健脾通络方联合甲钴胺治疗糖尿病周围神经病变患者的临床疗效及对其神经电生理、血液流变学的影响  

Clinical Efficacy of Jianpi Tongluo Formula Combined with Methylcobalamin in Treating Patients with Diabetic Peripheral Neuropathy and Its Effects on Neuroelec⁃trophysiology and Hemorheology

作　　者：祖立斌 贾洪伟 张颖 王东军 张英来 ZU Li-bin;JIA Hong-wei;ZHANG Ying;WANG Dong-jun;ZHANG Ying-lai(Department of Geriatrics,Tangshan Hospital of Traditional Chinese Medicine,Tangshan Hebei 063000;Department of Endocrinology II,Tangshan Hospital of Traditional Chinese Medicine,Tangshan Hebei 063000;Department of Internal Medicine II,Fengnan District Traditional Chinese Medicine Hospital,Tangshan Hebei 063300;College of Traditional Chinese Medicine,North China University of Science and Technology,Tangshan Hebei 063210)

机构地区：[1]唐山市中医医院老年病科,河北唐山063000 [2]唐山市中医医院内分泌二科,河北唐山063000 [3]唐山市丰南区中医医院内二科,河北唐山063300 [4]华北理工大学中医学院,河北唐山063210

出　　处：《世界中西医结合杂志》2024年第12期2433-2438,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局2022年度中医药类科研计划项目(2022554);河北省中医药管理局2024年度中医药类科研计划项目(2024355)。

摘　　要：目的探讨健脾通络方联合甲钴胺治疗糖尿病周围神经病变(Diabetic peripheral neuropathy,DPN)患者的临床疗效及对其神经电生理、血液流变学的影响。方法选取2021年4月—2023年3月期间唐山市中医医院就诊的DPN患者98例,采用随机数字法分为对照组和治疗组,每组各49例。两组患者均行常规降脂、降糖治疗,对照组在此基础上予甲钴胺治疗,治疗组在对照组基础上联合健脾通络方治疗,两组患者均持续给药3个月。观察两组患者治疗前后中医证候积分变化情况,测量两组患者治疗前后血液流变学指标(全血黏度、全血高切黏度、全血低切黏度)、氧化应激指标[丙二醛(Malondialdehyde,MDA)、超氧化物歧化酶(Superoxide dismutase,SOD)]、神经电生理指标[腓总神经及正中神经感觉神经传导速度(Sensory nerve conduction velocity,SCV)、运动神经传导速度(Motor nerve conduction velocity,MCV)],评估临床疗效,记录用药期间患者胃肠功能紊乱、过敏反应等不良反应。结果治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者全血黏度、全血高切黏度、全血低切黏度均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血液流变学指标明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清MDA水平均较治疗前降低,SOD水平均较治疗前升高,差异有统计学意义(P<0.05);且治疗组血清MDA水平明显低于对照组,SOD水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者腓总神经及正中神经SCV、MCV指标均较治疗前升高,差异有统计学意义(P<0.05);且治疗组神经电生理指标明显高于对照组,差异有统计学意义(P<0.05)。治疗后治疗组神经电生理疗效总有效率93.88%(46/49)明显高于对照组77.55%(38/49),差异有统计学意义(P<Objective To investigate the clinical efficacy of Jianpi Tongluo Formula combined with methylcobalamin in treating patients with diabetic peripheral neuropathy(DPN)and its effects on neuroelectrophysiology and hemorheology.Methods A total of 98 patients with DNP treated at Tangshan Hospital of Traditional Chinese Medicine between April 2021 and March 2023 were selected as subjects.They were divided into a control group and a combined traditional Chinese medicine(TCM)and Western medicine treatment group according to the random table number method,with 49 cases in each group.Both groups received conventional lipid-lowering and glucose-lowering treatments.The control group was treated with methylcobalamin,while the combined TCM and Western medicine treatment group was treated with Jianpi Tongluo in addition to the control group′s treatment.Both groups were treated for 3 months.Changes in TCM syndrome scores,hemorheological indicators(whole blood viscosity,high-shear whole blood viscosity,low-shear whole blood viscosity),oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD)],and neuroelectrophysiological indicators[sensory nerve conduction velocity(SCV)and motor nerve conduction velocity(MCV)of the common peroneal and median nerve]were measured before and after treatment.Clinical efficacy was evaluated,and adverse reactions such as gastrointestinal dysfunction and allergic reactions during treatment were recorded.Results After treatment,the TCM syndrome scores significantly decreased in both groups compared to before treatment,with statistically significant differences(P<0.05).The combined TCM and Western medicine treatment group had significantly lower TCM syndrome scores than the control group,with statistically significant differences(P<0.05).After treatment,whole blood viscosity,high-shear whole blood viscosity,and low-shear whole blood viscosity significantly decreased in both groups,with statistically significant differences(P<0.05).The hemorheological indicators in the combined TCM and W

关 键 词：健脾通络方 糖尿病周围神经病变 氧化应激 神经传导速度 甲钴胺 

分 类 号：R587.1[医药卫生—内分泌] R745[医药卫生—内科学]