中医综合治疗方案对糖尿病周围神经病变BDNF和IGF-1影响的临床研究  

Effect of Comprehensive Treatment of Traditional Chinese Medicine on BDNF and IGF-1 in Diabetic Peripheral Neuropathy Patients

作　　者：李国菁[1] 全红[2] 付旭彦 程飞[1] 高惠娟[2] 张韦华 冯兴中[1] LI Guojing;QUAN Hong;FU Xuyan;CHENG Fei;GAO Huijuan;ZHANG Weihua;FENG Xingzhong(Capital Medical University Affiliated Beijing Shijitan Hospital,Beijing 100038,China;Beijing Fangshan District Liangxiang Hospital,Beijing 102488,China)

机构地区：[1]首都医科大学附属北京世纪坛医院,北京100038 [2]北京市房山区良乡医院,北京102488

出　　处：《中华中医药学刊》2021年第11期28-31,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局“十二五”重点专科建设项目(国中医药医政发[2012]2号);国家中医药管理局重大疑难疾病中西医临床协作试点项目(国中医药办医政发[2018]3号);北京市属医院科研培育计划(PZ2017004);北京中医药科技发展基金(QN2018-28)。

摘　　要：目的客观评价中医综合治疗方案对糖尿病周围神经病变(气阴两虚、血脉瘀滞证)的临床疗效以及对脑源性神经营养因子(brain derived neurotrophic factor,BDNF)和胰岛素样生长因子-1(insulin-like growth fators-1,IGF-1)的影响,初步探讨其作用机制。方法将符合诊断标准的93例糖尿病周围神经病变(气阴两虚、血脉瘀滞证)患者随机分为治疗组47例、对照组46例。在采用相同治疗的基础上,对照组给予甲钴胺,治疗组采用中药内服联合外洗综合治疗,疗程为3个月。观察两组治疗后临床疗效、多伦多临床评分系统(TCSS)评分、腓总神经、胫神经传导速度及血清BDNF和IGF-1的变化。结果治疗后,治疗组总有效率明显高于对照组(P<0.05);治疗组患者神经传导速度较对照组明显提高(P<0.05);治疗组能明显增加患者血清BDNF和IGF-1的表达,差异有统计学意义(P<0.05)。结论采用中药内服联合外洗综合治疗方案可提高糖尿病周围神经病变患者的临床疗效,其作用机制可能与增加患者BDNF和IGF-1有关。Objective To evaluate the clinical effect of TCM comprehensive treatment on diabetic peripheral neuropathy(Qi and Yin deficiency and blood stasis syndrome)and its effect on BDNF and IGF-1,and explore its mechanism.Methods A total of 93 cases of diabetic peripheral neuropathy(Qi and Yin deficiency and blood stasis syndrome)were randomly divided into treatment group 47 cases and control group 46 cases.On the basis of the same treatment,the control group was given Mecobalamin.The treatment group was treated with the combination of traditional Chinese medicine and external washing.The course of treatment was 3 months.The clinical effect,TCSS score,conduction velocity of common peroneal nerve,tibial nerve,BDNF and IGF-1 in serum were observed.Result After treatment,the total effective rate of the treatment group was significantly higher than that of the control group(P<0.05).The nerve conduction velocity of the treatment group was significantly higher than that of the control group(P<0.05).The expressions of BDNF and IGF-1 in the treatment group were significantly increased,and the difference was statistically significant(P<0.05).Conclusion The therapeutic effect of traditional Chinese medicine combined with external washing can improve the clinical efficacy of diabetic peripheral neuropathy.The mechanism may be related to the increase of BDNF and IGF-1.

关 键 词：糖尿病周围神经病变 BDNF IGF-1 中医综合治疗 

分 类 号：R295.872[医药卫生—民族医学]