益肾通络法对糖尿病周围神经病变治疗作用的理论及实验研究
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摘要
背景:糖尿病周围神经病变(DPN)是糖尿病患者常见的并发症,其发病趋势在不断增长,可累及感觉神经,运动神经及植物神经,产生肢体麻木疼痛、运动障碍,肌肉萎缩甚至痿废失用和植物神经功能障碍。其发病机制至今未明,亦缺乏特异性的治疗方法及药物。近年来随着糖尿病及其并发症基础研究的进展,对糖尿病神经病变的发病机制有了较深入的认识,有血管、代谢、神经生长因子、自身免疫及炎症等诸多因素,且这些因素共同作用相互影响,为寻找针对性的药物提供了理论基础和依据。
目的:本研究探讨糖尿病周围神经病变的中医病理机制,指出肾阴亏虚,络脉瘀阻是DPN的主要病理机制,制定益肾通络的治疗法则,旨在验证益肾通络法的中药方剂防治糖尿病周围神经病变的作用,并探讨其对糖尿病周围神经病变防治作用的机制,提供药物临床应用的理论依据,为中药防治糖尿病神经病变提供新的研究思路。
方法:以链脲佐菌素(STZ)诱发糖尿病模型大鼠,成模后,分正常组、模型组、阳性对照组(弥可保)、中药小剂量组、大剂量组,治疗10周后,观察中药复方对模型大鼠血糖、体重、SOD、MDA、NO、NOS、NGF含量的影响,并对治疗后的实验性糖尿病大鼠坐骨神经组织进行病理学检查。
结果:经益肾通络治疗后的糖尿病大鼠的体重升高,血糖降低,血清SOD的含量明显增多,MDA的含量明显降低,血清NO、NOS含量明显降低,血清NGF含量明显升高,AGEs含量减少,与模型组比较有显著差异。通过形态学观察,该药对坐骨神经的也有保护作用。
结论:1、本文在前人关于消渴病病机及治疗论述基础上,提出糖尿病周围神经病变的中医病机主要为肾阴亏虚、络脉瘀阻,制定了益肾养阴、活血通络的治疗法则和方药。2、实验研究发现益肾通络的中药可明显减轻糖尿病周围神经病变的程度,对糖尿病周围神经病变有明显治疗作用,而且随着药物浓度的增高,治疗作用越明显。
Background: With an increasing incidence, diabetic peripheral neuropathy(DPN) is one of the most common complications of diabetes mellitus. It is related to the function loss of sensory, motor, autonomic nerve exhibiting numbness, soreness, dyscinesia, muscular atrophy even paralyzed and autonomic nerve dysfunction. Its pathogenesis is still unknown so far, but also the specific therapy and drug are lack. In recent years, with diabetes and its complications in the progress of basic research, the pathogenesis of diabetic neuropathy mechanisms have a more in-depth understanding. Several mechanisms may play an important role leading to the disturbance and have an interaction: vascular, metabolism, nerve growth factor, autoimmune and inflammation. It contributes to seek therapies and effective drugs for diabetic neuropathy. Objective: To discuss the pathology mechanism of traditional Chinese medicine in diabetic peripheral neuropathy, point out that deficiency of kidney yin, blood stagnation in collateral is the major pathology mechanism of DPN, establish kidney-nourishing and collateral-activating therapy , study the effect of traditional Chinese medicine by kidney-nourishing and collateral-activating therapy on DPN, discuss the protective and therapeutic mechanisms of the therapy for peripheral neuropathy in experimental diabetic rats, establish the foundation of clinical application and provide new research clues of prevention on DPN with traditional Chinese medicine.
Methods: The rats model of diabetes were induced by streptozotocin. The rats were randomly divided into normal control group, model group, positive control group (Methycobal), low dose of traditional Chinese medicine treated group, high dose of traditional Chinese medicine treated group. To observe the effect of kidney-nourishing and collateral-activating therapy on blood glucose, body weight, SOD, MDA, NO, NOS, NGF, content from rat serum after 10 weeks, and experimental diabetic rat sciatic nerve pathology organizations.
Results: Compareed with model group, the content of blood glucose, MDA, NO, NOS, AGEs in serum of rats of traditional Chinese medicine treated group were significantly decreased, body weight, SOD, NGF content were significantly increased. By observing the morphology of the sciatic nerve, the drug also has a protective effect on the nerve.
Conclusion: 1、We study forefathers about Xiaokezheng on machine and treatment exposition foundation, point out that deficiency of kidney yin and blood stagnation in collateral were the pathology mechanism of traditional Chinese medicine of DPN, which have established kidney-nourishing and collateral-activating therapy with the prescription of traditional Chinese medicine.
2、Experiment study found that traditional Chinese medicine of kidney-nourishing and collateral-activating therapy can alleviate obviously the degree of diabetic peripheral neuropathy. And for diabetic peripheral neuropathy, it has obvious therapeutic effect, and along with increased drug concentration, therapeutic effect is the more obvious.
目的:本研究探讨糖尿病周围神经病变的中医病理机制,指出肾阴亏虚,络脉瘀阻是DPN的主要病理机制,制定益肾通络的治疗法则,旨在验证益肾通络法的中药方剂防治糖尿病周围神经病变的作用,并探讨其对糖尿病周围神经病变防治作用的机制,提供药物临床应用的理论依据,为中药防治糖尿病神经病变提供新的研究思路。
方法:以链脲佐菌素(STZ)诱发糖尿病模型大鼠,成模后,分正常组、模型组、阳性对照组(弥可保)、中药小剂量组、大剂量组,治疗10周后,观察中药复方对模型大鼠血糖、体重、SOD、MDA、NO、NOS、NGF含量的影响,并对治疗后的实验性糖尿病大鼠坐骨神经组织进行病理学检查。
结果:经益肾通络治疗后的糖尿病大鼠的体重升高,血糖降低,血清SOD的含量明显增多,MDA的含量明显降低,血清NO、NOS含量明显降低,血清NGF含量明显升高,AGEs含量减少,与模型组比较有显著差异。通过形态学观察,该药对坐骨神经的也有保护作用。
结论:1、本文在前人关于消渴病病机及治疗论述基础上,提出糖尿病周围神经病变的中医病机主要为肾阴亏虚、络脉瘀阻,制定了益肾养阴、活血通络的治疗法则和方药。2、实验研究发现益肾通络的中药可明显减轻糖尿病周围神经病变的程度,对糖尿病周围神经病变有明显治疗作用,而且随着药物浓度的增高,治疗作用越明显。
Background: With an increasing incidence, diabetic peripheral neuropathy(DPN) is one of the most common complications of diabetes mellitus. It is related to the function loss of sensory, motor, autonomic nerve exhibiting numbness, soreness, dyscinesia, muscular atrophy even paralyzed and autonomic nerve dysfunction. Its pathogenesis is still unknown so far, but also the specific therapy and drug are lack. In recent years, with diabetes and its complications in the progress of basic research, the pathogenesis of diabetic neuropathy mechanisms have a more in-depth understanding. Several mechanisms may play an important role leading to the disturbance and have an interaction: vascular, metabolism, nerve growth factor, autoimmune and inflammation. It contributes to seek therapies and effective drugs for diabetic neuropathy. Objective: To discuss the pathology mechanism of traditional Chinese medicine in diabetic peripheral neuropathy, point out that deficiency of kidney yin, blood stagnation in collateral is the major pathology mechanism of DPN, establish kidney-nourishing and collateral-activating therapy , study the effect of traditional Chinese medicine by kidney-nourishing and collateral-activating therapy on DPN, discuss the protective and therapeutic mechanisms of the therapy for peripheral neuropathy in experimental diabetic rats, establish the foundation of clinical application and provide new research clues of prevention on DPN with traditional Chinese medicine.
Methods: The rats model of diabetes were induced by streptozotocin. The rats were randomly divided into normal control group, model group, positive control group (Methycobal), low dose of traditional Chinese medicine treated group, high dose of traditional Chinese medicine treated group. To observe the effect of kidney-nourishing and collateral-activating therapy on blood glucose, body weight, SOD, MDA, NO, NOS, NGF, content from rat serum after 10 weeks, and experimental diabetic rat sciatic nerve pathology organizations.
Results: Compareed with model group, the content of blood glucose, MDA, NO, NOS, AGEs in serum of rats of traditional Chinese medicine treated group were significantly decreased, body weight, SOD, NGF content were significantly increased. By observing the morphology of the sciatic nerve, the drug also has a protective effect on the nerve.
Conclusion: 1、We study forefathers about Xiaokezheng on machine and treatment exposition foundation, point out that deficiency of kidney yin and blood stagnation in collateral were the pathology mechanism of traditional Chinese medicine of DPN, which have established kidney-nourishing and collateral-activating therapy with the prescription of traditional Chinese medicine.
2、Experiment study found that traditional Chinese medicine of kidney-nourishing and collateral-activating therapy can alleviate obviously the degree of diabetic peripheral neuropathy. And for diabetic peripheral neuropathy, it has obvious therapeutic effect, and along with increased drug concentration, therapeutic effect is the more obvious.
引文
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