“双通法”内外同治联合西医治疗糖尿病周围神经病变临床研究  

Clinical study on“double unblocking”internal and external therapy combined with western medicine in the treatment of diabetic peripheral neuropathy

作　　者：魏萱[1] 梁贵廷 左建娇[1] 谢秋芳 WEI Xuan;LIANG Guiting;ZUO Jianjiao;XIE Qiufang(Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang 050051, Hebei, China)

机构地区：[1]石家庄市中医院,河北石家庄050051

出　　处：《现代中西医结合杂志》2021年第14期1511-1515,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2018224)。

摘　　要：目的观察“双通法”内外同治联合西医常规治疗糖尿病周围神经病变疗效及对血管内皮功能的影响。方法将2018年1月—2020年5月在石家庄市中医院内分泌科治疗的90例糖尿病周围神经病变患者按照随机数字表法分为2组,对照组45例予甲钴胺等西医常规治疗,治疗组45例在对照组治疗基础上加用双通法(趾尖放血联合阳和汤中药口服)治疗,2组均以2个月为1个疗程,治疗1个疗程。观察比较2组治疗前后中医症状总积分、多伦多临床评分(TCSS)、血糖指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]、血管内皮功能指标[血浆一氧化氮(NO)、一氧化氮合酶(NOS)、内皮素(ET)]、正中神经和腓神经传导速度,统计2组临床疗效。结果治疗后,2组中医症状总积分、TCSS评分、FPG、2hPG、HbA1c及血浆ET水平均明显降低(P均<0.05),且治疗组均明显低于对照组(P均<0.05);2组血浆NO、NOS水平均明显升高(P均<0.05),且治疗组均明显高于对照组(P均<0.05);2组正中神经和腓神经感觉及运动神经传导速度均明显加快(P均<0.05),且治疗组均明显快于对照组(P均<0.05)。治疗组和对照组总有效率分别为88.9%(40/45)和68.9%(31/45),治疗组明显高于对照组(P<0.05)。结论双通法治疗糖尿病周围神经病变能明显减轻临床症状,有利于血糖控制,可明显改善血管内皮功能,提高神经传导速度,疗效优于单纯西医治疗。Objective It is to observe the curative effect of“double unblocking”internal and external therapy combined with conventional western medicine in the treatment of diabetic peripheral neuropathy and its influence on vascular endothelial function.Methods Ninety patients with diabetic peripheral neuropathy treated in the Department of Endocrinology,Shijiazhuang Hospital of Traditional Chinese Medicine from January 2018 to May 2020 were divided into 2 groups according to the random number table method.45 patients in the control group was given conventional western medicine such as mecobalamin,45 cases in the treatment group were treated with“double unblocking”internal and external therapy(toe-tip bloodletting combined with oral administration of Yanghe Decoction)on the basis of the treatment of the control group.Both groups were treated for a treatment course of 2 months.The total scores of TCM symptom,Toronto clinical scoring system(TCSS),blood glucose indicators[fasting blood glucose(FPG),2 h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c)],vascular endothelial function indicators[plasma one nitric oxide(NO),nitric oxide synthase(NOS),endothelin(ET)],conduction velocity of median nerve and peroneal nerve before and after treatment were compared between the two groups,the clinical efficacy of the two groups was calculated.Results After treatment,the total scores of TCM symptoms,TCSS score,the levels of FPG,2hPG,HbA1c and plasma ET in the two groups were significantly reduced(all P<0.05),and the treatment group was significantly lower than the control group(P<0.05);the levels of plasma NO and NOS were significantly increased(all P<0.05),and the treatment group was significantly higher than the control group(P<0.05);the sensory and motor nerve conduction velocity of median and peroneal nerve in the two groups were significantly increased,and the treatment group was significantly faster than the control group(P<0.05).The total effective rates of the treatment group and the control group were 88.9

关 键 词：糖尿病周围神经病变 双通法 趾尖放血 阳和汤 甲钴胺 

分 类 号：R587.2[医药卫生—内分泌]