益气活血通络方对糖尿病周围神经病变患者血清TNF-α、IL-10、CD40及CD40L的影响

姜志妮; 牛云飞; 方朝晖

文章摘要

姜志妮，牛云飞，方朝晖.益气活血通络方对糖尿病周围神经病变患者血清TNF-α、IL-10、CD40及CD40L的影响[J].实用中西医结合临床,2021,21(16):121-124

益气活血通络方对糖尿病周围神经病变患者血清TNF-α、IL-10、CD40及CD40L的影响

Influence of Yiqihuoxuetongluo Decoction on Serum TNF-α, IL-10, CD40 and CD40L Levels in Patients with Diabetic Peripheral Neuropathy

DOI：

中文关键词: 糖尿病周围神经病变益气活血通络方甲钴胺胶囊

英文关键词: Diabetic peripheral neuropathy Yiqihuoxuetongluo decoction Mecobalamin capsules

基金项目:国家中医药管理局中医临床基地科研专项（编号：JDZX2015001）；国家中医药管理局国家基本公共卫生服务项目（编号：20131012）

作者	单位
姜志妮，牛云飞，方朝晖	安徽中医药大学研究生院2019级硕士研究生；安徽中医药大学第一附属医院

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中文摘要:

目的：观察益气活血通络方治疗气虚血瘀型糖尿病周围神经病变患者的临床疗效和安全性，及其对患者肿瘤坏死因子-α、白细胞介素-10、CD40、CD40L水平的影响。方法：选取糖尿病周围神经病变患者90例，随机分为治疗组和对照组各45例。两组均行糖尿病基础治疗，对照组给予甲钴胺胶囊口服，治疗组在对照组基础上加用益气活血通络方口服治疗，两组均治疗12周。对比两组临床疗效，治疗前后神经传导速度、多伦多临床评分系统评分，血清肿瘤坏死因子-α、白细胞介素-10、CD40、CD40L水平及不良反应发生情况。结果：治疗组总有效率为91.1%，高于对照组的73.3%（P＜0.05）。与治疗前比较，两组治疗后正中神经、腓总神经的运动神经传导速度、感觉神经传导速度显著增加，且治疗组增加更为明显（P＜0.05）；两组治疗后多伦多临床评分系统评分降低，且治疗组降低更为明显（P＜0.05）；两组治疗后血清肿瘤坏死因子-α、CD40、CD40L水平均下降，且治疗组下降更为明显（P＜0.05）；两组治疗后血清白细胞介素-10水平均上升，且治疗组上升更明显（P＜0.05）。两组治疗期间均未出现严重不良反应。结论：采用益气活血通络方治疗气虚血瘀型糖尿病周围神经病变患者疗效确切、安全性较好，能降低患者血清肿瘤坏死因子-α、CD40、CD40L水平，升高白细胞介素-10水平，对致炎因子网络具有双向调节作用。

英文摘要:

Objective: To observe the clinical efficacy and safety of Yiqihuoxuetongluo decoction in the treatment of diabetic peripheral neuropathy with Qi deficiency and blood stasis type, and its influence on tumor necrosis factor-α、interleukin-10, CD40 and CD40L levels. Methods: 90 patients with diabetic peripheral neuropathy were selected and randomly divided into treatment group and control group, with 45 cases in each group. The two groups were treated with basic treatment of diabetes, The control group was given mecobalamin capsules orally. On this basis, the treatment group was treated with Yiqihuoxuetongluo decoction orally, and the two groups were treated for 12 weeks. The nerve conduction velocity, Toronto clinical scoring system score, tumor necrosis factor-α level, interleukin-10 level, CD40 level, CD40L level, adverse reactions before and after treatment and clinical efficacy were compared between the two groups. Results: The total effective rate in the treatment group was 91.1%, which was higher than 73.3% in the control group (P＜0.05). Compared with before treatment, the motor nerve conduction velocity and sensory nerve conduction velocity of median nerve, common peroneal nerve in the two groups increased significantly after treatment, and the increase was more obvious in the treatment group (P＜0.05); the scores of Toronto clinical scoring system decreased in the two groups after treatment, and the decrease was more obvious in the treatment group (P＜0.05); serum tumor necrosis factor-α, CD40 and CD40L levels decreased, and the decreases were more obvious in the treatment group (P＜0.05); the levels of serum interleukin-10 increased in both groups after treatment, and the increase was more obvious in the treatment group (P＜0.05). There were no serious adverse reactions in both groups during treatment. Conclusion: Yiqihuoxuetongluo decoction is exactly effective and good security in treating diabetic peripheral neuropathy with Qi deficiency and blood stasis type, and can reduce serum tumor necrosis factor-α, CD40 and CD40L levels, increase the level of interleukin-10, which has a two-way regulatory effect on the inflammatory factor network.

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