活血降糖饮联合硫辛酸治疗糖尿病周围神经病变临床疗效观察
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摘要
【目的】观察活血降糖饮联合硫辛酸治疗糖尿病周围神经病变(DPN)的临床疗效。【方法】将56例气阴两虚夹瘀型DPN患者随机分为治疗组和对照组,每组各28例。对照组给予控制血糖及硫辛酸治疗,治疗组在对照组基础上联合口服活血降糖饮治疗,2组疗程均为4周,观察2组治疗前后中医证候积分、胫神经的神经传导速度[运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)]及血清25羟维生素(OH)D3水平的变化情况,评价2组临床疗效及安全性。【结果】(1)治疗4周后,治疗组总有效率为89.29%,对照组为57.14%,治疗组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的中医证候积分均较治疗前明显下降(P<0.01),且治疗组的下降作用优于对照组(P<0.05)。(3)治疗后,2组患者两侧胫神经MNCV和SNCV均较治疗前增快(P<0.05或P<0.01),且治疗组对胫神经MNCV和SNCV的改善作用均优于对照组(P<0.05或P<0.01)。(4)治疗后,2组患者血清25(OH)D3水平均较治疗前明显升高(P<0.01),且治疗组的升高作用明显优于对照组(P<0.05)。(5)2组患者治疗前后均未出现恶心呕吐、皮疹等不良反应,血常规、肝肾功能和心电图检查均未见明显异常改变。【结论】活血降糖饮联合硫辛酸治疗DPN,可改善患者的临床症状和体征,加快神经传导速度,升高血清25(OH)D3水平,具有较好的临床疗效。
Objective To observe the therapeutic effect of Huoxue Jiangtang Decoction combined with lipoic acidfor the treatment of diabetic peripheral neuropathy. Methods Fifty-six cases of diabetic peripheral neuropathy withQi-yin deficiency blended with blood stasis were randomly divided into treatment group and control group,28 cases in each group. The control group was given blood glucose control and lipoic acid treatment,and the treatmentgroup was treated with Huoxue Jiangtang Decoction on the basis of treatment for the control group. The treatmentfor the two groups lasted for 4 weeks. Before and after treatment,traditional Chinese medicine(TCM)symptomscores,nerve conduction velocity(NCV)including motor NCV(MNCV)and sensory NCV(SNCV) of the tibialnerve,and serum 25 hydroxyl vitamin D3 [25(OH)D3] level in the two groups were observed. After treatment,the clinical efficacy and safety in the two groups were evaluated. Results(1)After treatment for 4 weeks,the totaleffective rate in the treatment group was 89.29%,and that in the control group was 57.14%,the clinical efficacyof the treatment group being superior to that of the control group(P<0.01).(2)The scores of TCM symptoms in thetwo groups after treatment were significantly lower than those before treatment(P < 0.01),and the decrease in thetreatment group was superior to that in the control group(P < 0.05).(3) MNCV and SNCV of the tibial nerve inthe two groups after treatment were faster than those before treatment(P < 0.05 or P < 0.01),and the improvementof MNCV and SNCV in the treatment group was superior to that in the control group(P < 0.05 or P < 0.01).(4)The serum level of 25(OH)D3 in the two groups after treatment was increased(P < 0.01 compared with thatbefore treatment),and the increase in the treatment group was superior to that in the control group(P < 0.05).(5)No adverse reaction of nausea, vomiting, or skin rash was found in the two groups. The routine bloodexamination parameters, hepatic and renal function, and electrocardiography in the two groups showed noabnormal changes. Conclusion Huoxue Jiangtang Decoction combined with lipoic acid is effective for the treatmentof diabetic peripheral neuropathy by relieving symptoms and signs,accelerating NCV,and increasing the level ofserum 25(OH)D3.
Objective To observe the therapeutic effect of Huoxue Jiangtang Decoction combined with lipoic acidfor the treatment of diabetic peripheral neuropathy. Methods Fifty-six cases of diabetic peripheral neuropathy withQi-yin deficiency blended with blood stasis were randomly divided into treatment group and control group,28 cases in each group. The control group was given blood glucose control and lipoic acid treatment,and the treatmentgroup was treated with Huoxue Jiangtang Decoction on the basis of treatment for the control group. The treatmentfor the two groups lasted for 4 weeks. Before and after treatment,traditional Chinese medicine(TCM)symptomscores,nerve conduction velocity(NCV)including motor NCV(MNCV)and sensory NCV(SNCV) of the tibialnerve,and serum 25 hydroxyl vitamin D3 [25(OH)D3] level in the two groups were observed. After treatment,the clinical efficacy and safety in the two groups were evaluated. Results(1)After treatment for 4 weeks,the totaleffective rate in the treatment group was 89.29%,and that in the control group was 57.14%,the clinical efficacyof the treatment group being superior to that of the control group(P<0.01).(2)The scores of TCM symptoms in thetwo groups after treatment were significantly lower than those before treatment(P < 0.01),and the decrease in thetreatment group was superior to that in the control group(P < 0.05).(3) MNCV and SNCV of the tibial nerve inthe two groups after treatment were faster than those before treatment(P < 0.05 or P < 0.01),and the improvementof MNCV and SNCV in the treatment group was superior to that in the control group(P < 0.05 or P < 0.01).(4)The serum level of 25(OH)D3 in the two groups after treatment was increased(P < 0.01 compared with thatbefore treatment),and the increase in the treatment group was superior to that in the control group(P < 0.05).(5)No adverse reaction of nausea, vomiting, or skin rash was found in the two groups. The routine bloodexamination parameters, hepatic and renal function, and electrocardiography in the two groups showed noabnormal changes. Conclusion Huoxue Jiangtang Decoction combined with lipoic acid is effective for the treatmentof diabetic peripheral neuropathy by relieving symptoms and signs,accelerating NCV,and increasing the level ofserum 25(OH)D3.
引文
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[8] Shehab D,Aljarallah K,Mojiminiyi O A,et al. Does vitamin D deficiency play a role in peripheral neuropathy in type 2 diabetes[J]. Diabet Med,2012,29(1):43.
[9]李兴梅,王艳妮.老年2型糖尿病患者周围神经病变与25-羟维生素D3的相关性研究[J].中国医学前沿杂志(电子版)2016,8(5):107.
[10]臧天霞,叶健.查玉明治疗糖尿病周围神经病变经验摭拾[J].实用中医内科杂志,2008,22(1):7.
[11]宋秀玲.益气养阴化瘀法治疗气阴两虚兼血瘀型糖尿病周围神经病变86例临床疗效观察[J].数理医药学杂志,2012,25(3):309.
[12]李惠林,张志玲,朱章志,等.活血降糖饮对实验性糖尿病大鼠作用及机制[J].中国组织工程研究,2007,11(38):7589.
[13]李惠林,张志玲,朱章志,等.活血降糖饮对实验性糖尿病大鼠氧自由基的影响[C]//中华中医药学会第七次全国中医糖尿病学术大会,2003:844.
[2]仝小林,刘喜明,魏军平,等.糖尿病中医防治指南[M].北京:中国中医药出版社,2007.
[3]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002.
[4] Papanas N,Dan Z. Efficacy ofɑ-lipoic acid in diabetic neuropathy[J]. Expert Opin Pharmaco,2014,15(18):2721.
[5] Deluca H F. Overview of general physiologic features and functions of vitamin D[J]. Am J Clin Nutr,2004,80(Suppl 6):1689S.
[6]杨敏.妊娠期糖尿病患者血清25-羟维生素D水平及胰岛素抵抗的关系[J].中国妇幼保健,2013,28(28):4639.
[7]刘妙珠.黄芪桂枝五物汤合当归活血汤治疗糖尿病周围神经病变的疗效观察及机制探讨[D].合肥:安徽中医药大学,2017.
[8] Shehab D,Aljarallah K,Mojiminiyi O A,et al. Does vitamin D deficiency play a role in peripheral neuropathy in type 2 diabetes[J]. Diabet Med,2012,29(1):43.
[9]李兴梅,王艳妮.老年2型糖尿病患者周围神经病变与25-羟维生素D3的相关性研究[J].中国医学前沿杂志(电子版)2016,8(5):107.
[10]臧天霞,叶健.查玉明治疗糖尿病周围神经病变经验摭拾[J].实用中医内科杂志,2008,22(1):7.
[11]宋秀玲.益气养阴化瘀法治疗气阴两虚兼血瘀型糖尿病周围神经病变86例临床疗效观察[J].数理医药学杂志,2012,25(3):309.
[12]李惠林,张志玲,朱章志,等.活血降糖饮对实验性糖尿病大鼠作用及机制[J].中国组织工程研究,2007,11(38):7589.
[13]李惠林,张志玲,朱章志,等.活血降糖饮对实验性糖尿病大鼠氧自由基的影响[C]//中华中医药学会第七次全国中医糖尿病学术大会,2003:844.