加味黄芪桂枝五物汤口服联合当归四逆汤熏洗佐治糖尿病周围神经病变临床评价  

Clinical Evaluation of Oral Modified Huangqi Guizhi Wuwu Decoction Combined with Danggui Sini Decoction Fumigation and Washing in the Adjuvant Treatment of Diabetic Peripheral Neuropathy

作　　者：于爱红[1] 杨佳佳 浦强[1] 于毅 YU Aihong;YANG Jiajia;PU Qiang;YU Yi(Rugao Hospital of Traditional Chinese Medicine,Rugao,Jiangsu,China 226500)

机构地区：[1]江苏省如皋市中医院,江苏如皋226500

出　　处：《中国药业》2024年第22期130-133,共4页China Pharmaceuticals

基　　金：江苏省中医药科技发展计划项目[MS2022095]。

摘　　要：目的探讨加味黄芪桂枝五物汤口服联合当归四逆汤熏洗佐治糖尿病周围神经病变(DPN)的临床疗效。方法选取医院2022年7月至2023年11月收诊的DPN患者86例,根据治疗方法的不同分为对照组(41例)和观察组(45例)。两组患者均常规控制血糖、增强免疫及营养神经,观察组患者在此基础上加用加味黄芪桂枝五物汤口服联合当归四逆汤熏洗。两组均以14 d为1疗程,治疗3个疗程。结果观察组总有效率为93.33%,显著高于对照组的78.05%(P<0.05)。治疗后,两组患者的中医证候主症评分、次症评分及总评分均显著降低(P<0.05);多伦多临床评分系统评分均显著降低(P<0.05);腓总神经与正中神经的感觉神经传导速率和运动神经传导速率均显著加快(P<0.05);血清基质金属蛋白酶9、NOD样受体热蛋白结构域3炎性小体水平均显著降低,血清超氧化物歧化酶水平均显著升高(P<0.05);血清丙二醛水平均显著降低(P<0.05);且观察组各指标均显著优于对照组(P<0.05)。两组患者不良反应发生率相当(11.11%比7.32%,P>0.05)。结论加味黄芪桂枝五物汤口服联合当归四逆汤熏洗佐治DPN,可改善患者临床症状,提高神经传导速率,减轻炎性反应与氧化应激反应。Objective To investigate the clinical efficacy of oral modified Huangqi Guizhi Wuwu Decoction combined with Danggui Sini Decoction fumigation and washing in the adjuvant treatment of diabetic peripheral neuropathy(DPN).Methods A total of 86 patients with DPN admitted to the hospital from July 2022 to November 2023 were selected and divided into the control group(41 cases)and the observation group(45 cases)based on different treatment regimens.The patients in the two groups were given routine blood glucose control,immune enhancement,and nerve nutritional support;on this basis,the patients in the observation group were given oral modified Huangqi Guizhi Wuwu Decoction combined with Danggui Sini Decoction fumigation and washing.Both groups were treatd for three courses with 14 d as one course.Results The total effective rate in the observation group was 93.33%,which was significantly higher than 78.05%in the control group(P<0.05).After treatment,the main traditional Chinese medicine(TCM)syndrome score,secondary TCM syndrome score and total score in the two groups significantly decreased(P<0.05);the Toronto Clinical Scoring System(TCSS)score significantly decreased(P<0.05);the sensory nerve conduction velocity(SNCV)and motor nerve conduction velocity(MNCV)of the common peroneal nerve and median nerve significantly increased(P<0.05);the serum matrix metalloproteinase-9(MMP-9)and NOD-like receptor thermal protein domain associated protein 3(NLRP3)inflammasome levels significantly decreased,the serum superoxide dismutase(SOD)level significantly increased(P<0.05);the serum malondialdehyde(MDA)level significantly decreased(P<0.05);and the above indexes in the observation group were significantly better than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(11.11%vs.7.32%,P>0.05).Conclusion Oral modified Huangqi Guizhi Wuwu Decoction combined with Danggui Sini Decoction fumigation and washing can improve the clinical symptoms of DPN patie

关 键 词：加味黄芪桂枝五物汤 中药熏洗 当归四逆汤 糖尿病周围神经病变 临床疗效 神经传导速率 炎性反应 氧化应激 辅助治疗 

分 类 号：R969.4[医药卫生—药理学] R587.2[医药卫生—药学]