Effects Of Liver-Nourishing And Endogenous Wind-Stopping And Collateral-Unblocking Decoction On DPN And Changes Of Plasma HCY Level

Diabetic peripheral neuropathy(DPN) is one of the most common complications of diabetes mellitus, the incidence of which is up to about 50%, it causes sensory, motor, and/or autonomic dysfunction. However, the pathogenesis of DPN has still not been very clear. Homocysteine(Hcy)is regarded as a reactive vascular scathing amino acid. In recent years, many studies have demonstrated that diabetic is associated with hyperhomocysteinemia. Hey has been found that it is not only a major and independent risk factor for diabetic vascular disease but also an important risk factor for DPN.Objective:1,To observe the clinical therapeutic effects of Liver-Nourishing and Endogenous Wind-Stopping and Collateral-Unblocking Decoction combined with methylcobalamin in patients with DPN, and to study the changes of the plasma Hey level.2,To investigate the relationship between plasma Hey level and TCM patterns in patients with type 2 diabetes mellitus(T2DM).Methods:1,Based on intensive control of blood glucose, totally 60 patients with DPN were randomly divided into the control group and the study group.30 cases were treated with methylcobalamin as the control group, while 30 cases were treated with Liver-Nourishing and Endogenous Wind-Stopping and Collateral-Unblocking Decoction additionally as the study group. The two groups were both treated for 8 weeks. Before and after treatment, all patients underwent laboratory testing including blood glucose, HbAlC, plasma Hey level, and Biochemical targets(ALT and Scr). Neurologic symptoms integral was evaluated, nerve conduction velocity (NCV) of median nerve and common peroneal nerve were performed. Comparing the change of these targets. Adverse events were observed in two groups during treatment period.2,A total of 202 patients with T2DM was categorized into three pattern groups: yin-deficiency and excessive heat pattern, qi-yin deficiency pattern and yin-yang deficiency pattern. Plasma Hey levels of each group were detected and their relationships with the TCM patterns were given statistical analysis.Results:1,After 8 weeks treatment, neurologic symptoms integral and plasma Hey level were significantly lowered than those of before treatment in two groups (P<0.01). SNCV and MNCV of median nerve and common peroneal nerve were significantly increased than those of before treatment(P<0.01). Improvement of neurologic symptoms integral and NCV, decline of plasma Hcy level, the effective rate of treatment in the study group were superior to those in the control group(P<0.01). Blood glucose was decreased but not statistical significance (P>0.05). Furthermore, there was no obvious toxic side effect found in the two groups.2> There were 73.76%of 202 T2DM patients accompanied heperhomocysteinemia. Plasma Hcy levels in patients with T2DM and T2DM accompanied heperhomocysteinemia among different pattern groups were ranked from high to low as follows:yin-yang deficiency pattern, qi-yin deficiency pattern and yin-deficiency and excessive heat pattern, the difference was statistical significance. (P＜O.05)Conclusion:1,Based on intensive control of blood glucose, the treatment of Liver-Nourishing and Endogenous Wind-Stopping and Collateral-Unblocking Decoction combined with methylcobalamin has a good and safe effect in patients with DPN. Simultaneously, its effect is superior to only using methylcobalamin.2,There is certain correlation between plasma Hcy level and TCM patterns in patients with T2DM. Plasma Hcy level can be regarded as a objective index for Traditional Chinese Medicine(TCM)syndrome differentiation in T2DM.