温通活血乳膏联合肢体气压治疗糖尿病痛性神经病变30例临床观察

Clinical Observation on Painful Diabetic Neuropathy Treated by Wengtong Huoxue Cream plus Limb Air-pressure Therapy: A Report of 30 Cases

目的观察温通活血乳膏联合肢体气压治疗糖尿病痛性神经病变(PDN)的临床疗效。方法将59例PDN患者随机分为治疗组30例和对照组29例,治疗组予温通活血乳膏外用联合肢体气压治疗,对照组予止痛药及神经营养药,必要时予以抗抑郁药。观察治疗前后患者肢体神经传导速度、药物疗效及神经症状、体征评分及视觉模拟疼痛评分(VAS)。结果两组治疗前后比较,腓总神经、胫神经的运动神经传导速度(MNCV)和感觉神经传导(SNCV)均有改善,差异具有统计学意义(P<0.01),并且治疗组治疗后腓总神经、胫神经的MNCV和SNCV提高优于对照组(P<0.05)。治疗组治疗后神经症状、体征、VAS评分方面均低于对照组(P<0.05)。治疗组总有效率为86.7%,对照组总有效率为72.4%,两组临床疗效总有效率比较差异具有统计学意义(P<0.01)。结论温通活血乳膏联合肢体气压对PDN患者神经传导速度、症状及体征均明显改善,优于美洛昔康片和甲钴铵针联用。

Objective To observe the effect of Wengtong Huoxue Cream （Cream for warming the meridians and activating blood） plus limb air-pressure therapy on painful diabetic neuropathy （PDN）. Methods Fifty-nine PDN patients were random- ized into treatment group of 30 cases and control group of 29 cases. The treatment group was treated with Wengtong Huoxue Cream and limb air-pressure therapy, while the control group was treated with analgesic, neurotrophy, and antidepressant on occasion. The nerve conduction velocity （NCV） of the affected limbs, medicinal effect, and symptom improvement of the patients were observed. Results After treatment, the motor nerve conduction velocity （MNCV） and sensory nerve conduction velocity （SNCV） of common peroneal nerve and tibial nerve of both groups were improved, and the difference was statistically significant （P〈0.01）. In the treatment group, the MNCV and SNCV of common peroneal nerve and tibial nerve were significantly increased, better than those in the control group （P〈0.05）. The improvement of neural symptoms and signs and VAS score of the treatment group was significant, and there was statistically significant difference between the two groups in comparison （P〈0. 05）. The total effective rate of the treatment group was 86.7%, while that of the control group was 72.4%. The difference of the total effective rate between the two groups was statistically significant （P^0.01）. Conclusion Wengtong Huoxue Cream plus limb air-pressure therapy is effective in improving the NCV and symptoms and signs of the PDN patients.