中医内外同治辅助依帕司他治疗糖尿病周围神经病变的临床观察  

Clinical observation of epalrestat assisted by internal and external treatment of traditional Chinese medicine in the treatment of diabetic peripheral neuropathy

作　　者：曹燕[1] 梁枫[1] 夏卫明[1] 夏伟[1] 刘春辉[1] 邹雨 CAO Yan;LIANG Feng;XIA Weiming;XIA Wei;LIU Chunhui;ZOU Yu(Department of Internal Medicine,Qidong Hospital of Traditional Chinese Medicine,Qidong 226200,Jiangsu Province,China)

机构地区：[1]启东市中医院内科,江苏启东226200

出　　处：《世界临床药物》2024年第8期850-856,共7页World Clinical Drug

基　　金：南通卫健委科研指导性课题(青年课题)(QNZ2022088)。

摘　　要：目的 观察中医内外同治辅助依帕司他治疗糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的临床效果。方法 将我院气阴两虚兼血瘀证DPN患者132例随机分为甲、乙、丙组,删除失访者,最终每组各42例。甲组予依帕司他,乙组在甲组治疗基础上予身痛逐瘀散,丙组在乙组治疗基础上予养阴通络方,3组疗程均为30 d。观察治疗前后3组空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2hPBG)、同型半胱氨酸(homocysteine,Hcy)及超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平,以及正中神经和腓总运动神经传导速度(motor nerve conduction velocity,MCV)、健康状况调查问卷(36-item short-form,SF-36)评分、多伦多临床评分系统(Toronto clinical scoring system,TCSS)评分、中医证候积分,并评价中医内外同治临床疗效及安全性。结果 治疗后,3组FBG、2hPBG及Hcy较前均降低(P<0.05),且乙、丙组Hcy水平较甲组差异显著(P<0.05)。3组双侧正中神经和腓总MCV均较前增快(P<0.05),且乙、丙组快于甲组(P<0.05)。3组SF-36评分较前均提高,hs-CRP水平、TCSS评分、中医证候积分较前均降低(P<0.05),且乙、丙组较甲组差异显著(P<0.05),丙组较乙组差异显著(P<0.05)。乙组临床有效率高于甲组(76.19% vs 64.29%,P>0.05);丙组临床有效率高于乙组(83.33% vs 76.19%,P>0.05),丙组较甲组差异显著(83.33% vs 64.29%,P<0.05)。结论 中医内外同治较单药依帕司他/联合外治法对DPN临床疗效更佳。Objective To observe the clinical effect of internal and external treatment of traditional Chinese medicine(TCM)with the aid of epalrestat in the treatment of diabetic peripheral neuropathy(DPN).Methods A total of 132 DPN patients with Qi Yin deffciency combined with blood stasis syndrome in our hospital were randomly divided into group A,group B and group C,and the missing patients were deleted,with 42 cases in each group.Group A was treated with epalrestat,group B was treated with Shentong Zhuyu powder on the basis of group A,group C was treated with Yangyin Tongluo prescription on the basis of group B.The treatment course of the 3 groups was 30 days.Fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPBG),homocysteine(Hcy),hypersensitive C-reactive protein(hsCRP),median nerve and common peroneal motor nerve conduction velocity(MCV),36-item short-form(SF-36)score,Toronto clinical scoring system(TCSS)score and TCM syndrome score of the 3 groups were observed before and after treatment, and clinical efffcacy and safety of internal and external TCM treatment were compared before and after treatment. Results After treatment, FBG, 2hPBG and Hcy in 3 groups were decreased compared with before treatment(P<0.05), and the Hcy level in groups B and C was signiffcantly different from that in group A(P<0.05). The median nerve and common peroneal MCV in 3 groups were faster than before treatment(P<0.05), and group B and C were faster than that of group A(P<0.05). The SF-36 score of 3 groups was increased compared with before, and the hs-CRP level, TCSS score and TCM syndrome score were decreased compared with before(P<0.05), and groups B and C had signiffcant differences compared with group A(P<0.05), and group C had signiffcant differences compared with group B(P<0.05). The clinical effective rate of group B was higher than that of group A(76.19% vs 64.29%, P>0.05), and the clinical effective rate of group C was higher than that of group B(83.33% vs 76.19%, P>0.05), and the difference between group C and group A

关 键 词：中医内外同治 依帕司他 糖尿病周围神经病变 气阴两虚兼血瘀证 

分 类 号：R259[医药卫生—中西医结合] R587.2[医药卫生—中医内科学]