加味黄芪桂枝五物汤治疗糖尿病周围神经病变临床疗效观察

Clinical observation on Modified Huangqi Guizhi Wuwu Decoction on diabetes peripheral neuropathy

目的观察加味黄芪桂枝五物汤治疗糖尿病周围神经病变(DPN)疗效。方法将我院118例DPN患者随机分为治疗组与对照组各59例。对照组给予硫辛酸治疗,治疗组在对照组治疗基础上联合应用加味黄芪桂枝五物汤治疗。比较两组总有效率、治疗前后血浆黏度和血小板聚集率及血糖水平、中医证候、犹他神经症状(UENS)、疼痛视觉模拟法(VAS)、踝肱指数(ABI)、震动感觉阈值(VPT)、正中神经、腓总神经潜伏期和波幅。结果治疗后,治疗组总有效率高于对照组(P<0.05);两组血浆黏度、血小板聚集率、血糖水平、中医证候、UENS、VAS、VPT、正中神经、腓总神经潜伏期均低于治疗前,治疗组血浆黏度、血小板聚集率、血糖水平、中医证候、UENS、VAS、VPT、正中神经、腓总神经潜伏期均低于对照组(P<0.05);两组ABI、正中神经、腓总神经波幅高于治疗前,治疗组ABI、正中神经、腓总神经波幅均均高于对照组(P<0.05)。结论加味黄芪桂枝五物汤能较好地改善DPN患者中医证候、肌电图和血液循环,降低神经痛和血糖,疗效优于仅用西药的效果。

Objective To observe the therapeutic effect ofmodified Huangqi GuizhiWuwu Decoction on diabetes peripheral neuropathy(DPN).Methods A tota of 118 DPN patients were randomly divided into treatment group and control group,59 cases in each group.Control group was treated with lipoic acid,and treatment group was treated with modified Huangqi Guizhi Wuwu Decoction on the basis of control group.The total effective rate,plasma viscosity,platelet aggregation rate,blood glucose level,TCM syndromes,Utah neurological symptoms(UENS),Visual analogue scale(VAS)scone,Ankle-brachial pressure index(ABI),vibratory sensory threshold(VPT),Median nerve,common peroneal nerve latency and amplitude were compared between two groups.Results After treatment,the total effective rate of treatment group was higher than control group(P<0.05);the plasma viscosity,platelet aggregation rate,blood glucose level,TCM syndromes,UENS,VAS score,VPT,Median nerve,and common peroneal nerve latency in both groups were lower than those before treatment.The plasma viscosity reduced in both groups,and were lower in treatment group than control group(P<0.05);the amplitudes of ABI,median nerve and common peroneal nerve in both groups were higher than those before treatment,and were higher in obsrvation group than control group(P<0.05).Conclusion Jiawei Huangqi Guizhi Wuwu Decoction can better improve the TCM syndromes,electromyography and blood circulation of DPN patients,reduce neuralgia and blood sugar,and its effect is better than that of western medicine alone.