通络除痹丸治疗糖尿病周围神经病变疗效观察
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摘要
目的观察通络除痹丸治疗气虚血瘀证糖尿病周围神经病变患者的临床疗效。方法将符合标准的60例气虚血瘀证糖尿病周围神经病变患者随机分为治疗组与对照组各30例,2组均予以基础治疗及甲钴胺片口服,治疗组在此基础上加服通络除痹丸,2组均以8周为1个疗程,连续治疗1个疗程。观察2组治疗前后中医症状评分和神经传导速度变化情况,统计2组临床疗效。结果 2组治疗后中医症状评分均明显降低(P均<0.05),且治疗组明显低于对照组(P<0.05);2组治疗后正中神经、腓总神经的运动神经传导速度和感觉传导速度均较治疗前明显增快(P均<0.05),且治疗组均明显快于对照组(P均<0.05)。治疗8周后,治疗组总有效率为90.0%,明显高于对照组的70.0%(P<0.05)。结论通络除痹丸能明显缓解气虚血瘀证糖尿病周围神经病变患者肢体疼痛、麻木、发凉等症状,有效促进神经传导功能恢复,提高临床疗效。
Objective It is to observe the efficacy of Tongluo Chubi Wan in the treatment of diabetic peripheral neuropathy diagnosed as deficiency of Qi and blood stasis type. Methods Sixty patients with diabetic peripheral neuropathy of syndrome of Qi deficiency and blood stasis who met the criteria were randomly divided into treatment group and control group, 30 cases in each group. Both groups were given basic treatment and mecobalamin tablets by oral administration. Additionally, the treatment group was given Tongluo Chubi pills orally, the two groups were treated for 8 weeks as a course of treatment, and one course of treatment was continued. The changes of TCM symptom scores and nerve conduction velocity before and after treatment were observed, and the clinical effects of the two groups were statistically analyzed. Results The scores of TCM symptoms in the two groups were significantly decreased after treatment(P<0.05), and the decrease in the treatment group was more significant than that in the control group(P<0.05). The motor nerve conduction velocity and sensation conduction velocity of the median nerve and the common peroneal nerve after treatment was significantly faster than that before treatment in the two groups(P<0.05), and the velocity in the treatment group was significantly faster than that in the control group(P<0.05). After 8 weeks of treatment, the total effective rate of the treatment group was 90.0%, which was significantly higher than that of the control group(70.0%)(P<0.05). Conclusion Tongluo Chubi pill can significantly relieve the symptoms of limb pain, numbness and chills effectively promote the recovery of nerve conduction function and improve clinical efficacy in patients with diabetic peripheral neuropathy of syndrome of Qi deficiency and blood stasis syndrome.
Objective It is to observe the efficacy of Tongluo Chubi Wan in the treatment of diabetic peripheral neuropathy diagnosed as deficiency of Qi and blood stasis type. Methods Sixty patients with diabetic peripheral neuropathy of syndrome of Qi deficiency and blood stasis who met the criteria were randomly divided into treatment group and control group, 30 cases in each group. Both groups were given basic treatment and mecobalamin tablets by oral administration. Additionally, the treatment group was given Tongluo Chubi pills orally, the two groups were treated for 8 weeks as a course of treatment, and one course of treatment was continued. The changes of TCM symptom scores and nerve conduction velocity before and after treatment were observed, and the clinical effects of the two groups were statistically analyzed. Results The scores of TCM symptoms in the two groups were significantly decreased after treatment(P<0.05), and the decrease in the treatment group was more significant than that in the control group(P<0.05). The motor nerve conduction velocity and sensation conduction velocity of the median nerve and the common peroneal nerve after treatment was significantly faster than that before treatment in the two groups(P<0.05), and the velocity in the treatment group was significantly faster than that in the control group(P<0.05). After 8 weeks of treatment, the total effective rate of the treatment group was 90.0%, which was significantly higher than that of the control group(70.0%)(P<0.05). Conclusion Tongluo Chubi pill can significantly relieve the symptoms of limb pain, numbness and chills effectively promote the recovery of nerve conduction function and improve clinical efficacy in patients with diabetic peripheral neuropathy of syndrome of Qi deficiency and blood stasis syndrome.
引文
[1] 陆祖谦,丁维.糖尿病周围神经病变诊治进展[J].药品评价,2013,10(17):35-45
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[12] Bri V.Neurom uscular complications of diabetes ellitus[J].Continuum,2014,20(3):531-544
[13] Mehra M,Merchant S,Gupta S,et al.Diabetic peripheral neuropathy:resource utilization and burden of illness[J].J Med Econ,2014,17(9):637-645
[14] 刘妙珠,刘怀珍,张媛媛.糖尿病周围神经病变发病危险因素及中医药防治[J].中医药临床杂志,2016,28(11):1501-1503
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[16] 张永文,韩康生,程燕.糖尿病周围神经病变的中医病因病机及证治[J].吉林中医药,2014,34(6):561-564
[17] 周承.中药黄芪药理作用及临床应用研究[J].亚太传统医药,2014,10(22):100-101
[18] 周秋秋,任谓明,王艳红,等.红参炮制、化学成分及药理活性研究进展[J].上海中医药杂志,2016,50(2):97-100
[19] 吴芸,陈志鹏,蔡宝昌.桃红四物汤化学成分及药理作用的研究进展[J].中成药,2011,33(11):1965-1966
[20] 史磊,张天锡,杜聪颖.中药全蝎活性成分、药理作用及临床应用研究进展[J].辽宁中医药大学学报,2015,17(4):89-90
[21] 方秀桐,莫可元.蜈蚣的药理研究进展[J].中国医药指南,2015,13(18):32-33
[22] 杨明.高速逆流色谱分离地龙中抗血栓活性成分的研究[J].中国医药导刊,2010,12(7):32-35
[23] 苏萍,王蕾,杜仕静,等.三七皂苷对神经系统疾病药理作用机制研究进展[J].中国中药杂志,2014,39(23):4516-5618
[24] 马丙详,董宠凯.丹参药理作用研究新进展[J].中国药房,2014,25(7):663-665
[25] 秦建鲜,黄锁义.鸡血藤药理作用的研究进展[J].时珍国医国药,2014,25(1):179-181
[26] 田硕,苗明三.牛膝的化学、药理及应用特点探讨[J].中医学报,2014,29(8):1186-1188
[2] 李廷尉.糖尿病周围神经病变的发病机制及诊治研究进展[J].右江医学,2015,43(3):369-370
[3] 陈爱萍,王庆云.中西医结合治疗糖尿病周围神经病变临床研究[J].中医学报,2014,29(10):1423-1424
[4] 段白露,梅之南,高铁祥.中医药防治糖尿病周围神经病变的研究进展[J].湖北中医杂志,2017,39(9):64-66
[5] 冯峰,邹庆玲.中药治疗糖尿病周围神经病变临床疗效观察[J].中华中医药学刊,2014,32(8):2008-2013
[6] 中国医师协会内分泌代谢科医师分会制定.糖尿病周围神经病变诊疗规范(征求意见稿)[J].中国糖尿病杂志,2009,17(8):638-640
[7] 方朝晖,吴以岭,赵进东.糖尿病周围神经病变中医临床诊疗指南(2016年版)[J].中医杂志,2017,58(7):625-630
[8] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):893-894
[9] 沈璐,胡筱娟,李婷,等.糖尿病周围神经病变与血瘀证的相关性探讨[J].陕西中医,2013,34(5):577
[10] 衡先培.糖尿病性神经病变诊断与治疗[M].北京:人民卫生出版社,2002:49-52
[11] 张爱旗,王会芳,李志茹.通脉降糖胶囊治疗糖尿病周围神经病变临床观察[J].现代中西医结合杂志,2012,21(10):1077-1080
[12] Bri V.Neurom uscular complications of diabetes ellitus[J].Continuum,2014,20(3):531-544
[13] Mehra M,Merchant S,Gupta S,et al.Diabetic peripheral neuropathy:resource utilization and burden of illness[J].J Med Econ,2014,17(9):637-645
[14] 刘妙珠,刘怀珍,张媛媛.糖尿病周围神经病变发病危险因素及中医药防治[J].中医药临床杂志,2016,28(11):1501-1503
[15] 柴可夫,张熙芮.从虚、瘀、痰论治糖尿病周围神经病变[J].中华中医药学刊,2011,29(9):1940-1941
[16] 张永文,韩康生,程燕.糖尿病周围神经病变的中医病因病机及证治[J].吉林中医药,2014,34(6):561-564
[17] 周承.中药黄芪药理作用及临床应用研究[J].亚太传统医药,2014,10(22):100-101
[18] 周秋秋,任谓明,王艳红,等.红参炮制、化学成分及药理活性研究进展[J].上海中医药杂志,2016,50(2):97-100
[19] 吴芸,陈志鹏,蔡宝昌.桃红四物汤化学成分及药理作用的研究进展[J].中成药,2011,33(11):1965-1966
[20] 史磊,张天锡,杜聪颖.中药全蝎活性成分、药理作用及临床应用研究进展[J].辽宁中医药大学学报,2015,17(4):89-90
[21] 方秀桐,莫可元.蜈蚣的药理研究进展[J].中国医药指南,2015,13(18):32-33
[22] 杨明.高速逆流色谱分离地龙中抗血栓活性成分的研究[J].中国医药导刊,2010,12(7):32-35
[23] 苏萍,王蕾,杜仕静,等.三七皂苷对神经系统疾病药理作用机制研究进展[J].中国中药杂志,2014,39(23):4516-5618
[24] 马丙详,董宠凯.丹参药理作用研究新进展[J].中国药房,2014,25(7):663-665
[25] 秦建鲜,黄锁义.鸡血藤药理作用的研究进展[J].时珍国医国药,2014,25(1):179-181
[26] 田硕,苗明三.牛膝的化学、药理及应用特点探讨[J].中医学报,2014,29(8):1186-1188