健脾通络方联合甲钴胺治疗2型糖尿病周围神经病变的临床效果  

Clinical observation on Jianpi Tongluo Recipe combined with mecobalamin in treating type 2 diabetes peripheral neuropathy

作　　者：贾洪伟 张颖 王东军 张英来 祖立斌 JIA Hongwei;ZHANG Ying;WANG Dongjun;ZHANG Yinglai;ZU Libin(Department of Endocrinology,Tangshan Traditional Chinese Medicine Hospital,Tangshan 063000,China;Department of the Second Traditional Chinese Medicine Hospital in Fengnan District,Tangshan 063300,China;Department of Traditional Chinese Medicine,School of Traditional Chinese Medicine,North China University of Technology,Tangshan 063210,China)

机构地区：[1]唐山市中医医院内分泌科,唐山063000 [2]唐山市丰南区中医医院内二科,唐山063300 [3]华北理工大学中医学院中医系,唐山063210

出　　处：《西北药学杂志》2025年第2期226-231,共6页Northwest Pharmaceutical Journal

基　　金：河北省自然科学基金项目(编号:H2023209049);河北省中医药管理局科研计划项目(编号:2022554)。

摘　　要：目的探讨健脾通络方联合甲钴胺治疗2型糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的临床效果与机制。方法选取2021年9月—2022年5月收治的100例DPN患者作为观察对象,采用随机数字表法分为对照组与试验组,每组50例,对照组给予甲钴胺治疗,试验组在对照组治疗的基础上联合健脾通络方治疗。对比2组患者的中医证候疗效、血糖指标、血清炎症标志物水平、神经电生理指标及营养状况。结果试验组的总有效率为92.00%(46/50),高于对照组的76.00%(38/50),P<0.05。2组治疗前及治疗后1、6、12周的空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(postprandial blood glucose,PBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、同型半胱氨酸(homocystine,Hcy)、超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)水平均降低,且试验组治疗后1、6、12周的各指标均低于对照组(P<0.05)。2组治疗前及治疗后1、6、12周的正中神经、腓总神经运动神经传导速度(motor nerve conduction velocity,MCV)和感觉神经传导速度(sensory nerve conduction velocity,SCV)依次升高,且试验组治疗后1、6、12周的各指标均高于对照组(P<0.05)。治疗后,试验组的营养筛查问卷(mininutritional assessment short form,MNA-SF)评分高于对照组(P<0.05)。结论健脾通络方联合甲钴胺可有效改善DPN患者的临床症状和营养状况,下调血清炎性因子,降低血糖,提高正中神经和腓总神经的传导速度,临床疗效优于单纯应用甲钴胺治疗。Objective To explore the clinical efficacy and mechanisms of Jianpi Tongluo Recipe combined with mecobalamin in treating type 2 diabetes peripheral neuropathy(DPN).Methods One-hundred DPN patients admitted to our hospital from September 2021 to May 2022 were included as observation subjects.They were randomly assigned to a control group of 50 cases and an experimental group of 50 cases using a random number table method.The control group received treatment of mecobalamin,while the experimental group was treated with Jianpi Tongluo Recipe in addition to mecobalamin.The therapeutic effects were compared between the 2 groups based on traditional Chinese medicine syndromes,blood glucose indicators,serum inflammatory marker levels,neuroelectrophysiological indicators,and nutritional status.Results The total effective rate in the experimental group was 92.00%(46/50),higher than the control group’s rate of 76.00%(38/50)(P<0.05).The fasting blood glucose(FBG),2-hour postprandial blood glucose(PBG),glycosylated hemoglobin(HbA1c),homocysteine(Hcy),and hypersensitive C-reactive protein(hs-CRP)levels decreased sequentially before treatment and at 1,6,and 12 weeks after treatment,with all indicators in the experimental group being lower than those in the control group at these time points(P<0.05).The motor nerve conduction velocity(MCV)and sensory nerve conduction velocity(SCV)of the median nerve and common peroneal nerve in both groups increased sequentially before treatment and at 1,6,and 12 weeks after treatment,and all indicators in the experimental group being higher than those in the control group at these time points after treatment(P<0.05).After treatment,the mini nutritional assessment short form(MNA-SF)scores in the experimental group were higher than that in the control group(P<0.05).Conclusion Jianpi Tongluo Recipe combined with mecobalamine can effectively improve the clinical symptoms and nutritional status of DPN patients,downregulate serum inflammatory factors,reduce blood glucose,and increase the conduction

关 键 词：健脾通络方 甲钴胺 2型糖尿病周围神经病变 

分 类 号：R977[医药卫生—药品]