黄芪桂枝五物汤合中医外治法对糖尿病周围神经病变(气虚血瘀证)作用探讨  

Effect of Huangqi Guizhi Wuwu Decoction and External Therapy of Traditional Chinese Medicine on Diabetic Peripheral Neuropathy(Qi Deficiency and Blood Stasis Syndrome)

作　　者：陈苹[1] 魏爱生[1] 王甫能[1] 劳美玲 吕丽雪[1] CHEN Ping;WEI Aisheng;WANG Funeng;LAO Meiling;LYU Lixue(Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong,China)

机构地区：[1]佛山市中医院,广东佛山528000

出　　处：《辽宁中医药大学学报》2020年第5期134-138,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：广东省中医药局科研课题(2010003)。

摘　　要：目的探讨黄芪桂枝五物汤合中医外治法对糖尿病周围神经病变(气虚血瘀证)的作用。方法选取2015年2月—2019年1月收治的238例经中医辨证为气虚血瘀证的糖尿病周围神经病变患者,随机分为甲组(60例)、乙组(60例)、丙组(59例)、丁组(59例)。甲组给予西医常规治疗,乙组给予西医常规+黄芪桂枝五物汤治疗,丙组给予西医常规+中医外治法(中药熏洗、穴位贴敷、针刺、离子导入)治疗,丁组给予西医常规+黄芪桂枝五物汤+中医外治法治疗。对比治疗前后中医临床症状积分及正中神经、腓总神经的感觉神经传导速度(SNCV)与运动神经传导速度(MNCV),并对比临床疗效,且观察治疗安全性。结果4组治疗后中医主症及次症积分均低于治疗前,丁组治疗后主症及次症积分<乙组、丙组<甲组,均具有统计学意义(P<0.05);4组治疗后正中神经及腓总神经的SNCV、MNCV均大于治疗前,丁组治疗后正中神经及腓总神经的SNCV、MNCV>乙组、丙组>甲组,差异均有统计学意义(P<0.05);4组临床疗效等级分布比较有统计学意义(P<0.05),甲组总有效率与乙组、丙组无显著统计学意义(P>0.01),乙组总有效率与丙组无显著统计学意义(P>0.01),丁组总有效率明显高于甲组、乙组、丙组(P<0.01);4组总不良事件发生率比较无统计学意义(P>0.05)。结论在常规西药治疗基础上,对糖尿病周围神经病变(气虚血瘀证)患者应用黄芪桂枝五物汤合中医外治法,可明显促进临床症状缓解及神经传导速度改善,提高治疗效果,且具有一定安全性。Objective To explore the effect of Huangqi Guizhi Wuwu Decoction combined with external treatment of traditional Chinese medicine on diabetic peripheral neuropathy(Qi deficiency and blood stasis syndrome).Methods 238 diabetic peripheral neuropathy patients with neuropathy Qi deficiency and blood stasis syndrome differentiated by TCM admitted in our hospital from February 2015 to January 2019 were selected,who were randomly divided into A group(60 cases),B group(60 cases),C group(59 cases)and D group(59 cases).The A group was treated with routine Western medicine,and the B group was treated with routine Western medicine and Huangqi Guizhi Wuwu Decoction,and the C group was treated with routine Western medicine plus external treatment of TCM(fumigation and washing of traditional Chinese medicine,acupoint application,acupuncture,iontophoresis),while the D group was treated with routine Western medicine and Huangqi Guizhi Wuwu Decoction and external treatment of TCM.The scores of TCM clinical symptoms and the sensory nerve conduction velocity(SNCV)and motor nerve conduction velocity(MNCV)of median nerve and common peroneal nerve before and after treatment were compared,and the clinical efficacy were compared and the safety of treatment were also observed.Results The scores of main symptoms and secondary symptoms of TCM in the 4 groups after treatment were lower than those before treatment,which in the D group after treatment<B group and C group<A group,with significant differences(P<0.05).The SCNV and MNCV of median nerve and common peroneal nerve in the 4 groups after treatment were greater than those before treatment,which in the D group>B group and C group>A group,with significant differences(P<0.05).There was a significant difference in the distribution of clinical efficacy grades between the 4 groups(P<0.05),and there was no significant difference in the total effective rate between A group and B group and C group(P>0.01),and there was no significant difference in total effective rate between B group and C group

关 键 词：黄芪桂枝五物汤 中医外治法 糖尿病周围神经病变 气虚血瘀证 临床效果 

分 类 号：R259[医药卫生—中西医结合]