| Objective:Study the pathology mechanism and treatment method of type 2 diabetic cerebral infarction (DCI). Make the hypothesis, that main pathology mechanism of DCI is"deficiency, blood stasis and toxicant", in other words,"qi deficiency and blood stasis-stasis heat reducing toxicant-toxicant damaging brain collaterals","toxicant damaging brain collaterals"is the key of pathogenesis. The treatment methods of clearing away heat and toxic materials and supplementing qi and activating blood circulation maybe a valid therapy for improving the finality of DCI ;To observe the clinical curative effects of Chinese traditional medicine compound, Yi-xiao-fu-tan decoction, on treatment of type 2 diabetic cerebral infarction. To inquire into its biology mechanisms onintervention and treatment of DCI, provide new theoretical basis and valid prescription on prevention and treatment of DCI with traditional Chinese medicine.Methods: 1. Methods of theory study: We studied the pathology mechanism of type 2 diabetic cerebral infarction (DCI) with document and logical analysis methods; 2. Methods of clinical study: 30 cases with type 2 diabetic cerebral infarction were taken as objects, and treatmeant with chinses medicine Yi-xiao-fu-tan decoction. The whole course of treatment group was 8 weeks. By means of comparative the curative effect for patients before and after therapy between treatment group and control group which treated with Bu-yang-huan-wu decoction, the observations on effects were made. The indexes of curative effects included: clinical symptoms integrals; nervus dysfunctions system (NIHSS), cognitive function (MMSE), viability (Barthel), quality of life index(QLI), blood glucose, Glycosylated Hemoglobin A-1c(HbA1c), insulin sensitivity index (ISI) ,blood-lipid (TC, TG, LDL, HDL), blood rheologp (whool blood riscosity, plasmic riscosity, fibrinogen), the functions of endothelial cell (ET, NO), serum inflammatory index (c-reactive protein,CRP),etc. The safety evalutions were monitored surveillanced at the same time, which included:Blood routine examination, routine uronoscopy, fecal routine examination, liver and renal functions and so on.Results:1. Results of Theory StudyAccording to tutor's academic thoughts, we think that type 2 diabetic cerebral infarction is developed from basis of T2DM, spleen qi deficiency is the main pathogenesis of T2DM, prolonged qi deficiency leads to blood stasis blocking collaterals, heat caused by prolonged stasis reduces toxicant, toxicant damages brain collaterals, so DCI appears. Therefore, qi deficiency and blood stasis are T2DM's basic pathogenesis, toxicant damaging brain collaterals is the key of pathogenesis. In accordance with the principles of treating both the incidental and fundamental aspects, putting emphasis on"collaterals"and"Poison-evil", the treatment methods are clearing away heat and toxic materials Supplement qi and activate blood circulation. Clinical application strengthens clearing away heat and toxic materials, Promoting blood circulation to remove obstruction in the collaterals; surpplyment vitality, regulate qi and blood; employment drugs of parasitosis that could go to everywhere in one's body, expelling pathogenic factor and removing obstruction in the channels, and so on. Especially, we consider the selecting of the drugs which to guide channel tropism to brain, give consideration to drug targeting function of both the incidental and fundamental aspects, and stratified choice of herbals with functions of clearing heat and removing toxic materials.2.Results of Clinical StudyAfter 8 weeks, the scores of patients'symptoms declined, the distinctly improvement symptoms were hemiplegia, numbess, thirst, polydipsia, polyuria, asthenia, shortness of breath ,and spontaneous perspiration (P<0.01), the scores of facial hemiparalysis lowered shorterly (P<0.05). The indexes of NIHSS, MMSE, viability and QLI were all quite obviously improved (P<0.01). The blood glucose, HbA1c and ISI were clearly improved. Blood glucose and HbA1c were more lower than before treatment (P<0.01), ISI was increased(P<0.01); The whole and plasmic viscosity and blood lipid declined much than befor treatment (P<0.01). The level of ET was lowered(P<0.01) and of NO was rised(P<0.01), moreover, the amount of c-reactive protein was declined obviously (P<0.01). The outcomes of statistic showed that, the indexes above of Yi-xiao-fu-tan decoction were better than that of the group of Bu-yang-huan-wu decoction (P<0.05).Conclusions: After 8 weeks treatment on T2DCI with Yi-xiao-fu-tan decoction, patients'clinical symptoms and various laboratory findings were improved obviously. The concrete expressions are as such: clinical symptoms and physical signs of nervous system and endocrine system were decreased and improved; Blood glucose, HbA1c, islet function, blood rheology and blood-lipid were improved; the functions of endothelial cell were protected; serum inflammatory index was decreased. Statistics show that all indexes improved in treatment group were superior to ones in control group, The significance of difference is obvious(P<0.05).It is indicated that Yi-xiao-fu-tan decoction has exact functions of treatment and protection on diabetes and cerebrovascular disease. This research proved qi deficiency and blood stasis and toxicant damaging brain collaterals was main pathogenesis of T2DCI, clearing away heat and toxic materials Supplement qi and activate blood circulation to remove obstruction in the channels was important treatment methods. Yi-xiao-fu-tan decoction has obviously clinical curative effects, it is an effective compound herbal recipe on treatment T2DCI. |
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