The Clinical Observation Of Nourishing Yin, Invigorating Qi, Extinguishing Wind, Promoting Blood Circulation And Draining Collateral Method To DPN And The Experiment Study Of The Sciatic Nerve Schwann Cells Apoptosis To DM Rats

Objective:To observe the clinical effect of nourishing Yin,invigorating Qi,extinguishing wind,promoting blood circulation and draining collateral method to DPN,to discuss the mechanism that nourishing Yin, invigorating Qi,extinguishing wind,promoting blood circulation,Extinguishing wind and draining collateral method to treat DPN,to provide the theory basis for TCM to treat DPN.Method:Clinical part:The selected patients were randomly devided into treatment group and control group,each group has 30 patients.The two groups patients were belong to symptoms of accumulation of blood, deficiency of both qi and yin.The treatment group patients take jiangtangshuluo formula,the control group patients take methycobal tablets,observe the ordinary circumstances,clinical effect,syndrome effect,Symptom integral,BG,HbA₁c and NCV between before treatment and after treatment.The two groups carry on the treatment based on controlling BG by the western medicine.One month is a treatment course,altogether observe a treatment course.Experiment part:48 SD femail rats were randomly devided normal group,model group,western medicine group,jiangtangshuluo fomula high dosage group,jiangtangshuluo formula middle dosage group,jiangtangshuluo formula low dosage group into 6 groups,had abdominal cavity injection by STZ to make SD rats DM model.Compared with methycobal and gliclazide,took ordinary circumstances,BG,HbA₁c,SINS,sciatic nerve schwann cells apotosis,the expression of caspase-3(caused apotosis)-and bcl-2,bax(adjusted and controlled apotosis) as observational targets.Results:Clinical part:The clinical and syndrome effect and the mayor symptoms of the treatment group patients were equalled with the control group(P＞0.05),but the effect of the treatment group to the clinical apparent rate,syndrome heal rate and the secondary symptoms were superior to the control group(P＜0.05).There was statistics significance of the FBG,PBG,HbA₁C and NCV,the two groups compared after treatment with before treatment(P＜0.01),and there is no statistics significance after treatment of the two groups compared(P＞0.05).Experiment part:There were no obviously changement of water intake,body weight,food quantity, urine volume,BG of each group DM rats before making models(P＞0.05).There were obviously significance of water intake,body weight,food quantity,urine volume,BG of each group DM rats after making models(P＜0.01),with the process of using medicines,the water intake,food quantity,urine volume of the western medicine group and the TCM group DM rats obviously reduced compared with the model group DM rats,the levels of BG dropped gradually,but the body weight obviously increased compared with the model group(P＜0.01).After the experiment ended,the ordinary circumstances and BG of the western medicine group and the TCM group had obviously changement compared with the model group,the effect of TCM group to warer intake,food quantity,urine volume was better than the western medicine group,and assumed the dosage dependence.The effect of body weight and BG of western medicine group DM rats restored better than the TCM group(P＜0.01),the curative effect of each TCM group compared,the high dosage group was better than the other two groups(P＜0.05),but there was no statistical significance among the TCM groups(P＞0.05).The levels of serum insulin,HbA₁c of the model group compared with the normal group had remarkable difference(P＜0.01),the serum insulin,HbA₁c of the treatment group and the control group all had statistics significance than the model group after treatment(P＜0.01),the effect of the high dosage TCM group and the middle dosage TCM group to the surem insulin,HbA1c was superior than the western group obviously(P＜0.05or 0.01),the curative effect of the control group to the serum insulin,HbA₁c was better than the low dosage TCM group(P＜0.01),the curative effect of each TCM group compared,the high dosage group and the middle dosage group was better than the low dosage groups(P＜0.01).The DM rats sciatic nerve schwann cells apotosis,caspase-3,bax gene protine expressed of the model group rats sciatic nerve higher and the bcl-2 gene protine expressed lower than the normal group obviously(P＜0.01).There were statistics significance both TCM group and western medicine group compared with the model group to the sciatic nerve schwann cells apotosis,caspase-3,bax and bcl-2(P＜0.01).The effect of each TCM high and middle dosage group to the schwann cells apotosis,caspase-3,bax and bcl-2 was superior to the western medicine group(P＜0.05),the curative effect of each TCM group compared,the high dosage group was better than the other two groups(P＜0.05or0.01).Conclusion:Nourishing Yin,invigorating Qi,extinguishing wind, promoting blood circulation and draining collateral method can stabilizate dlood glucoge,improve the clinical symptoms and nerve conductive velocity of the DPN patients,estimate it's curative effect has something to do with improving sugar metabolism,inhibiting the activity of aldose reductase.Nourishing Yin,invigorating Qi,extinguishing wind,promoting blood circulation and draining collateral method can improve the levels of Insulin and reduce the level of HbA1c on DM rats,inhibit schwann cells apoptosis,it was thought that the function mechanism was concerned on inhibiting the activeness of caspase-3,the expressing of bax and promoting the expressing of bcl-2,and the effect of the method to each observation target show the dosage dependence.