Clinical Observation And Experimental Study Of Effect Mechanism On Electroacupuncture Treating Diabetic Peripheral Neuropathy

Background and Objective:Diabetes is a kind of global popular chronic diseases.Diabetic peripheral neuropathy(DPN)is one of the major factors of chronic complication and mutilation caused by diabetes mellitus, according to statistics,The prevalence rate of DPN has been estimated to be 47%to 91%.Since the high incident rate,DPN has become the important project in diabetic research.Finding effective medicines for diabetes mellitus is a focus of modern researches.Although there has been great progress in the study of molecule mechanism about polyol pathway,advanced glycation end products,protein kinase C and hexosamie.Clinically effective diabetic peripheral neuropathy treatments remain elusive and ultimately.Strategies must look beyond the single pathway for a more integrative answer to diabetic peripheral neuropathy.The theory of unifying mechanism was proposed by Browlee et al.In 2001 year,in which it said that the four hypothesis fore mentioned probably based on the consequences following excessive oxygen free radicals produced in the mitochondrial electron transport chain under the conduction of high glucose.It was all outstanding superiority that this theory had considered the damages to peripheral nerves caused by oxygen free radicals as an integrity process via various channels in researches in DPN,instead of single channels.It is a great feature of Traditional Chinese Medicine(TCM)in therapy that pay attention to the regulation in integrity. It has a broad prospect of TCM in treatment of diabetes,acupuncture treatment of diabetes appears very long in ancient China,Development work on clinical study and basic experimental study about acupuncture treatment of diabetes have been made in China and abroad since 1980s and obtained the certain achievement.This research consists two parts:clinical trials and experimental research. PartⅠ:clinical trialsObjective:to assess the clinic effect of electroacupuncture for treating DPN.Method:52 DPN patients conforming to the diagnostic criteria were randomly divided into the electroacupuncture group(26patients)and control group(26patients).Based on the basic treatment,the electroacupuncture group was given electroacupuncture.The control group was given intramuscular injection the methycobaK mecobalamin),treatment the patients for 4 weeks.The changes in the symptoms,Toronto clinical scoring system (TCSS),fasting blood glucose(FBG)and nerve conduction velocity observed in the patients.Results:The effects of electroacupuncture treatment on nerve conduction velocity:The electroacupuncture group and the control group had obviously difference in improvement of the nerve conductive velocity(P＜0.01).Conclusion:The electroacupuncture treatment can improve the conduction velocities of DPN patients effectly,thus the effect of treating DPN by eletroacupuncture is affirmative.PartⅡ:experimental researchObjective:by using the diabetic models induced by streptozotocin,are to observe the changes of oxidation and anti-oxidative defense system of organism and peripheral nerve in experimental diabetes rats,and to study the relation between these changes and AGEs and RAGEmRNA in sciatic nerve. In this study,we hope to investigate the possible mechanism of Protective effects of electroacupuncture treatment on diabetic peripheral neuropathy in diabetic rats and provide electroacupuncture treatment with evidence of theory in therapeutic effects.Methods:(1)70 male Wistar rats randomly were divided into five groups:including normal control group,model-control group,methycobal-control group,acupuncture-treated group and electroacu-puncture-treated group,the diabetic models induced by streptozotocin.(2)general conditions were observed and the plasma glucose of tail vein were measured by plasma glucose instrumen after and before treatment respectively.(3)The rats were killed after the treatment and then the sciatic nerve were taken out,which was observed by morphometric evaluation under light microscope and transmission electron microscope,and detecting the speed of conduction in sciatic nerve before being killed respectively.(4)The rats were killed after treatment respectively:the blood serum and sciatic nerve were taken out, and then various parameters were measured as follows:The content of MDA,SOD,T-AOC in blood serum and sciatic nerve were analysed by chromatometry.Results:(1)The changes of pathological morphology and ultrastructure in sciatic nerve:Compared with the normal-control group,there were obvious reactions to the damage all in model-control group,methycobal-control group,acupuncture-treated group and electroacupuncture-treated group, after the 16th week of STZ injection,however,the reactions in methycobal-control group,acupuncture-treated group and electroacupuncture -treated group were weaker than that in model-control group.The reactions in electroacupuncture-treated group were better than that in methycobal-control group and acupuncture-treated group,however,there was no significant difference in methycobal-control group and acupuncture-treated group.(2)The changes of sciatic nerve conduction velocity:Compared with the normal-control group,the sciatic nerve conduction velocity of all treatment groups is significantly slow on the 16th week after treatment(P＜0.05). compared with the model-control group,the sciatic nerve conduction velocity of all treatment groups is significantly accelerate on the 16th week after treatment(P＜0.05).Compared with methycobal-control group and acupuncture-treated group,electroacupuncture-treated group could accelerate the nerve conduction velocity,the difference were significant (P＜0.05),And at the same time there was no significant difference between methycobal-control group and acupuncture-treated group(P＞0.05). (3)The effects of electroacupuncture treatment on serum and sciatic nerve of MDA,SOD and T-AOC:compared with the normal-control group,the rats of model-control group have a significantly increased in serum and sciatic nerve of MDA on 16th week after having been induced by STZ (P＜0.01),but the content of SOD,T-AOC in serum and sciatic nerve were obviously lower than that in the normal-control group in the corresponding time period(P＜0.01).When compared with the model-control group the electroacupuncture treatment could attenuate the content of MDA in serum and sciatic nerve(P＜0.05),and elevate the content of SOD,T-AOC (p＜0.05).These results had significant difference with methycobal-control group and acupuncture-treated group(P＜0.05).Conclusion:1,electro acupuncture treatment can lessen the damages to structure and function of peripheral nerves in diabetic rats and postpone the development of neuropathy.2,Electro acupuncture treatment have the effect of anti-oxidative stress during decreasing the level of MDA and increasing level of SOD and T-AOC in serum and sciatic nerve.