Observing The Effect Of Limb Ischemia Treatment On Patients With Diabetic Peripheral Neuropathy

Objective To explore the therapeutic value of ischemic preconditioning(IPC) on patients with diabetic peripheral neuropathy(DPN).China is one of the countries with the highest incidence of (diabetes mellitus, DM). With the development of economy, and the improvement of living standard, the incidence has an increasing tendency. Either type1or2DM, acute diabetic complications have greatly reduced, owing to the wide application of insulin and a variety of new antidiabetic drugs, and chronic complications have become a major hazard to human. DPN as the main form of diabetic neuropathy,has become the most common chronic complications of diabetes and the main factors of disability.It have diverse clinical manifestations,and distal symmetric sensory neuropathy is the most common among them.Patient’s health and quality of life have been seriously affected. However, the pathogenesis of DPN is not understood completely, it may be caused by many factors:1.Polyol pathway and metabolic disorders:activation of polyol pathway is an important mechanism;2. Glycation end products which are out of non-enzymatic glycosylation cells might interfere with cell adhesion and cell reaction, and that in cells could change the transport and function of protein, caused neuronal damage Indirectly;3. Oxidative stress The generation of reactive oxygen species under strict control under normal conditions, but excessive reactive oxygen species produced under the condition of the metabolic disorder would lead to cell damage;4. Neurotrophic factors Neurotrophic factors played an important role in the development of the nervous system and palying normally function, reducing of the neurotrophic factors may lead to neurons or nerve atrophy in diabetic neuropathy;5.Insulin and C peptide:Both insulin and C peptide have the effects of Neuroprotective and anti-apoptotic effects.Physiological conditions, insulin not only can stimulate the growth of axonal, but also be the crucial to the survival of sympathetic and sensory6. Neuranagenesis DPN is characterized by progressive loss of nerve fiber, which may be related to the damage of regeneration reaction in the process of degeneration;7. Cell apoptosis etc. But ischemic treatment is a powerful endogenous protective mechanisms of the body, the specific mechanisms are as follows:effectively improve the ability of scavenging oxygen free radical, make the capability of protecting the integrity of structure and function of cell membrane stronger, promote the formation of collateral circulation,improve the endothelium function, resist oxidative stress, reduce mitochondrial calcium overload, slow the apoptotic cell death, active mitochondrial ATP sensitive potassium channel (KATP) and inhibite mitochondrial permeability pore etc. In order to have a protective effect on the body hypoxic ischemic tissues.This paper is based on diabetic peripheral neuropathy (DPN) patients with ischemia treatment on forearm, to investigate the therapeutic effects of treatment of ischemia in patients with DPN.Methods Sixty DPN patients were chosen,and respectively divided into two groups(n=30)randomly. Based on giving the patients of drug treatment and health education,The experimental group treated with ischemic preconditioning:arm ischaemia (induced by five cycles of alternating5-min inflation and5-min deflation of a standard upper-arm blood-pressure cuff).Contents the nerve conduction velocity of all patients before and after the experiment,and degree of symptom relief were assessed.Results The nerve conduction velocity and the degree of symptoms relief of A group patients is higher than B group patients. Compared A group patients of the index before and after the experiment, and compared with A group and B group have statistically significant (p<0.01).Conclusion Noninvasive limb ischemia treatment as human powerful endogenous protective mechanism, possibly through promoting DNP patients body microcirculation and the formation of stable microvascular endothelial function, so as to improve blood flow, and nutrition nerve, antioxidant stress, reduce free radical damage, make a diabetic peripheral neuropathy patients blood vessel and nerve symptom is reduced. Limb ischemic preconditioning can be implemented repeatedly, It Is a simple, economic, non-invasive physical therapy,and it can improve symptoms in patients with DPN effectively.