加减化瘀解毒方联合西药治疗糖尿病周围神经病变伴抑郁障碍60例临床观察

Clinical Observation on Modified Huayu Jiedu Formula Combined with Western Medicine for 60 Cases of Diabetic Peripheral Neuropathy

目的观察加减化瘀解毒方联合西药治疗糖尿病周围神经病变(DPN)伴抑郁障碍的临床疗效。方法将120例DPN伴抑郁障碍患者随机分为治疗组和对照组各60例。在降糖治疗基础上,对照组服用甲钴胺片,每日3次,每次0.5mg,治疗组加服加减化瘀解毒方,每日1剂,两组均治疗8周后观察疗效,并比较两组治疗前后主要中医症状积分(下肢麻木、下肢疼痛、双足发凉、踩棉花感)及总积分、汉密尔顿抑郁量表(HAMD-17)总分、神经传导速度(腓总神经、胫神经、正中神经、腓肠神经)的变化。结果治疗组总有效率为75.0%,对照组总有效率为53.3%,治疗组临床疗效明显优于对照组(P<0.01)。两组治疗后主要中医症状积分及总积分、HAMD-17总分均有改善,治疗组主要中医症状积分及总积分、HAMD-17总分改善明显优于对照组(P<0.05或P<0.01)。治疗后治疗组各条神经神经传导速度改善明显优于对照组(P<0.05)。结论加减化瘀解毒方联合西药可改善DPN伴抑郁障碍患者症状、神经传导速度及抑郁障碍,临床疗效肯定。

Objective To observe the therapeutic effect of Modified Huayu Jiedu Formula （Modified Stasis-Transforming Toxin-Resolving Formula, MHJF） combined with western medicine for diabetic peripheral neuropathy （DPN）. Methods Totally 120 cases of DPN were randomized into the treatment group and control group, with 60 in each. On the basis of hypoglycemie therapy, the control group was given 0.5 mg methylcobalamin tablets 3 times daily and the treatment group was given 1 agent of MHJF daily. Both groups were treated for 8 weeks. The TCM symptoms scores, Hamilton Depression Rating Scale （HAMD-17） total score and nerve conductive velocity （NCV） were observed before and after treatment. Results The total effective rate of the treatment group and control group was 75% and 53.3% respectively, with a significant difference between groups （P〈0.01）. The TCM symptoms scores and HAMD-17 total score were significantly improved in both groups after treatment, especially in the treatment group （P〈0.01）. Comparing with the control group, the NCV in the treatment group was significantly improved after treatment （P〈0.01）. Conclusion MHJF is effective for DPN. It can relieve the symptoms and depression and improve NCV and quality of life.