Clinical Study On The Effect Of Qigui Tangtongning Granules On The Treatment Of Diabetic Peripheral Neuropathy Patients And The Serum-EP And NGFmRNA Levels In Rats With DPN Model

Purpose:With Qi for promoting blood circulation method,to observe the effect of Qigui Tangtongning Granules with peripheral neuropathy in patients with type 2 diabetes and clinical intervention on the serum β-EP and NGF content,to explore the mechanism of neural function repair of Qigui Tangtongning Granules may have pain from the molecular and genetic level,to explore the mechanism of Astragalus and angelica polysaccharide Qigui Tangtongning Granules on patients with DPN lesions and the neuroprotective effect of nerve injury in DPN rats under the state.Method: 1 Clinical studiesAccording to the 1999 WHO diagnostic criteria for diabetes prevention guidelines from Anhui University of traditional Chinese Medicine First Affiliated Hospital from June 2015 to June 2016 menstrual in our hospital outpatient and ward diagnosed 64 patients with deficiency of both qi and Yin with blood stasis syndrome of diabetic peripheral neuropathy,were randomly divided into control group and treatment group of 32 cases.The control group was given diabetes education,diet and exercise to receive basic treatment,including the control of blood glucose,blood lipids,oral administration of Mecobalamin Tablets(0.5mg,TID)based regimens,the treatment group in the control group treated with Astragalus and Angelica Qigui Tangtongning Granules(be taken in boiling water,bid).For 12 weeks,fasting glucose were recorded before and after treatment(FPG),2 hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),electromyography nerve conduction speed(NCV),β-EP,NGF and other related index,TCM syndrome score,Toronto score,using statistical methods to analyze the difference before and after treatment.2 Experimental study60 male healthy SD rats were fed with adaptive feeding for a period of 1 week,and then were randomly divided into blank group(n = 10)and experimental group(n = 50).The blank group rats whole to normal diet,the experimental group of rats with streptozotocin combined with high fat diet made diabetes model,observation of mechanical ventilation threshold and sciatic nerve conduction velocity was slowed as the success of the DPN modeling symbol.The 45 rats were randomly divided into the following groups according to the random principle,including the model group(n = 15),the traditional Chinese medicine high dose group(n = 15)and the low dose group of traditional Chinese medicine(n = 15).The blank group and model group were treated with normal saline,and the high dose and low dose group of Chinese medicine were treated with different doses of 12 cases.After 12 weeks,the rats in each group were observed,and the samples were taken to examine the biochemical indexes.The sciatic nerve tissue was isolated and the expression of β-EP and NGFmRNA was detected by RT-PCR.Result 1 Clinical findingsThe clinical observation showed that after 12 weeks of treatment,the total effective rate of treatment group 86.67%,control group total effective rate was 66.67%,the difference was statistically significant(P<0.05);after the treatment of TCM syndrome integral of the two groups were significantly decreased than before treatment,and the treatment group than in control group(P<0.01);after treatment,the two groups of FPG,2hPG and HbA1 c were lower than before treatment(P<0.01),compared with the control group,the treatment group decreased significantly(P<0.05);the two groups after treatment TG,TC,LDL-C levels lower than before treatment(P < 0.05),elevated levels of HDL-C(P < 0.05),a statistically significant difference.Compared with before treatment,TCM quantitative symptom scores and Toronto scores were lower after treatment in two groups(P < 0.01),improve nerve conduction velocity(P<0.01),and the treatment group than the control group,there was significant difference between two groups(P<0.05).The serum β-EP and NGF levels in the treatment group and the control group were significantly higher than those before treatment(P<0.05),and the treatment group was significantly better than the control group(P<0.01).2 Animal experiment resultsThe results of animal experiment showed that the blood glucose,mechanical pain threshold and the conduction velocity of sciatic nerve in DPN rats were significantly different from those in the blank group(P < 0.05).After administration of traditional Chinese medicine two group,mechanical pain threshold and conduction velocity of sciatic nerve were compared with the model group,the numerical decreased(P < 0.05 or P < 0.01);compared with the control group,the content of NGF,β-EP,the rats in the model group decreased significantly(P < 0.01);compared with the model group.Chinese medicine gavage group rat β-EP,the increased expression of NGFmRNA(P<0.05).Conclusion:Qigui Tangtongning Granules can effectively improve the peripheral neuropathy of type 2 diabetes patients with limb numbness,cold pain and other symptoms and signs,improve nerve conduction velocity,its mechanism may be related to lower blood glucose,glycosylated hemoglobin,blood lipid regulation,increased β-EP,NGF expression levels,improve inflammation,anti-oxidation,repair of nerve injury and so on.