加味黄芪桂枝五物汤治疗糖尿病周围神经病变的临床疗效观察  

Clinical efficacy observation of Modified Huangqi Guizhi Wuwu Decoction in treating diabetic peripheral neuropathy

作　　者：秦保锋[1] 翁伟力[1] 章丽琼[2] 郭咏梅[1] QIN Baofeng;WENG Weili;ZHANG Liqiong;GUO Yongmei(Department of Neurology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of Endocrinology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院神经内科,上海201203 [2]上海中医药大学附属曙光医院内分泌科,上海201203

出　　处：《上海中医药杂志》2020年第S01期57-60,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局第六批全国老中医药专家学术经验继承项目[国中医药人教发(2017)29];第五批曙光高级中医师项目;上海中医药大学课程建设项目.

摘　　要：目的探讨加味黄芪桂枝五物汤治疗糖尿病周围神经病变的临床疗效以及对血清肿瘤坏死因子-α(TNF-α)的影响。方法将200例糖尿病周围神经病变患者随机分为治疗组和对照组,每组100例。两组患者均给予常规降糖药物和营养神经等治疗,治疗组在常规治疗的基础上给予加味黄芪桂枝五物汤。连续治疗1个疗程(12周)后,观察两组临床疗效,以及多伦多临床系统评分(TCSS评分)、腓总神经传导速度、血清TNF-α浓度、生活质量评分变化情况。结果治疗组临床有效率显著优于对照组(P<0.05);治疗后两组TCSS评分较治疗前均显著改善(P<0.05),且治疗组明显低于对照组(P<0.05);治疗以后,两组运动神经传导速度、感觉神经传导速度较治疗前显著改善(P<0.05),且治疗组优于对照组(P<0.05);治疗前两组TNF-α水平差异无统计学意义(P>0.05),治疗后治疗组显著低于照组(P<0.05);治疗前两组生活质量评分比较无统计学意义(P>0.05),治疗后治疗组评分明显优于对照组(P<0.05)。结论加味黄芪桂枝五物汤可有效改善糖尿病周围神经病变患者腓总神经传导速度以及血清TNF-α水平,提高临床疗效,改善患者生活质量,其作用机制可能与炎症调节有关。Objective To investigate the clinical efficacy of Modified Huangqi Guizhi Wuwu Decoction in treating diabetic peripheral neuropathy(DPN)and its effect on serum tumor necrosis factor-α(TNF-α).Methods Two hundred patients with DPN were randomly divided into the treatment group and control group,100 cases in each group.Patients in both groups were treated with conventional hypoglycemic drugs and nerve nutritional treatment.The treatment group was treated with Modified Huangqi Guizhi Wuwu Decoction based on the conventional therapy.After treatment for one course(12 weeks),the clinical efficacy,Toronto clinical system scale(TCSS)score,conduction velocity of common peroneal nerve,serum TNF-αconcentration and life quality score were measured.Results The clinical effective rate of the treatment group was significantly higher than that of the control group(P<0.05).After treatment,the TCSS score in the two groups was significantly improved compared with that before treatment(P<0.05),and that in the treatment group was significantly lower than that in the control group(P<0.05).After treatment,the motor nerve conduction velocity and the sensory nerve conduction velocity in the two groups were significantly improved compared with those before treatment(P<0.05),and those in the treatment group was superior to the control group(P<0.05).Before treatment,there was no statistically significant difference in TNF-αlevel between the two groups(P>0.05),and the TNF-αlevel in the treatment group was significantly lower than that in the control group after treatment(P<0.05).Before treatment,there was no statistically significant difference in life quality score between the two groups(P>0.05),and the life quality score of the treatment group was better than that of the control group after treatment(P<0.05).Conclusion Modified Huangqi Guizhi Wuwu Decoction can effectively improve the conduction velocity of common peroneal nerve and serum TNF-αlevel in patients with DPN,enhance the clinical efficacy and improve the life quality of pat

关 键 词：糖尿病周围神经病变 黄芪桂枝五物汤 神经传导速度 生活质量 肿瘤坏死因子-Α 

分 类 号：R587.2[医药卫生—内分泌]