芪桂类方内外合治气阴两虚兼痰瘀阻络型2型糖尿病周围神经病变的临床研究  

Treatment of Type 2 Diabetic Peripheral Neuropathy Patients of Qi-Yin Deficiency Complicated Phlegm-Dampness Blocking Collaterals Syndrome by Internal Application of Qigui Mixture and External Application of Qigui Huoxue Lotion:a Clinical Study

作　　者：刘杰[1] 孙冰[2] 班博[2] 张梅[2] 孙海玲[2] 李萍[2] 李艳英[2] 张艳红[2] 

机构地区：[1]山东大学研究生院,济南250100 [2]济宁医学院附属医院内分泌科,山东272029

出　　处：《中国中西医结合杂志》2014年第9期1053-1058,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：山东省中医药科技发展计划项目(No.2011-230)

摘　　要：目的评价芪桂类方内外合治气阴两虚兼痰瘀阻络型2型糖尿病周围神经病变（diabetic peripheral neuropathy,DPN）的疗效,并对其作用机制进行初步探讨。方法采用随机数字表法,将62例气阴两虚兼痰瘀阻络型的DPN患者分为试验组和对照组,每组各31例。两组患者均给予一般综合治疗,对照组予甲钴胺片口服,500μg/次,每日3次。试验组在此治疗基础上予芪桂合剂口服,200 m L/次,每日2次;另外配合芪桂活血洗剂每晚泡脚外洗10~15 min,连续应用3个月。通过两组患者治疗前、治疗2、3个月后中医证候积分及多伦多临床评分系统（Toronto clinical scoring system,TCSS）进行疗效评价;并测定治疗2、3个月时两组患者神经传导速度及血清总抗氧化能力（T-AOC）、丙二醛（MDA）、超氧化物歧化酶（SOD）水平。结果治疗2、3个月时试验组患者中医证候及TCSS评分疗效总有效率明显高于对照组（P〈0.05）。试验组患者神经传导速度较治疗前明显提高（P〈0.01）;两组治疗前后右正中神经、双侧胫神经、双侧腓总神经运动支及左正中神经、双侧尺神经、左胫神经感觉支传导速度差值比较,差异均有统计学意义（P〈0.05）。治疗2、3个月时,与本组治疗前比较,试验组血清T-AOC、SOD水平明显升高,MDA显著降低（P〈0.01）,对照组仅SOD明显升高（P〈0.01）;治疗2个月时,两组患者T-AOC升高水平比较,差异无统计学意义（P〉0.05）,而MDA降低水平、SOD升高水平比较,差异有统计学意义（P〈0.05）;治疗3个月时,两组患者T-AOC升高水平、MDA降低水平、SOD升高水平差异均有统计学意义（P〈0.05）。两组均未发生不良反应。结论芪桂类方内外合治联合甲钴胺治疗DPN安全有效,且疗效比单纯应用甲钴胺显著,其作用机制可能与抗氧化应激有关。Objective To evaluate the efficacy of internal application of Qigui Mixture（QM） and external application of Qigui Huoxue Lotion（QHL） in treating type 2 diabetic peripheral neuropathy（DNP）patients of qi-yin deficiency complicated phlegm-dampness blocking collaterals syndrome（QYD-PDBCS）,and to primarily discuss its mechanism.Methods Totally 62 DPN patients of QYD-PDBCS were randomly assigned to the treatment group（31 cases） and the control group（31 cases）.All patients received routine comprehensive therapy.Patients in the control group took Mecobalamine Tablet,500 μg each time,3 times per day.Patients in the treatment group additionally took QM,200 mL per day,twice daily.Besides,they had foot bath in QHL 10-15 min every evening for 3 months.The efficacy was assessed by Chinese medical symptom integrals and Toronto clinical scoring system（TCSS） before treatment,2 and 3 months after treatment.The nerve conduction velocity was determined;the serum levels of total antioxidant capacity（TAOC）,malondialdehyde（MDA）,and superoxide dismutase（SOD） were detected 2 and 3 months after treatment.Results The total effective rates of Chinese medical symptom integrals and TCSS score were obviously higher in the treatment group than in the control group（P0.05）.The nerve conduction velocity was significantly improved in the treatment group,when compared with before treatment（P〈0.01）.There was statistical difference in the nerve conduction velocity difference of right median nerve motor branch,bilateral tibial nerve motor branches,bilateral common peroneal nerve motor branches,bilateral ulnar nerve sensory branches,and left tibial nerve sensory branch（P〈0.05）.Compared with before treatment,serum levels of T-AOC and SOD significantly increased,and the level of MDA decreased significantly in the treatment group after 2 and 3 months of treatment（P〈0.01）.But only the SOD level increased significantly in the control group（P0.01）.There was no statistical difference in increas

关 键 词：芪桂类方 芪桂活血洗剂 甲钴胺 糖尿病周围神经病变 氧化应激 

分 类 号：R259[医药卫生—中西医结合]