 6例 ,无效 6例 ,总有效率88.5 %。治疗前血液流变学主要指标均明显高于健康人 ( P<0 .0 1 ) ;U- LPO值 ,肾阳气虚血瘀证患者明显高于肾气阴虚血瘀证患者 ( P<0 .0 5 )。治疗后 Fbg、Va、Vp、U- LPO均明显下降 ( P<0 .0 1～0 .0 5 ) ,肾阳气虚血瘀证 Ht下降不明显 ( P>0 .0 5 )。结论 :益肾补阳还五汤治疗老年人糖尿病周围神经病变的作用机理与抗氧自由基损伤及改善血液流变学有关。肾阳气虚血瘀证氧自由基损伤程度较重 ,为微观辨证提供了依据。

Objective: To investigate Traditional Chinese Medical Syndrome of 48 cases of aged diabetic peripheral neuropathy; and observe the curative effect of Buyanghuanwu decoction and its effect on urine lipid peroxide and blood hemorrheology. Methods:48 patients were treated by series of Buyanghuanwu decoction according to their different syndrome, with their blood sugar controlled by diets and medicine. The level of u Lpo and blood hemorrheology were checked before treatment.Results: There were 30 cases (62.5%) of kidney Qi and Yin deficiency with blood stasis syndrome,18cases (37.5) of kidney Yang and Qi deficiency with blood stasis syndrome among 48 patients. The markedly effective rate was 54.17%, effective rate 33.33%, no effective rate 12.5%, total effective rate 88.5%. Before treating, the levels of blood hemorrheology in two syndrome groups were markedly higher than that in normal group( P <0.001～0.01); the level of u Lpo in kidney Yangqi deficiency with blood stasis syndrome was markedly higher than that m kidney Qiyin deficiency with blood stasis syndrome( P <0.05). After treatment,the levels of Fbg,Va,Vp and u Lpo both m two syndrome groups were decreased significantly( P <0.01~0.05), while the level of Ht in kidney Yangqi deficiency with blood stasis reduced unmarkedly( P >0.05). Conclusion:The mechamsm of Yishenbuyanghuanwu decoction treating aged diabetic peripheral neuropathy is related to anti oxygen free radical damage and improve blood hemorreology, the damage of oxygen free radical is more serious in kidney Yangqi deficiency with blood stasis syndrome, which affords foundation to micro syndrome assay.