Effect Of Acupuncture Combined With Xingcan Decoction On Polyol Pathway Inpatients With Diabetic Peripheral Neuropathy Of Phlegm And Blood Stasis Type

Objective:To observe the effect of acupuncture combined with Xingcan decoction on the clinical efficacy and the indexs of polyol pathway in patients with diabetic peripheral neuropathy(DPN)of phlegm and blood stasis type,and to discuss the clinical mechanism of treating DPN by this method.Methods:1.90 patients with diabetic peripheral neuropathy who accord with the diagnostic criteria divided randomly into three groups,acupuncture group,acupuncture combined with TCM group,western medicine group,30 cases per group.Three groups of patients were given the same basic treatment.The acupuncture group was treated with acupuncture at Quchi,Shousanli,Waiguan,Hegu,Taichong,Baxie,Zusanli,Fenglong,Sanyinjiao,Taixi and Bafeng points,acupuncture combined with TCM group was treated by combined Xingcan decoction with the treatment of acupuncture group,western medicine group was given an oral epalrestat 50 mg daily three times before meals.There groups were threated for eight weeks.2.Observe three groups before and after treatment:(1)Clinical efficacy changes.(2)Changes of TCM syndrome scores.(3)Indexs of polyol pathway:Changes of aldose reductase(AR)activity,erythrocyte sorbitol content and Na+-K+-ATP enzyme activity.Results:1.Comparison of TCM syndrome scores:After therapy TCM syndrome scores decreased significantly acupuncture combined with TCM group group compared with acupuncture group and western medicine group,statistical significance(P<0.05).2.Clinical efficacy comparison:Acupuncture combined with TCM group:1 case was cured,11 cases were markedly effective,15 cases were effective,3 cases were invalid,total effective rate was 90.0%;Acupuncture group:0 case was cured,1 case was markedly effecive,19 cases were effective,10 cases were invalid,total effective rate was 66.67%;Western medicine group:0 case was cured,3 cases were markedly effective,18 cases were effective,9 cases were invalid,total effective rate was 70%,3.Indexs.of polyol pathway:(1)Aldose reductase activity:After treatment,activity of AR decreased significantly in there groups,compared between three groups,acupuncture combined with TCM group was significantly superior to acupuncture group and western medicine group,with statistical significance(P<0.05).(2)Erythrocyte sorbitol content:After treatment,erythrocyte sorbitol content decreased significantly in three groups,compared between three groups,acupuncture combined with TCM group was significantly superior to acupuncture group and western medicine group,with statistical significance(P<0.05),(3)Na+-K+-ATP enzyme activity:After treatment,the activity of Na+-K+-ATP enzyme increased significantly in three groups,compared between three groups,acupuncture combined with TCM group was significantly superior to acupuncture group and western medicine group,with statistical significance(P<0.05).Conclusions:Acupuncture combined with Xingcan decoction was effective in treating diabetic peripheral neuropathy of phlegm and blood stasis type,it can significantly improve the clinical manifestations and TCM syndrome scores.This method can achieve the treatment of diabetic peripheral neuropathy by inhibiting the activity of aldose reductase(AR),reducing the content of erythrocyte sorbitol,enhancing the activity of Na+-K+-ATP enzyme and affecting the function of polyol pathway.