| Background: Diabetes Mellitus(DM)is a common chronic metabolic system disease in clinic,and its complications are numerous and complex.Changes in structure and function of different organs of multiple systems can be involved.Diabetic Peripheral neuropathy(DPN)is one of the most common complications of diabetes mellitus.The pathogenesis of DPN has obvious diversity and complexity,so far there is no single theory to explain the etiology of DPN,but it is believed that neurotrophic factor and its receptor decrease.Loss or damage is one of the important pathogenic links.Clinically,patients often see limb numbness and pain,and feel strange.Especially during night or cold,their symptoms are more consistent with those of traditional Chinese medicine,such as diabetes,blood deficiency and cold coagulation syndrome.Western medicine is still lack of specific therapy in the treatment of DPN.Clinical mainly to control blood sugar as the basis for treatment,more supplemented by the blood vessel expansion drugs,neurotrophic drugs,improve metabolic disorders such as drugs and antioxidants and other drugs for comprehensive treatment.But through clinical observation,the treatment of DPN with a single application of Western medicine has little effect on the improvement of clinical symptoms.At present,the use of integrated Traditional Chinese and western medicine to treat DPN according to TCM syndrome differentiation type application of Danggui sini decoction combined with the treatment of cobalt,although more clinical observation cases,the curative effect is satisfactory,but the evaluation standard is not uniform,the objective therapeutic index is less,and the comparison is not beneficial to the clinical communication and wide application.Under the guidance of the theory of Chinese and Western medicine,this experiment uses modern scientific research methods to carry out animal research on the related target protein.Purpose: Effects of Danggui sini decoction combined with mecobalamin on sciatic nerve conduction velocity(NVC),nerve growth factor(NGF)and its tyrosine protein kinase receptor(TrkA)in diabetic rats with peripheral neuropathy are observed.To investigate the effects of Danggui sini decoction combined with mecobalamin on the sciatic nerve SNCV,MNCV,NGF and its receptor TrkA in diabetic peripheral neuropathy rats.Methods: Select SPF adult 50 male SD rats,10 rats were randomly selected as the normal group,the other 40 rats of diabetic model,then randomly divided into 4 groups,diabetes group,mecobalamin group,Danggui sini decoction group,Danggui sini decoction combined with mecobalamin group.And observed the general status and blood glucose monitoring of all rats.Thereafter,3 drug groups were treated for 12 weeks.Before and after drug treatment,the pain threshold time of the plantar light and heat stimulation,sensory nerve conduction velocity(SNCV)and motor nerve conduction velocity(MNCV)of plantar photothermal stimulation were measured in 5 groups of rats.Then,immunohistochemical method was used to detect the expression of NGF and TrkA in sciatic nerve of 5 groups of rats.In light microscope,the positive expression products of brown or brown granules in and around the axons of Schwann cells were observed,and the mean optical density was measured.Finally,all the experimental data were statistically summarized,and the single factor analysis of variance was used in each group.Results: 1.Comparison of pain threshold time of plantar photothermal stimulation in rats of each group: Compared with normal group,the pain threshold time of plantar photothermal stimulation was prolonged before and after drug treatment in diabetic control group and 3 treatment groups(P <0.01).After 12 weeks of treatment,the 3 treatment groups were significantly shorter than those in diabetic control group(P < 0.01).There was no significant difference between the group of mecobalamin and Danggui sini decoction(P >0.05).The combination group was shorter than the other two groups,and the difference was statistically significant(P <0.05).Compared with two times in the control group of diabetes mellitus,the time was significantly prolonged after 12 weeks,and there were significant differences(P <0.01).2.Comparison of sciatic nerve SNCV and MNCV in rats: Compared with the normal group before and after the medication,diabetic control group,mecobalamin group,Danggui sini decoction group and combined treatment group of SNCV and MNCV decreased significantly(P < 0.01).After 12 weeks of medication,the SNCV and MNCV levels of the 3 drug groups were all higher than those of the diabetic control group,and the combined drug group had a significantly higher upregulation rate(P < 0.01).At the same time,the combined drug group was significantly different from the other two monotherapy groups,and had statistically significant(P <0.01,P <0.05).The comparison between the two single drug group,mecobalamin group SNCV is higher,the difference was statistically significant(P <0.05),but there was no significant difference in MNCV,no statistical significance(P >0.05).Before and after the drug treatment,the diabetic control group SNCV and MNCV both decreased significantly,the difference was statistically significant(P <0.01).3.Comparison of NGF and TrkA of sciatic nerve of rats in each group:Compared with normal group,the expression level of NGF and TrkA protein of sciatic nerve in diabetic control group and 3 groups of rats were decreased(P <0.01,P <0.05).Compared with the control group of diabetes mellitus,the expression of NGF and TrkA protein increased in 3 groups(P <0.01,P <0.05).Among them,the combination drug group was significantly higher than the two single drug groups,the difference was statistically significant(P <0.05).The level of NGF expression in Danggui sini decoction group was slightly lower than that in mecobalamin group,and the difference was statistically significant(P <0.05),and the expression level of TrkA protein was no statistically significant difference between the two groups(P >0.05).Conclusion:1.Danggui sini decoction combined with mecobalamin can improve the conduction velocity of sciatic nerve in rats with diabetic peripheral neuropathy;2.Danggui sini decoction combined with mecobalamin can obviously improve the expression of NGF and TrkA protein in sciatic nerve of diabetic peripheral neuropathy rats,and the effect is better than that of single mecobalamin or Danggui sini decoction. |
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