Function Of Complex Prescription QiTengTongLuo Decoction On Diabetic Peripheral Neuropathy Rats And Its Possible Therapeutic Mechanism

Background:Diabetic mellitus is the most common chronic disease which involves various organs and systems of the body. While diabetic peripheral neuropathy (DPN) is considered to be a severe complication of diabetic mellitus which affects sensory nerve,motor nerve and autonomic nerve and it is most commonly seen in sensory nerves. The clinical manifestations of DPN are paraesthesia,pain,numb,skin ulceration and myoathophy. Recent years,with the advancement of fundamental researches on nervous blood flow volume measurement,neuropathical ultramicrostructure and enzyme kinetics,pathogenesis of DPN has been further studied. It is thought that DPN is the co-acting result of metabolic disturbance,vascular disorder,impairment of neurotrophic factors,cell factor disorder,oxygen free radical impairment and immune factors. Microangiopathy,hemodynamic alteration,nervous metabolic disorder caused by chronic hyperglycosemia and active polyalcohol passageway are the causative factors of DPN.Insulin-like growth factor-1 (IGF-1) prevents neuropathy under the condition of hyperglycosemia. While insulin is insufficient or inactive,neuropathy is induced by secondary decreased activity of IGF-1. Therefore,the improvement of DPN through the prevention of insulin and IGF-1 are mediated by its neurotrophical effects. It is found that IGF-1 has favorable effects on peripheral neuropathy.Objective: To study the preventive and therapeutic mechanism of QiTengTongLuo Decoction on rats with DPN induced by STZ.Method: Rats were fed with Qitengtongluo Decoction through stomachfor eight weeks continuously. Changes on body weight, blood glucose,HbA1c were measured. Morphologic changes on sciatic nerves were also observed. The expression of IGF–1(Insulin-like growth factor-1) in sciatic nerves was detected through immunohistochemistry.Result:1,There was significant difference in weight between DM and NC group after 4 and 8 weeks (P<0.05), significant difference was found between DM and herbal medication group(P<0.05). Both glucose and HbA1c level in herbal medication group decreased, there was significant difference compared with DM group (P<0.05).2,There were less significant pathological changes of sciatic nerves in herbal medication group than those in DM group, denaturation and atrophia of neuraxon and ecclasis of medullary sheath were also less.3,IGF-1 expressions in sciatic nerve of herbal medication group ( 60.33±5.52 ) % were significantly higher than those in DM group (49.25%±5.10%)(P<0.05).Conclusion: QiTengTongLuo Decoction improves the metabolism of peripheral nerve tissues of diabetic rats, enhances the survival and promotes the regeneration and restoration of nerves, its function may be achieved through increasing the IGF-1 expression in sciatic nerves of diabetic rats.