| purpose:To observe the clinical intervention of Qiguitongluo Granules on patients with type 2 diabetes mellitus and qi-induced deficiency of qi and yin deficiency,and to explore the mechanism of action of Qiguitongluo Granules on patients with DPN lesions and Mechanism of neuroprotection in DPN rats under nerve injury.method: 1.Clinical study The observation cases were selected from the hospitalization and outpatient department of the Department of Endocrinology,the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from December 2017 to June 2018.80 cases of DPN patients diagnosed as qi and yin deficiency type were diagnosed.They were randomly divided into control group and treatment group,40 cases each.In the basic treatment,the control group took mecobalamin tablets,and the treatment group took mecobalamin tablets + Qiguitongluo granules for 12 weeks.The changes of blood glucose,TCM syndrome score,TCSS score,nerve conduction velocity,serum SOD,MDA and T-AOC content were compared between the two groups,and the total effective rate was calculated and the curative effect was determined.2.Animal experiments Seventy-one SPF SD rats were selected for adaptive feeding for 1 week.The rats were randomly divided into blank control group and model group.The model group was prepared for diabetic rat model.Finally,the rats with successful modeling were randomly divided into model group,western medicine group,Chinese medicine high-dose group,traditional Chinese medicine middle-dose group,and traditional Chinese medicine low-dose group.The blank group and the model group were given normal saline,and the high-,medium-,and low-dose groups of Chinese medicine were given different doses of Qiguitongluo Granules for 12 weeks.After 12 weeks of drug intervention,the general condition of each group of rats was observed,blood glucose monitoring and weighing were performed and recorded,and the time of the foot thermal reaction,the mechanical pain threshold and the speed of the sciatic nerve were measured.Blood samples were taken and serum SOD,MDA,and T-AOC levels were measured by biochemical methods.result: 1.Clinical findings After 12 weeks of drug intervention,the total effective rate was 86.84% in the treatment group and 69.23% in the control group.The difference was statistically significant(P<0.05).Comparison within the group: After treatment,the TCM scores of the two groups improved compared with the previous ones,and the TCSS scores decreased compared with the previous ones,the difference was statistically significant(P<0.05);the two groups of subjects had median nerves and sputum compared with before treatment.The sensory and motor conduction velocity of the total nerves increased compared with the previous ones,and the FPG,2hPG,and HbA1 c decreased earlier,and the difference was statistically significant(P<0.05 or P<0.01).After treatment,the serum SOD,MDA,T-AOC of the two groups.The content was improved.The levels of SOD and T-AOC were higher than those before treatment,and the serum MDA level was lower than that before treatment.The difference was statistically significant(P<0.05).Comparison between groups: Compared with the control group,the TCM syndrome scores in the treatment group improved significantly,FPG and 2hPG decreased significantly,and the sensory and motor conduction velocity of the median nerve and the common peroneal nerve increased,the difference was statistically significant(P<0.05 or P<0.01).There was no significant difference in the TCSS score between the treatment group and the control group(P>0.05).The SOD and MDA levels in the treatment group were significantly improved compared with the control group(P<0.05).The T-AOC content was not significantly different from the control group(P>0.05).2.Animal experiment results Compared with the blank group,the blood glucose of the model group was significantly increased,the time of the thermal reaction of the foot was prolonged,the conduction velocity of PMWT and sciatic nerve was decreased,the SOD and T-AOC decreased,and the MDA level was increased.The difference was statistically significant(P<0.01);Compared with the group,the levels of T-AOC in the high and middle dose groups of Chinese medicine increased(P<0.05).Compared with the middle dose group of traditional Chinese medicine,the levels of SOD in the western medicine group and the high and low dose groups of Chinese medicine increased,and the level of MDA decreased(P<0.05).The difference of T-AOC level in the middle dose group of Chinese medicine was different from that in the western medicine group and the low dose group.Statistically significant(P<0.05).ompared with the model group,the blood glucose of the rats in the high,middle and low dose groups of western medicine group and Chinese medicine were lower than before,the time of heat reaction of the foot was shortened,the level of PMWT was increased,the conduction speed of sciatic nerve was accelerated,level of SOD and T-AOC increased and the level of MDA decreased(P<0.01 or P<0.05).Among them,the blood glucose in the middle dose group was higher than that in the low dose group(P<0.01),and the western medicine group and Chinese medicine were higher and lower.In the dose group,the PMWT value and the nerve conduction velocity increased significantly in the middle dose group(P<0.05 or P<0.01).Conclusion:QiguiTongluo Granules can effectively improve the clinical symptoms of patients with DPN,improve the syndrome of Qi and Yin deficiency,increase nerve conduction velocity,reduce the blood sugar of DPN model rats,improve the neuropsychiatric state of rats,increase serum SOD,T-AOC levels,and reduce MDA levels.The mechanism may be related to scavenging free radicals,improving oxidative stress and reducing nerve damage. |
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