中医综合疗法联合甲钴胺改善糖尿病周围神经病变的临床疗效研究  

Study on the clinical effects of comprehensive therapy of traditional Chinese medicine combined with mecobalamin on diabetic peripheral neuropathy

作　　者：冯圣钰 吴腾飞[1] 丛亿蕾 张金晶 邹冉 杨华[1] FENG Shengyu;WU Tengfei;CONG Yilei;ZHANG Jinjing;ZOU Ran;YANG Hua(Department of Endocrinology,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Department of Internal Medicine Second,Fangta Hospital of Traditional Chinese Medicine,Songjiang District,Shanghai 201699,China)

机构地区：[1]上海中医药大学附属龙华医院内分泌科,上海200032 [2]上海市松江区方塔中医医院内科二,上海201699

出　　处：《世界临床药物》2023年第3期237-244,共8页World Clinical Drug

基　　金：龙华医院科技创新项目(KY1925)。

摘　　要：目的观察中医综合疗法联合甲钴胺改善糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的临床疗效。方法纳入70例气虚血瘀证DPN患者随机分为治疗组(中医综合治疗+甲钴胺)和对照组(甲钴胺),每组35例,疗程为12周。观察治疗前后两组双下肢神经传导速度、心率变异性、密西根神经病变筛选量表(Michigan neuropathy screening instrument,MNSI)以及中医证候评分等改善情况,评价中医综合疗法的临床疗效和安全性。结果治疗后,治疗组的有效率(74.28%)明显高于对照组的(51.42%)(P<0.05),且中医证候积分低于对照组,差异有统计学意义(P<0.05);治疗组的双下肢腓肠神经感觉神经传导速度较治疗前时间延长,且疗效优于对照组,差异有统计学意义(P<0.05);治疗组的MNSI积分较治疗前明显下降(P<0.01);治疗组的收缩压变化疗效优于对照组,差异具有统计学意义(P<0.05)。结论中医综合疗法联合甲钴胺可提高气虚血瘀证DPN患者神经传导速度,且在改善患者的症状及体征方面,疗效优于单用甲钴胺。Objective To observe the clinical efficacy of comprehensive therapy of traditional Chinese medicine(TCM)combined with mecobalamin for diabetic peripheral neuropathy(DPN).Methods A tatal of 70 DPN patients with Qi deficiency and blood stasis were randomly divided into treatment group(comprehensive therapy of TCM+mecobalamin)and control group(mecobalamin),35 cases in each group,and the course of treatment was 12 weeks.The improvement of nerve conduction velocity,heart rate variability,Michigan neuropathy screening instrument(MNSI)and TCM syndrome score before and after treatment were observed in both groups,and the clinical efficacy and safety of comprehensive therapy of TCM were evaluated.Results After treatment,the effective rate in the treatment group(74.28%)was significantly higher than that in the control group(51.42%)(P<0.05),and the TCM syndrome score was lower than that in the control group,the difference was statistically significant(P<0.05).After treatment,the sensory nerve conduction velocity of lower extremities sural nerve in the treatment group was longer than that before treatment,and the effect was better than that in the control group,the difference was statistically significant(P<0.05).MNSI score in the treatment group was significantly lower than that before treatment(P<0.01).The therapeutic effect of systolic blood pressure in the treatment group was better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Comprehensive therapy of TCM combined with mecobalamin can increase the nerve conduction velocity in DPN patients with Qi deficiency and blood stasis,and the efficacy is better than mecobalamin alone in improving the symptoms and signs of patients.

关 键 词：中医综合疗法 甲钴胺 糖尿病周围神经病变 

分 类 号：R587.1[医药卫生—内分泌] R255.4[医药卫生—内科学] R255.6[医药卫生—临床医学]