补阳还五汤联合中医定向透药疗法治疗气虚血瘀型糖尿病周围神经病变疗效观察  

Observation on curative effect of Buyang Huanwu Decoction combined with TCM directional permeation on diabetic peripheral neuropathy of syndrome of Qi deficiency and blood stasis

作　　者：韩明珠 张宏利 贝鹏剑[1] 李丽华 朱祎[1] 付佳闻 李晓华[1] HAN Mingzhu;ZHANG Hongli;BEI Pengjian;LI Lihua;ZHU Yi;FU Jiawen;LI Xiaohua(The Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137

出　　处：《现代中西医结合杂志》2020年第26期2876-2880,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：上海市科学技术委员会中医引导类项目(18401903400);上海市卫计委中医优势病种培育项目(zybz-2017021);浦东新区卫计委特色专病项目(PWZzb2017-28)。

摘　　要：目的观察补阳还五汤联合中医定向透药疗法治疗气虚血瘀型糖尿病周围神经病变的临床疗效。方法将2018年3月—2019年2月在上海中医药大学附属第七人民医院治疗的86例气虚血瘀型糖尿病周围神经病变患者随机分为治疗组和对照组各43例,所有患者首先进入为期2周的导入期或洗脱期,然后再进入为期4周治疗期。在治疗期,对照组给予甲钴胺片口服,治疗组在口服甲钴胺片的基础上加用补阳还五汤联合中医定向透药疗法治疗。观察2组治疗前后血糖[空腹血糖(FPG)、餐后2 h血糖(2 hPG)]、中医症状评分、Toronto临床评分(TCSS评分)、肌电图神经传导速度变化,统计2组中医证候疗效及不良反应发生情况。结果与治疗前比较,治疗后2组FPG及2 hPG均无明显变化(P均>0.05),中医症状评分、TCSS评分均明显降低(P均<0.05),治疗组正中神经、腓浅神经感觉传导速度和正中神经、胫神经、腓总神经运动传导速度及对照组正中神经、胫神经、腓总神经运动传导速度均明显加快(P均<0.05);与对照组比较,治疗组中医症状评分、TCSS评分更低(P均<0.05),正中神经、腓浅神经感觉传导速度和正中神经、胫神经、腓总神经运动传导速度更快(P均<0.05)。治疗后治疗组总有效率为86.0%(37/43),对照组总有效率为62.8%(27/43),治疗组明显高于对照组(P<0.05);2组均无不良反应发生。结论补阳还五汤联合中医定向透药疗法治疗气虚血瘀型糖尿病周围神经病变可明显改善患者的临床症状,提高神经传导速度,且安全性良好。Objective It is to observe the clinical efficacy of Buyang Huanwu Decoction combined with TCM directional drug penetration therapy on diabetic peripheral neuropathy of syndrome of Qi deficiency and blood stasis.Methods A total of 86 patients with diabetic peripheral neuropathy of syndrome of Qi deficiency and blood stasis type treated at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine from March 2018 to February 2019 were randomly divided into treatment group and control group,43 cases in each group.All patients firstly need to enter the 2-week lead-in or wash-out period,and then enter the 4-week treatment period.During the treatment period,the control group was given mecobalamin tablets orally,and the treatment group was treated with Buyang Huanwu Decoction combined with Chinese medicine directed drug penetration therapy on the basis of oral mecobalamin tablets.The changes of blood glucose[fasting plasma glucose(FPG),2 h blood glucose(2 hPG)],TCM symptom score,Toronto clinical score(TCSS score),and EMG nerve conduction velocity before and after treatment were observed in the two groups.The curative effect of TCM syndromes was evaluated and the occurrence of adverse reactions was recorded in the 2 groups.Results Compared with before treatment,there was no significant change in FPG and 2 hPG in the two groups after treatment(both P>0.05),but TCM symptom scores and TCSS scores were significantly reduced(both P<0.05),the sensory conduction velocity of the median nerve,superficial peroneal nerve and the motor conduction velocity of the median nerve,tibial nerve,and common peroneal nerve in the treatment group and the motor conduction velocity of median nerve,tibial nerve,and common peroneal nerve in the control group were significantly increased(P<0.05);compared with the control group,the TCM symptom scores and TCSS scores were lower(all P<0.05),the sensory conduction velocity of the median nerve,superficial peroneal nerve and the motor conduction velocity of the median nerve,ti

关 键 词：糖尿病周围神经病变 补阳还五汤 中医定向透药疗法 活血通络方 

分 类 号：R587.2[医药卫生—内分泌]