Theoretical,Clinical And Experimental Studies In Treating Diabetic Peripheral Neuropathy With Modified Huangqiguizhiwuwu Decoction

Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes mellitus(DM), and the main cause of disability and death. Its pathogenesis is not understood clearly now and had no good therapeutic. It is an international attention in reseaching good therapeutic and medicines and explanting the pharmacological functions. It is thought Qi deficiency, blood stasis and meridian block is the essential pathogenesis for DPN. Supplying Qi, promoting blood circulation, warming and removing obstruction in channels are basic therapeutic for it. Modify HuangQi GuiZhi WuWu decoction, which come from Zhang Zhongjing's work and my tutor's clinical experience, was studied both on clinical observation and experiment research.Clinical observationObjective:to observe effectiveness and mechanism on treatment of DPN with modify HuangQi GuiZhi WuWu decoction.Methods:Forty patients with DPN were randomly divided into treatment group and control group with 20 case each. In controlling blood sugar, blood pressure, and blood lipids, modify HuangQi GuiZhi WuWu decoction was orally given in treatment group, and Mikebao (Jia Gu An) was taken in control group. The course of treatment was 8 weeks, and the symptoms, nerve conduction velocity and blood pressure, blood lipids and blood sugar were recored.Results:The total effective rate in treatment group and control group is 90% and 65%. The total effective rate in treatment group is higher than in control group (P<0.05). Improvements of clinical symptoms, both sides'posterior motor nerve, and sensory nerve conduction velocity in treatment group are better than in control group, (P<0.05). There is no side effects are found in both groups.Conclusion:Modify HuangQi GuiZhi WuWu decoction on the DPN is better than Mikebao in improving clinical symptom, and accelerating nerve conduction velocity.Experimental studyObjective:To investigate mechanism of the modify HuangQi GuiZhi WuWu decoction in treating DPN and provide the theoretical basis for clinical applications of new drugs.Methods:Ten of 60 of 200-220g Wistar male rats was randomly taken to the normal control group, Diabetic model was established in rest of 50 rats by induction of streptozotocin, and then was randomly divided into model group, Mikebao gruop, three JiaWei HuangQi GuiZhi WuWu decoction groups in high, medium and low dosage with 10 in each. Body weight, blood sugar, malondialdehyde (MDA), glutathione (GSH), and reaction time, of cold and hot stimulation, sciatic nerve conduction velocity and expression of sciatic nerve growth factor (NGF) were measured after 8 weeks of treatment. Finally diabetic rat sciatic nerve tissue was examined in pathologyResults:Compare with model group, body weight, and blood sugar, the content of MDA significantly reduced; serum levels of serum GSH and NGF increased significantly, reaction time for cold and hot stimulation was shortened and nerve conduction velocity increased significantly. Pathological observation showed pathological changes of sciatic nerve tissue were improved obviously by this drug.Conclusion:1 Modify HuangQi GuiZhi WuWu decoction could alleviate peripheral nerve injury, and delay neuropathy process in DM rat2 Modify HuangQi GuiZhi WuWu decoction can reduce serum MDA level, increase level of serum GSH, and improve the oxidation and stress response of surrounding tissues. The changes may be coused by the protection mechanisms.3 It could be another protection mechanism for modify HuangQi GuiZhi WuWu decoction in increasing the expression of NGF, and content of NGF.