糖尿病周围神经病变经当归四逆汤治疗后的神经传导速度与疗效观察  

Observation on Nerve Conduction Velocity and Therapeutic Effect of Danggui Sini Decoction(当归四逆汤)Treating Diabetic Peripheral Neuropathy

作　　者：陈焱[1] 季聚良[1] 牛越 CHEN Yan;JI Juliang;NIU Yue(Department of Endocrinology,Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450053,Henan,China)

机构地区：[1]河南省中医院内分泌科,河南郑州450053

出　　处：《辽宁中医杂志》2024年第11期81-85,共5页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的探讨糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)经当归四逆汤治疗后的神经传导速度与疗效。方法采用随机数字表法将104例于2021年12月—2022年12月在河南省中医院接受治疗的DPN患者分为A组和B组,各52例。B组患者采用常规治疗,A组在B组基础上给予当归四逆汤治疗。以4周为1个周期,两组均维持治疗1个周期。比较两组治疗4周后的临床疗效,治疗前、治疗4周后的中医证候评分、血清学指标、血糖指标、神经传导情况及治疗期间的不良反应发生情况。结果与B组比较,A组治疗4周后的临床总有效率较高,[98.08%(51/52)vs 84.62%(44/52)];相较于治疗前,两组治疗4周后的肌肉萎缩、感觉减退、肢体麻木、四肢疼痛、四肢发凉各项评分、血清餐后2 h血糖(2 h postprandial blood glucose,2 h PBG)、糖化血红蛋白(glycated hemoglobin,HbA1c)、丙二醛(malondialdehyde,MDA)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-23(interleukin-23,IL-23)水平、胰岛素抵抗指数(insulin resistance index,HOMA-IR)值均降低,且相较于B组,A组更低,两组治疗4周后的正中神经感觉神经传导速度(sensory nerve conduction velocity,SNCV)、腓总神经SNCV、正中神经腓总神经运动神经传导速度(motor nerve conduction velocity,MNCV)、腓总神经MNCV、血清总抗氧化能力(T-AOC)水平均升高,且与B组比较,A组较高(P<0.05)。两组均未发生明显不良反应。结论当归四逆汤治疗DPN可有效改善患者临床症状,减轻机体炎症以及氧化应激反应,稳定患者血糖水平,增强神经传导速度,疗效显著,且安全性较高。Objective To investigate the nerve conduction velocity and curative effect of Danggui Sini Decoction(当归四逆汤)treating diabetic peripheral neuropathy(DPN).Methods A total of 104 patients with DPN who received treatment at Henan Provincial Hospital of Traditional Chinese Medicine from December 2021 to December 2022 were divided into the group A and the group B by the random number table method,with 52 cases in each group.The patients of group B received routine treatment,while those of the group A were treated with Danggui Sini Decoction on the basis of the group B.The treatment lasted for one cycle after four weeks.The clinical effects of the two groups after four weeks of treatment were compared,together with the traditional Chinese medicine syndrome scoring,serological indicators,blood glucose indicators,nerve conduction and adverse reaction during the treatment before and after four weeks of treatment.Results Compared with those of the group B,the rates of total clinical effective in the group A after four weeks of treatment was higher(98.08%vs 84.62%).Compared with those before treatment,after four weeks of treatment,the scores of muscle atrophy,hypoesthesia,limb numbness,limb pain and limb cooling,the levels of serum 2 h postprandial blood glucose(2 h PBG),glycated hemoglobin(HbA1c),malondialdehyde(MDA),tumor necrosis factor-α(TNF-α),interleukin-23(IL-23)and insulin resistance index(HOMA-IR)of the two groups were all decreased,and compared with those of the group B,the level of the group A was lower.After four weeks of treatment,the values of median sensory nerve conduction velocity(SNCV),common peroneal nerve SNCV,median common peroneal nerve motor nerve conduction velocity(MNCV)and common peroneal nerve MNCV and levels of serum T-AOC of the median nerve and common peroneal nerve in the two groups were increased,and compared with those of the group B,the indexes of the group A were higher(P<0.05).No obvious adverse reactions were observed in the two groups.Conclusion Danggui Sini Decoction could ef

关 键 词：糖尿病 周围神经病变 当归四逆汤 神经传导速度 疗效 

分 类 号：R255.4[医药卫生—中医内科学]