联合疗法治疗糖尿病周围神经病变的临床观察

Clinical observation of combination therapy for the treatment of diabetic peripheral neuropathy

目的探讨参芪降糖颗粒、甲钴胺片口服配合艾灸联合疗法治疗糖尿病周嗣神经病变的临床疗效。方法将69例糖尿病周围神经病变患者随机分为2组。治疗组在基础治疗的同时加参芪降糖颗粒，每次3g，每日3次；甲钴胺片每次500μg，每日3次口服；配合外用穴位艾灸（选取双侧足三里、太溪穴、三阴交，艾灸每个穴位5～7min，至皮肤微微泛红，每周3次）；对照组在基础治疗的同时口服参芪降糖颗粒和甲钴胺片，与治疗组相同剂量。疗程为3个月。观察两组的临床疗效，治疗前后多伦多临床神经病变评分（TCSS）和肌电图神经传导速度（NCV）的变化。结果2组总有效率比较差异有统计学意义（P〈0．01）。2组治疗后TCSS评分与本组治疗前比较显著降低（P〈0．01），治疗组差值高于对照组，2组差值比较差异有统计学意义（P〈0．01）。2组治疗后正中神经、腓总神经的感觉神经传导速度（SNCV）和正中神经、腓浅神经的运动神经传导速度（MNCV）均升高，2组治疗前后比较差异有统计学意义（P〈0．01）；治疗组差值高于对照组，2组差值比较差异有统计学意义（P〈0．01）。结论参芪降糖颗粒与甲钴胺片口服配合艾灸联合疗法治疗糖尿病周嗣神经病变疗效优于单纯口服药治疗。

Objective To explore the clinical efficacy of combination therapy （Shenqi hypoglycemic particles, mecobalamin and moxibustion） for the treatment of diabetic peripheral neuropathy （DPN）. Methods Sixty-nine cases of DPN were randomly divided into two groups. With basic treatment, the Shenqi hypoglycemic particles （3g per time, 3 times per day）, mecobalamin tablets （500 ~g per time, 3 times per day, oral administration） and moxibustion （at Zusanli, Taixi Sanyinjiao, 5 to 7 min per acupoint until slight red of skin, three times per week） were applied in the treatment group. With basic treatment, oral administration of Shenqi hypoglycemic particles and mecobalamin tablets was applied with identical dose as treatment group. Three months were required in the treatment. The clinical efficacy of two groups and changes of Toronto Clinical Scoring System （TCSS） and neural conductive velocity （NCV） before and after treatment were observed. Results There was statistical significance on total effective rate between＇two groups （P 〈 0. 01 ）. Compared before treatment, the TCSS was significantly decreased after the treatment in both groups （P 〈 0. 01 ）, and the difference in the treatment group was higher than that in the control group with a statistical significance （ P 〈 0. 01 ）. After the treatment, the sensory NCV of median nerve and common peroneal nerve as well as motor NCV of median nerve and superficial peroneal nerve were all increased in both groups, which had statistical significance compared before the treatment （ P 〈 0. 01 ）. The NCV difference in treatment group was high than that in the control group with a statistical significance （P 〈 0.01 ）. Conclusion The combined therapy of Shenqi hypoglycemic particles, mecobalamin and moxibustion has superior efficacy to treatment of oral administration for DPN.