化痰通络法治疗糖尿病周围神经病变的临床研究

目的：探讨糖尿病周围神经病变痰瘀互结的病理实质及化痰通络法治疗该病的作用机制。方法：比较58例患者治疗前与30例健康人血NO与NOS水平及Na^＋-K^＋-ATPase活性,并比较糖尿病周围神经病变经化痰通络法治疗2个月后NO与NOS水平、Na^＋-K^＋-ATPase活性、TC、TG、FBG、PBG、胫神经和正中神经的运动传导速度（MCV）和感觉传导速度（SCV）。结果：糖尿病周围神经病变患者NO、NOS水平较健康人显著降低（P〈0.01）,Na^＋-K^＋-ATPase活性也明显降低（P〈0.05）。治疗2个月后,NO与NOS水平、Na^＋-K^＋-ATPase活性明显升高（P〈0.05）;FBG、PBG明显降低（P〈0.05）;胫神经和正中神经MCV、SCV明显加快（P〈0.05）;TC、TG无显著变化（P〉0.05）。结论：糖尿病周围神经病变存在着痰瘀互结的病理实质。化痰通络法通过多靶点、多环节改善高血糖引起的代谢异常及周围神经损伤而达防治糖尿病周围神经病变的作用。

Clinical Study on Phlegm-Resolving and Collateral-Unblocking Therapy for Diabetic Peripheral Neuropathy

Objective:To approach the pathological essence of phlegm and blood-stasis and the mechanism of phlegm-resolving and collateral-unblocking therapy for diabetic peripheral neuropathy.Methods:The levels of NO and NOS,Na+-K+-ATPase activity were compared between 58 subjects and 30 healthy people.And the levels of NO and NOS,Na+-K+-ATPase activity,TC,TG,FBG,PBG,MCV and SCV of tibial nerve and median nerve were observed before and after treatment by phlegm-resolving and collateral-unblocking therapy.Results:In diabetic peripheral neuropathy patients,the levels of NO and NOS decreased obviously(P < 0.01),Na+-K+-ATPase activity significantly fell(P < 0.05).After 2-month treatment by phlegm-resolving and collateral-unblocking therapy,the levels of NO and NOS,Na+-K+-ATPase activity rose strikingly(P < 0.05);FBG and PBG reduced evidently(P < 0.05);MCV and SCV of tibial nerve and median nerve remarkably increased(P < 0.05);TC and TG changed little(P > 0.05).Conclusion:Diabetic peripheral neuropathy is pathologically of phlegm and blood-stasis accumulation.This therapy acts in multiple pathways on diabetic peripheral neuropathy.