活血降糖饮联合硫辛酸治疗糖尿病周围神经病变临床疗效观察  

Clinical Observation of Diabetic Peripheral Neuropathy Treated with Huoxue Jiangtang Decoction Combined with Lipoic Acid

作　　者：帅优优 李惠林[2] 张学文[3] 楚淑芳[2] 廖思[1] 曾霖 SHUAI You-You;LI Hui-Lin;ZHANG Xue-Wen;CHU Shu-Fang;LIAO Si;ZENG Lin(The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine,Shenzhen 518033 Guangdong,China;Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033 Guangdong,China;The First Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000 Shaanxi,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院,广东深圳518033 [3]陕西中医药大学第一附属医院,陕西咸阳712000

出　　处：《广州中医药大学学报》2019年第1期31-35,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：深圳市医疗卫生三名工程项目国医大师张学文团队研究项目(编号:SZSM201512043);李惠林广东省名老中医专家传承工作室建设项目

摘　　要：【目的】观察活血降糖饮联合硫辛酸治疗糖尿病周围神经病变(DPN)的临床疗效。【方法】将56例气阴两虚夹瘀型DPN患者随机分为治疗组和对照组,每组各28例。对照组给予控制血糖及硫辛酸治疗,治疗组在对照组基础上联合口服活血降糖饮治疗,2组疗程均为4周,观察2组治疗前后中医证候积分、胫神经的神经传导速度[运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)]及血清25羟维生素(OH)D3水平的变化情况,评价2组临床疗效及安全性。【结果】(1)治疗4周后,治疗组总有效率为89.29%,对照组为57.14%,治疗组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的中医证候积分均较治疗前明显下降(P<0.01),且治疗组的下降作用优于对照组(P<0.05)。(3)治疗后,2组患者两侧胫神经MNCV和SNCV均较治疗前增快(P<0.05或P<0.01),且治疗组对胫神经MNCV和SNCV的改善作用均优于对照组(P<0.05或P<0.01)。(4)治疗后,2组患者血清25(OH)D3水平均较治疗前明显升高(P<0.01),且治疗组的升高作用明显优于对照组(P<0.05)。(5)2组患者治疗前后均未出现恶心呕吐、皮疹等不良反应,血常规、肝肾功能和心电图检查均未见明显异常改变。【结论】活血降糖饮联合硫辛酸治疗DPN,可改善患者的临床症状和体征,加快神经传导速度,升高血清25(OH)D3水平,具有较好的临床疗效。Objective To observe the therapeutic effect of Huoxue Jiangtang Decoction combined with lipoic acid for the treatment of diabetic peripheral neuropathy. Methods Fifty-six cases of diabetic peripheral neuropathy with Qi-yin deficiency blended with blood stasis were randomly divided into treatment group and control group, 28 cases in each group. The control group was given blood glucose control and lipoic acid treatment,and the treatment group was treated with Huoxue Jiangtang Decoction on the basis of treatment for the control group. The treatment for the two groups lasted for 4 weeks. Before and after treatment,traditional Chinese medicine(TCM)symptom scores,nerve conduction velocity(NCV)including motor NCV(MNCV)and sensory NCV(SNCV) of the tibial nerve,and serum 25 hydroxyl vitamin D3 [25(OH)D3] level in the two groups were observed. After treatment, the clinical efficacy and safety in the two groups were evaluated. Results(1)After treatment for 4 weeks,the total effective rate in the treatment group was 89.29%,and that in the control group was 57.14%,the clinical efficacy of the treatment group being superior to that of the control group(P<0.01).(2)The scores of TCM symptoms in the two groups after treatment were significantly lower than those before treatment(P < 0.01),and the decrease in the treatment group was superior to that in the control group(P < 0.05).(3) MNCV and SNCV of the tibial nerve in the two groups after treatment were faster than those before treatment(P < 0.05 or P < 0.01),and the improvement of MNCV and SNCV in the treatment group was superior to that in the control group(P < 0.05 or P < 0.01).(4) The serum level of 25(OH)D3 in the two groups after treatment was increased(P < 0.01 compared with that before treatment),and the increase in the treatment group was superior to that in the control group(P < 0.05). (5)No adverse reaction of nausea, vomiting, or skin rash was found in the two groups. The routine blood examination parameters, hepatic and renal function, and electrocardiography in the

关 键 词：糖尿病周围神经病变 气阴两虚夹瘀型 活血降糖饮 硫辛酸 25羟维生素D3 

分 类 号：R259.872[医药卫生—中西医结合]