温阳化瘀方治疗糖尿病痛性神经病变疗效及机制研究  

Effect and Mechanism of Wenyang Huayu Formula(温阳化瘀方)on Painful Diabetic Neuropathy

作　　者：郝永蕾 徐江红[1] 陈冰[1] 吴雪红 周颖[1] 张振锋[1] 陶李[1] 李超[1] HAO Yonglei;XU Jianghong;CHEN Bing;WU Xuehong;ZHOU Ying;ZHANG Zhenfeng;TAO Li;LI Chao(Department of Endocrinology,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市中医医院内分泌科,河北秦皇岛066000

出　　处：《山东中医杂志》2023年第8期820-825,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：秦皇岛市科学技术研究与发展计划项目(编号:202101A173)。

摘　　要：目的:探讨温阳化瘀方治疗糖尿病痛性神经病变(PDPN)疗效及对核因子κB(NF-κB)/诱导型一氧化氮合酶(iNOS)mRNA/一氧化氮(NO)信号通路的影响。方法:选择2021年5月至2022年5月秦皇岛市中医医院收治的PDPN患者90例,按照随机数字表法分为观察组和对照组各45例。对照组接受糖尿病常规治疗,并口服甲钴胺片、依帕司他片;观察组在此基础上予以中药温阳化瘀方口服,两组疗程均为4周。比较两组治疗前后中医证候评分、疼痛视觉模拟(VAS)评分和正中神经、胫后神经的运动神经传导速度(MNCV)和感觉神经传导速度(SNCV);并比较两组外周血NF-κB、iNOS mRNA、NO含量。比较两组治疗总有效率。结果:治疗后观察组肢端刺痛、手足麻木、气短乏力、腰膝酸软评分均低于对照组(P<0.01),疼痛VAS评分低于对照组(P<0.01);正中神经MNCV、SNCV和胫后神经MNCV、SNCV优于对照组(P<0.01),外周血NF-κB、NO、iNOS mRNA含量均低于对照组(P<0.01);治疗总有效率高于对照组(P<0.05)。结论:温阳化瘀方可改善PDPN中医证候,有效缓解神经痛,提高神经传导速度,其机制可能与抑制NF-κB/iNOS mRNA/NO信号通路有关。Objective:To investigate the effect of Wenyang Huayu Formula(温阳化瘀方)on painful diabetic polyneuropathy(PDPN)and on nuclear factor-κB/inducible nitric oxide synthase mRNA/nitric oxide(NF-κB/iNOS/NO)signaling pathway.Methods:From May 2020 to May 2022,90 patients with PDPN admitted to Qinhuangdao Hospital of Traditional Chinese Medicine were included and divided into the observation group(45 patients)and control group(45 patients)according to the random number table method.The control group was treated with routine treatment for diabetes with oral administration of mecobalamin tablet and epalastat tablet;besides the treatment in the control group,the observation group were further treated with oral administration of Wenyang Huayu Formula.The treatment course of both groups lasted for 4 weeks.The traditional Chinese medicine(TCM)syndrome score,pain visual analogue scale(VAS)score,motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of median nerve and posterior tibial nerve were compared between the two groups before and after treatment.Levels of NF-κB,iNOS mRNA,NO in the peripheral blood were compared between the two groups.The total effective rate in both groups was compared.Results:After treatment,the scores of extremity tingling,numbness of hands and feet,shortness of breath and fatigue,soreness of waist and knees in the observation group were lower than those in the control group(P<0.01),and VAS score in the observation group was lower than that in the control group(P<0.01).MNCV and SNCV of median nerve and posterior tibial nerve were superior to those of the control group(P<0.01).Levels of NF-κB,NO and iNOS mRNA in the observation group were lower than those in the control group(P<0.01).The total effective rate in the observation group was higher than that in the control group(P<0.05).Conclusions:Wenyang Huayu Formula could improve TCM syndromes,effectively relieve neuralgia,increase nerve conduction velocity of PDPN,and the mechanism might be related to the inhibition of

关 键 词：糖尿病痛性神经病变 温阳化瘀方 核因子ΚB 诱导型一氧化氮合酶 一氧化氮 

分 类 号：R587.2[医药卫生—内分泌] R255.4[医药卫生—内科学]