足部护理干预对46例糖尿病周围神经病变患者神经传导速度和临床疗效的影响

目的分析足部护理干预对糖尿病周围神经病变(DPN)患者神经传导速度和临床疗效的影响。方法采用随机数字表法将91例DPN患者分为对照组和观察组,在常规治疗基础上,对照组予基础护理,观察组予基础护理配合足部护理措施,观察30d末2组患者的神经传导速度和临床疗效。结果 2组均能够明显改善周围神经传导速度;30d末,观察组周围神经传导速度明显优于对照组(P<0.01);观察组总有效率93.48%,明显优于对照组的77.78%(P<0.05)。结论在常规治疗和基础护理的基础上配合足部护理措施能够明显改善DPN患者神经传导速度,提高临床疗效,在提高患者的生存质量和改善预后方面具有重要意义,值得临床推广。

空气压力波与安诺治疗仪联合治疗糖尿病周围神经病变对神经传导速度的影响

目的:探讨空气压力波与安诺治疗仪联合治疗糖尿病周围神经病变对神经传导速度的影响。方法:对123例住院的2型糖尿病的患者,凡是符合:(1)有糖尿病周围神经病变临床症状(密歇根问卷评分≥4分);(2)感觉神经定量测定异常(密歇根体检≥2分);(3)神经电图有神经传导速度异常。同时具备上述三条者,可确诊DPN并纳入研究。随机分为四组,分别采取:常规治疗组,常规治疗+红外线激光照射,常规治疗+空气压力波,常规治疗+空气压力波+红外线激光照射治疗,每组治疗2周。治疗前测定空腹血糖(FPG),餐后2h血糖(2hPG),空腹胰岛素(FIns)、糖化血红蛋白(HbA1c),治疗前后测尺神经、正中神经和腓总神经传导速度及"神经病变主觉症状问卷"(密歇根评分)做为观察指标进行相关分析研究。结果治疗2周后,FPG、2hPG和各组比较,无明显差异,(P﹥0.01);各组治疗后运动神经传导速度(MNCV)和感觉神经传导速度(SNCV)治疗前后无明显差异(P>0.05),各组密歇根评分较治疗前均有改善(P<0.05),但空气压力波联合红外线激光治疗组较其他治疗组评分改善更明显,(P<0.05)。结论各组治疗后密歇根评分较治疗前均有改善,但空气压力波与安诺治疗仪联合治疗组密歇根评分改善与其他三组比较改善更显著;对神经传导速度的影响各治疗组无明显差异,可能与治疗时间短,神经修复本身是一比较缓慢的过程。

单纤维肌电图对糖尿病周围神经病及糖尿病肾病的早期诊断价值

目的探讨单纤维肌电图(SFEMG)对糖尿病周围神经病(DPN)及糖尿病肾病的早期诊断价值。方法应用SFEMG对43例2型糖尿病患者行指总伸肌的颤抖(jitter)和纤维密度(FD)测定,同时检测神经传导速度(NCV),并测空腹血糖(FBG)、糖化血红蛋白(HbA1c)、血脂、同型半胱氨酸(Hcy)及尿微量白蛋白/尿肌酐比值(UACR)。比较SFEMG和NCV的异常检出率,并分析颤抖和FD与病程、LDL-C、HbA1c、Hcy、UACR的相关性。结果全部患者颤抖、FD和NCV的异常检出率分别为65.1%、53.5%和48.8%,24例无DPN症状患者分别检出9例(20.9%)、4例(9.3%)和2例(4.7%)。颤抖和FD呈正相关,且均与病程、LDL-C、HbA1c、Hcy和UACR呈正相关。结论 SFEMG是DPN的早期诊断指标,SFEMG异常者行HbA1c、Hcy和UACR联合检测对DPN和糖尿病肾病的早期诊治有帮助。

糖痹康对ob／ob小鼠感觉神经功能的保护作用

目的：探讨糖痹康对糖尿病周围神经病（diabeticperipheralneuropathy，DPN）小鼠感觉神经功能的影响。方法：将60只8～9周龄的ob／ob小鼠随机分为5组，另选取12只同龄C57BL／6J小鼠为对照组，分别给予甲钴胺、糖痹康及溶媒8周。监测体质量、50％机械缩足阈值（mechanicalwith—drawthreshold，MwT）、甩尾反射潜伏期（tail-flicklatency，TFL）、感觉神经传导速度（sensorynerveconductionvelocity，SCV）。结果：与对照组比较，给药后模型组体质量显著增加（P〈0．001），50％MWT显著下降（P〈O．05），TFL显著延长（P〈0．05），SCV显著减慢（P〈0．05）；与模型组相比，各给药组体质量未见显著差异；给药4周时，糖痹康高剂量组50％MWT明显上升（P〈0．05），糖痹康高、低剂量组及甲钴胺组TFL显著缩短（P〈0．05）；给药8周时，糖痹康高、中剂量组及甲钴胺组50％MWT明显上升（P〈0．05），糖痹康高、低剂量组及甲钴胺组TFL显著缩短（P〈0．05），糖痹康中剂量组及甲钴胺组SCV显著上升（P〈0．05）。结论：ob／ob品系小鼠模型适合于药物对DPN疗效的评价，糖痹康能改善DPN小鼠的感觉神经功能。

DISCUSSION OF MECHANISM ON LUMBAR DISC HERNIATION TREATED WITH BLOODLETTING ON W■IZH■NG(委中BL40)

Objective To observe the changes of sciatic nerve conduction velocity （SNCV） and interleukin-1α （IL-1α）, phospholipase A2 （PLA2） and prostaglandin E2 （PGE2） in neucleus pulposus tissue in experimental rabbits with lumbar disc herniation （LDH） ; and discuss the mechanism of LDH treated with bloodletting on Wěizhōng （委中 BL40）. Methods 40 normal named control group, LDH model group, BL40 group New Zealand rabbits were randomized into 4 groups, and comparative point group. The experimental LDH model was prepared by the self-made LDH animal pathological modeling device. Bloodletting on BL40 or on comparative point was applied for 7 days. BL-410 physiological signal recorder was used to record SNCV. Enzyme-linked immunosorbent assay （ELISA） and radioimmunology methods were used to determine the contents of IL-1α and PLA2 in neucleus pulposus tissue and PGE2 in serum. Results In BL40 group, SNCV was significantly increased after treatment comparing with that before treatment （P〈0. 01 ）, and the difference in SNCV value before and after treatment was significantly bigger than that in model group and comparative point group （P〈0.05）. Bloodletting on BL40 reduced the contents of IL-1α and PLA2 in neucleus pulposus tissue and serum PGE2 in LDH rabbits, which indicated significant difference or very significant results in the comparison with model and comparative point groups （P〈0.01 or 0. 05）. Conclusion Bloodletting speeded up rapidly SNCV and reduced the contents of inflammatory factors, i.e. IL-1α, PLA2 and serum PGE2 in LDH rabbits, which indicated that alleviation of local inflammatory reaction is probably one of the mechanisms on LDH treated by bloodletting on BL40.

CLINICAL AND ELECTROPHYSIOLOGICAL OBSERVATIONS ON DIABETIC PERIPHERAL NEUROPATHYTREATED BY WARM NEEDLING AND MOXIBUSTION

Objective To observe clinical therapeutic effects of warm needling and moxibustion on diabetic peripheral neuropathy （DPN） and their influence on nerve conduction velocity. Methods Fifty two cases were randomly divided into a treatment group （n =26） and a control group （n =26）. In addition to basic treatment for lowering blood sugar in both groups, Pǐshū （BL 20）, Shènshū （BL 23）, Huántiào （GB 30）, Zùsānlǐ （ST 36）, Yánglíngquán （GB 34）, Sānyīnjiāo （SP 6）, Tàixī （KI 3）, Qǔchí （LI 11）, Wàiguān （TE 5） and Hégǔ （LI 4） were selected for warm needling and moxibustion in the treatment group. Methycobal was intramuscularly injected in the control group. Clinical symptoms and conduction velocities of the tibial nerve and common peroneal nerve were compared before and after treatment. Results Warm needling and moxibustion could alleviate such clinical symptoms as numbness of limbs, pain and hypoesthesia, and obviously improve the conduction velocities of both tibial and common peroneal nerves. Conclusion Warm needling and moxibustion exhibit good therapeutic effects on diabetic peripheral neuropathy.

Indoor thermal comfort studies based on physiological parameter measurement and questionnaire investigation

Physiological parameters of people and enact assessment standard of indoor thermal environment that are appropriate to our national conditions were explored from the perspective of physiology. From December 2005 to January 2006, nerve conduction velocities and skin temperatures of 20 healthy students were tested with questionnaire investigation. The results show that the nerve conduction velocities as well as skin temperatures present an obvious decline trend in a continuous draught, and that the nerve conduction velocities and skin temperatures have a definite linear relationship. Draught velocity is an important factor in winter that affects body comfort, and the subjects are sensitive to air velocity.

Effect of electroacupuncture on conduction velocity of the sciatic nerve in experimental diabetic rats and its mechanisms

Objective To investigate the mechanisms of acupuncture in accelerating regeneration of injured sciatic nerve, the effect of electroacupuncture （EA） at ＂Huantiao （环跳 GB 30）＂ and ＂Zusanli （足三里 ST 36）＂ on conduction velocity and mRNA expression of receptors of advanced glycation end products （RAGE） of the sciatic nerve were observed in experimental diabetic rats. Methods Streptozotocin was injected into the left abdomen in 30 male rats to establish diabetes mellitus （DM） models with hyperglycemia （〉16.7 mmol/L）. Thirty rats with DM were divided into a diabetes model group （group DM）, a Methycobal group （group MET） and an EA group （group EA）. Another 8 rats comparable in body weight and age were used as a normal control group （group NC）. General situation and blood sugar levels of all the rats were recorded, and the conduction velocities of the sciatic nerves were measured. RAGE mRNA expression of the sciatic nerve was detected by means of reverse transcription polymerase chain reaction（RT-PCR）16 weeks after treatment. Results After 16 weeks, the conduction velocities of the sciatic nerves were lowered in group DM, compared with those in group NC, indicating lesion of peripheral nerves. Compared with group DM, the conduction velocities of the sciatic nerves were significantly elevated in both group EA and group MET （P〈0.01 ）, and there was a significant difference between the two groups, showing superiority of EA to Methycobal （P〈0.01）. The RAGE mRNA levels of the sciatic nerves in group DM were significantly higher than those in group NC （P〈0.01）. The RAGE mRNA levels of the sciatic nerves in both group EA and group MET were remarkably lowered than those in group DM （P〈0.01）, and the decrease in group EA was more obviously than that in group MET （P〈0.01）. Conclusion EA may exert its therapeutic effects on diabetic perineuropathy （DPN） by way of regulating abnormal expression of RAGE mRNA in the sciatic nerve and alleviating its injury caused by advanced glycation end products （AGEs） accumulation and diminishing oxidative stress to enhance its conduction velocity.

Using the Implantable Electrical Stimulator for Peripheral Nerve Rehabilitation:A Study in an Animal Model

The present study presents a peripheral nerve injury animal model for evaluation of an implantable electrical stimulator we designed.The evaluation was confirmed by ethological,electrophysiological and histologic study.Twenty New Zealand rabbits were used.The left sciatic nerve was crushed with a micro-vessel clamp in all rabbits,and the stimulators were implanted in ten rabbits.The other ten rabbits were in a control group.As compared with the implantation group,3 and 6 weeks after operation,the histology showed the typical pathologic atrophy by hematoxylin-eosin(HE) ,the motor nerve conduction velocity(MCV) was found significantly slowed and the axon of crushed nerve at distal portion exhibited breakdown in the control group.These results reveal that the implantable electrical stimulator was effective and was suitable for implantation in an animal model.

Experimental Study on Effect of Electro-acupuncture plus Musk Injection on Recovery of Sciatic Nerve Function in Rats

Objective： To explore the effect of electro-acupuncture and musk injection on recovery of injured sciatic nerve function in rats, so as to provide the experimental evidences for the promotion of peripheral nerve regeneration by electro-acupuncture and musk injection. Methods： Following establishing rat model of sciatic nerve injury by operation, the rats were randomly divided into electro-acupuncture group, musk injection group, electro-acupuncture plus musk injection group and model group, then sciatic functional index （SFI） and motor nerve conduction velocity （MNCV） were measured after 4 weeks of treatment, 8 weeks of treatment and 12 weeks of treatment respectively to evaluate recovery of nerve function. Results： SFI and MNCV in electro-acupuncture group, musk injection group and electro-acupuncture plus musk injection group were improved more obviously than that in model group, with significant differences（P〈0.01, P〈0.05）. Conclusions： Both electro-acupuncture and musk injection could promote recovery of injured nerve function, and they had a certain synergetic effect and might be the effective methods in promoting recovery of injured peripheral nerve function.