Study On "Clearing Heat And Nourishing Yin"Therapy In The Treat Ment Of Diabetic Peripheral Neuropathy

Diabetic Peripheral Neuropathy(DPN) is one of the most common complications of Type2Diabetes Mellitus(T2DM) to the patients.During the deteriorate of the lesion, it will influenced the evolution of the T2DM and the multiple organs. Through those year, it became a popular and necessary subject which are pathological changes research and the treatment method of the Chinese medical. Base on the theoretical exploration and clinical experience, the pathogenesis of the DPN are include "excessive heat of spleen and stomach","Fleeing into meridians and collaterals"," Yin deficiency"," Dystrophy of meridians and collaterals". Clearing heat and nourishing yin"is the fundamental therapy of this disease which is because the same pathogenesis.Observing the clinical effect of this therapy on DPN and investigating the echanism of it by theoretical studies and animal experiments in the way of using Wang's Hypoglycemic Decoction.Theoretical studiesâ‘ Concluding the cognitions of Pathogeny, Pathogenesis and Syndrome differentiation. Meanwhile, to analyze the treatment of DPN on the ancient medical experts by research of the journals.â‘ Summarizing the Pathogeny, Pathology, Treatment and Prognosis of DPN on the base of the results of rational medical studies.â‘¢Analyzing the basical therapy(Clearing heat and nourishing yin)of DPN by discussing the basic pathogenesis of DPN.â‘£Analyzing the representative decoction of this therapy(Wang's Hypoglycemic Decoction)which include the composition basis, medication characteristic, the card plus or minus,and the application in DPN.Experimetal studiesObjective:To observe the thrapeutical effect of Wang's Hypoglycemic Decoction on DPN model rats and related gene expression of sciatic nerve. Discussed the mechanism of the treatment on DPN, discover the mechanism of "Clearing heat and nourishing yin", preliminary explore its pharmacodynamic targets,then provide scientific basis for thorough research and clinical practice.Methods:the model rats male SD were established with disposable injection of low dose STZ and high caloie diet.Kinds of examinations were applied:ontaining biochemistry, electrophysiology,light microscope.immunohistochemical.Hua-lian rat gene expression profiling chip,and real time quantitative reverse transcription polymerase chain reaction technique to observe the effect of Wang's Hypoglycemic Decoction on indictors such as general conditions, fasting plasma C peptide level, thermal stimulus response threshold, the conduction velocity of sciatic nerve, sciatic nerve morphology,the expression of NGF and Trk A,especially gene expression profiling and PLA2G2A mRNA gene.Results:(1)The model of DPN rat has been cloned successfully.(2) Wang's Hypoglycemic Decoction has significant effects on decreasing blood glucose after1month influced,However, it hasn't decrease the fasting plasma C peptide level in comparing with the model group.(3)The Increased thermal stimulus response threshold significantly(p<0.001)in comparing with the model group.(4)The increased SNCV significantly (p<0.001) in comparing with the model group,but each groups'MNCVs haven't any differences.(5)Protecting sciatic nerve from microstructure pathology damaging,proctecting nerve function and easing the symptoms of DPN.(6)Increasing the expression of NGF in sciatic nerve,however the significants are differences of the expression of Trk A.(7)By analyzing gene chip,we found that there were genes expression204up-regulation and genes expression104down-regulation in the treatment group in comparing with the DPN model group rat sciatic nerves,some of there genes related to metabolism of Arachidonic acid, peroxisome proliferators activated receptor pathway, anti-oxidative.(8)With real time quantitative reverse transcription polymerase chain reaction technique to study DPN,results show that,the PLA2G2A mRNA gene was up-regulation in the DPN model group rat sciatic nerves and down-regulation in the Wang's Hypoglycemic Decoction treatment group rat sciatic nerves.Conclusions:DPN molecular mechanisns relation to genes expression regulations, over expression of PLA2G2A mRNA gene play an important role decreasing pain threshold and conduction velocity of sciatic nerve, microstructure pathology damages of sciatic nerve. The method of clearing heat and nourishing yin heat for primary principle is beneficial for controlling blood glucose,increasing pain threshold and conduction velocity of sciatic nerve through the machnism as follow:â‘ Promoting insulin secretion,increasing Insulin sensitivity at the same time.â‘¡ncreasing the retrograde transport of NGF,improve the material transport status in axonal.â‘¢Protecting sciatic nerve directly by regulating expressions of several genes,especially down-regulating the over-expression of PLA2G2A mRNA.