| Object i ve:In orde to observation the further explore about the treatment of the disease of acupoint injection, dynamic observation on the relationship of different time and curative effect after the treatment, and the experimental study animal, observation of acupoint injection method and effect on pathological changes of the disease model in rats, and provide clinical data more rich and objective experimental evidence to for the rational use of the therapy.Methods:1. Cl inical research:60patients met the diagnostic criteria and were included in the standard of diabetic peripheral neuropathy, in accordance with the random number table method with1:1ratio were divided into2groups, eventually, there were57cases with complete data, group27cases of acupoint injection therapy, medication and30patients in the control group. The main point is Zusanl,Sanyinjiao, Yanglingquan, Quchi, Pishu, shenshu. Each2points (bilateral)are alternate used. Selection of mecobalamin injection (each1ml,0.5mg), each point each injection of mecobalamin0.125mg, tertian1, treatment3times a week, drug therapy with the drug group, continuous treatment for2months. Drug treatment with insulin, metformin as main drug to control blood glucose, with patients adjust the dose,1times a day,7days are1period of treatment, continuous treatment for2months. Respectively, before treatment, after treatment for20days,40days,60days, two groups were observed in patients with clinical symptoms, nerve lesions integral and blood glucose (FPG,2hPPG) content dynamic variation. According to the2002"traditional Chinese medicine new medicine clinical research guiding principle"(for Trial Implementation) standards, a comprehensive assessment of efficacy, the data were processed by statistical software SPSS17.0.2. Exper imental study:200SD rats were divided into blank group32and model group with168rats, according to40mg/kg body weight intraperitoneal injection of streptozotocin (STZ) solution model, model1months after the successful model of the animal (104) again is divided into acupoint injection group with36rats, metformin group with36rats,32rats in model group.1months after STZ injection, point injection group take Shenshu, Zusanli,with mecobalamin (eachlml,0.5mg), each acupoint injection of0.1ml,tertianl,treatment of60days; metformin tablets,according to the0.04g/kg dose administered, tertian1, treatment the same time. The blank group and the model group in the same time to grab, fixed. Respectively, before treatment, after treatment for20days,40days,60days to detect the fasting blood glucose, nerve conduction velocity of sciatic nerve, nerve growth factor (NGF), and TrkA expression of sciatic nerve pathological changes (each time point blank group, model group8only, acupoint injection group, metformin group the detection of9only). Data were processed by statistical software SPSS17.0.Result:1.Clinical research: (1)two groups can reduce the clinical symptoms,compared to20days of treatment with before treatment, the treatment group had statistically significant difference betweent heintegral decreased (P<0.05),while the control group did not show significant change (P>0.05),in the treatment of40days,60days, the symptomint egral the treatment group was significantly lower than the control group (P<0.01).(2)two groups can improve neuropathy, but compared with symptoms,At the40day of treatment, the treatment group significantly decreased, while the control group before and after treatment level of similar. Comparing the two groups, the integral curve of treatment group than the control group(P<0.05).(3) two groups of treatment curative effect with the extension of time, the aging curve showed an upward trend. Comparison between the two groups at day40, the total effective rate in treatment group was significantly higher than that in control group (P<0.05),60days this advantage more evident(P<0.01).(4) two groups of patients with fasting and postprandial blood glucose in the treatment of20days were able to effectively control blood sugar, until the60day, are maintained at a good level, the difference between the two groups was not statistically significant (P>0.05).2. Experimental study:(1)the fasting blood glucose value comparison, with the extension of time, the blood glucose increased in model group, point injection group, group was decreased, there were significant differences compared with the model group (P<0.05). The2treatment groups were compared,the glucose-lowering effect of metformin was significantly better than the acupoint injection (P<0.01).(2)the nerve conduction velocity in the model group decreased significantly, while the point injection group, metformin group canimprove the rat model of SCV, MCV, two group of comparison, point injection group works faster,amplitude was superiorto metformin group and the improved(P<0.01).(3) expression in rat model of sciatic nerve of NGF and its receptor TrkA were significantly decreased after20days of therapy of acupoint injection group, the index is improved, compared with the P<0.05model group, metformin group and the change is not significant (P>0.05). For40days to60days, point injection group increased consistently better than metformin group (P<0.05).(4) analysis of sciatic nerve pathological changes, using metformin group and acupoint injection therapy, the pathological changes were able to improve the model of the rat sciatic nerve, alleviate God cell injury, the degree of improvement of acupoint injection group was superior to metformin group (P<0.05).Conelusion:acupuncture point injection intervention could accelerate the onset time of drug treatment alone, significantly improve the clinical efficacy. Expression can effectively improve the rat model of nerve conduction velocity and nerve growth factor and its receptor, relieve nerve cell injury, has a good protective effect on diabetic peripheral neuropathy, but the hypoglycemic effect of CO, clinical should be considered with the joint use of hypoglycemic drugs. |
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