Clinical Observation Of Qigui Tangtongning Recipe In The Treatment Of Type 2 Diabetic Peripheral Neuropathy With Qi Deficiency And Blood Stasis And Its Effect On IGF-1 And Hypersensitive3 C-reactive Protein

Objective:The purpose of this study was to observe the clinical effects of Qigui tangtongning recipe on Qi deficiency and haemostasis syndrome in diabetic peripheral neuropathy(DPN)and to investigate the effect of Qigui tangtongning recipe on the expression of Insulin-like growth factor-1(IGF-1)and hypersensitive C-reactive protein(hs-CRP)in patients with DPN and its neuroprotective mechanism,so as to provide reference for the clinical treatment of DPN.Methods:Using the method of random sampling,64 patients with DPN of Qi deficiency and haemostasis syndrome were randomly assigned to the Qigui tangtongning group(hereinafter the Qigui group)and the control group(n=32).Both groups received basic treatment including blood glucose control,diet and exercise therapy.The control group was treated with mecobalamin tablets(0.5mg tid),while the treatment group(Qigui group)received Qigui tangtongning prescription(One dose a day,take it in the morning and evening)combined with mecobalamin tablets.12 weeks later,changes in blood glucose,blood lipids,TCM symptom scale,Toronto Clinical score system(TCSS),nerve conduction velocity,IGF-1 and hs-CRP levels were compared before and after treatment.Results1.Curative effect:During the trial,4 cases were discontinued due to termination of observation,non-use of the drug and other reasons.At the end of the study,a total of 60 subjects were effective,30 cases in each group.After 12 weeks,the efficacy was 83.33%in the Qigui group and 60%in the control group.Comparison between the two groups showed that QiGui group had better therapeutic effect on DPN than the control group.2.Blood glucose levels:After 12 weeks of intervention,blood glucose levels decreased significantly in both groups(P<0.05);FPG and 2hPG decreased significantly in the Qigui group(P<0.05);and there was no statistical difference in the intervention effect of HbAlc between the two groups(P>0.05).3.Blood lipids:Blood lipids:After treatment,the levels of blood lipids in both groups were improved(P<0.05),and the improvement of TC and HDL-C in Qigui group was more obvious than that in the control group.(P>0.05).4.TCM evidence score:After 12 weeks of treatment,a reduction was observed in the drug-treated and control groups.(P<0.05).A comparison between groups showed that the Qigui group was more able to improve the TCM symptoms of DPN patients(P<0.05).5.TCSS score:After the intervention,the TCSS score of both groups decreased(P<0.05),and the decrease of TCSS score of Qigui group was more significant(P<0.05).6.Nerve conduction rate:After 12 weeks of drug intervention,the conduction velocity(MCV and SCV)of the median and common peroneal nerves in both groups were significantly higher than those before treatment(P<0.05),and the improvement of nerve conduction function in Qigui group was better than the control group(P<0.05).7.IGF-1 and hs-CRP:Compared with the pre-treatment period,hs-CRP levels decreased in both groups,while IGF-1 levels increased significantly(P<0.05),compared with the control group,the improvement in hs-CRP and IGF-1 indexes was more significant in the Qigui group(P<0.05).Conclusion:Qigui tangtongning formula can significantly improve the clinical symptoms of DPN patients,increase the serum IGF-1 content of subjects,reduce the level of hs-CRP,and improve nerve conduction velocity.It is speculated that Qiguitongning formula can improve glucose and lipid metabolism and protect nerves by regulating the expression of hs-CRP and IGF-1.