| Purpose:Numbness of the limbs is a common symptom of diabetic peripheral neuropathy(DPN).This study systematically summarizes the literatures in treating numbness from ancient and modern physicians,according to the experiences of diagnosis and treatment of numbness from my mentor,proposed that Qi and Yin deficiency and the meridians blocked by the wind,phlegm and stasis is the fundamental pathogenesis of DPN,and develop Juanbitongluo decoction according to nourishing qi and yin,dispelling pathogenic wind and eliminating sputum to dredge collateral.Recruiting DPN patients as subject of study,observe and evaluate the clinical efficacy of Juanbitongluo decoction for the treatment of diabetic peripheral neuropathy numbness,so as to provide an valid therapies and formulas in treating this disease.clinical curative effect for the clinical diagnosis and treatment of this disease to provide ideas and cure prescription drugs.Method:100 cases collected,which includes numbness cause by DPN.Randomly divided into Chinese medicine treatment group and control group,each group 50 cases.Both of the two groups were treated with routine treatment,such as controlling blood glucose,regulating blood fat and resisting platelet aggregation.For control group took mecobalamin 0.5mg and Vitamin B110mg,1 tablet every time,3 times a day,treatment group,uses Juanbi Tongluo Decoction on the basis of the treatment group,course of treatment for both groups is 8 weeks.By observing and comparing the differences between the two group in frequency of numbness seizures,reduce of numbness degree,ameliorating related symptoms of numbness,improving nerve conduction velocity,evaluate the efficacy of Juanbi Tongluo Decoction in the treatment of numbness due to DPN.Test the MD A,ACR and AGEs of serum and explore its possible mechanisms.Results:(1)The curative effects of the two groups were compared:43 cases in the treatment group,26 cases were cured(60.47%),12 cases took apparent effect(27.91%),3 cases were in effect(6.98%),2 cases were of no effect(4.65%),the curative and apparent effective rate was 88.38%,the total effective rate was 95.35%.41 cases in the control group,15 cases were cured(36.59%),9 cases took apparent effect(21.95%),9 cases were in effect(21.95%),8 cases were of no effect(19.51%),the curative and apparent effective rate was 58.54%,the total effective rate was 80.49%.The curable and apparent effective rate and total effective rate of the two groups were tested by the chi square test,P<0.01、P<0.05,the effect of the treatment group was better than that of the control group.(2)Comparison of numbness improvement:Levi special sensory neurotoxicity grading standard scoring and VAS scoring were used to observe the numbness of the two groups before and after treatment.The results showed that the improvement of numbness in the two groups were significantly reduced after treatment,the treatment group was better than the control group,P<0.05.(3)Comparison of two groups to reduce the frequency of numbness attack:43 cases left after treatment in the treatment group,persistent numbness in 1 case(2.32%),paroxysmal numbness in 0 case(0.00%),occasional numbness in 19 cases(44.19%),23 cases were cured(53.49%).Compared with that before treatment,date was tested by the chi square test,x2 =89.15,P<0.01.41 cases left after treatment in the control group,persistent numbness in 5 cases(2.32%),paroxysmal numbness in 8 case(19.51%),occasional numbness in 13 cases(31.71%),15 cases were cured(36.59%).Compared with that before treatment,date was tested by the chi square test,x2 =49.41,P<0.01.Two groups were tested after treatment by the chi square test,x2 =16.78,P<0.01.It showed that the frequency of numbness reduction in the treatment group was significantly better than that in the control group.(4)The effect of improving numbness related symptoms:The treatment group in improving soreness,distanding,swollen,pain symptom had better efficacy than control group,P<0.01,P<0.01.The accompanying symptoms are improved to varying degrees.Among them,the treatment group in improving weakness,pale,tactile allergy symptom had better efficacy than control group,P<0.01,P<0.01.(5)Comparison of nerve conduction velocity:The sensory conduction velocity of the superficial peroneal nerve and the motor conduction velocity of the peroneal nerve were examined by electromyography respectively,it was founded that the MCV of the peroneal nerve and the SCV of superficial peroneal nerve were improved after treatment in the two groups.But it was not up to the normal value.The improvement of nerve conduction velocity in the treatment group was better than that in the control group,there was a statistical difference of the curative effect between them.(6)Improvement of oxidative stress and other indexes:The levels of MDA in the two groups were decreased significantly after treatment,compared with before treatment,P<0.01 and P<0.05 respectively.After treatment,the two groups were compared,P<0.05,the decrease of MDA in the treatment group was better than that of the control group.The levels of AGEs in the two groups were decreased significantly after treatment,compared with before treatment,P<0.01 and P<0.05 respectively.After treatment,the two groups were compared,P<0.05,the decrease of AGEs in the treatment group was better than that of the control group.The levels of ACR in the two groups were decreased significantly after treatment,compared with before treatment,P<0.01respectively.After treatment,the two groups were compared,P<0.01,the decrease of ACR in the treatment group was better than that of the control group.Conclusion:On the basis of control group with Juanbitongluo decoction who can nourishing Qi and Yin,dispelling pathogenic wind and eliminating sputum to dredge collateral to treat DPN numbness,the efficacy of Juanbitongluo decoction in treating DPN numbness is greater than Mecobalamin and Vitamin B1,it can reduce the degree of numbness effectively,reduce the frequency of numbness,improve numbness related symptoms such as rheumatic,swell,swollen and pain,improve accompanying symptoms such as weakness,pale,tactile allergy,improve the nerve conduction velocity,reduce the level of MDA,ACR and AGEs.It shows that it can antagonize oxidative stress and reduce the damage to blood vessels and nerves in diabetic patients.This could be one of the mechanisms of its function.The efficacy of Juahbitongluo decoction in treating DPN numbness is great. |
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