黄芪桂枝五物汤加减联合α-硫辛酸及高压氧治疗糖尿病周围神经病变临床观察

Clinical Observation of Modified Huangqi Guizhi Wuwu Decoction Combined with Alpha Lipoic Acid and Hyperbaric Oxygen Treatment for Diabetic Peripheral Neuropathy

目的：观察黄芪桂枝五物汤加减联合α-硫辛酸及高压氧治疗糖尿病周围神经病变（DPN）的疗效。方法：将70例住院患者随机平分为2组，对照组应用α-硫辛酸及常规治疗，治疗组应用黄芪桂枝五物汤联合α-硫辛酸及高压氧治疗，疗程均为15天。观察①临床症状，包括患者自觉症状的变化；②神经传导速度；③跟膝反射及肌力；④血液流变学；⑤不良反应；⑥血、尿、粪常规，心、肝、肾功能。结果：总有效率治疗组为82．9％，对照组为62．9％，2组总有效率比较，差异有显著性意义（P〈0.05）。治疗期间2组的空腹血糖均稳定在（4．5～7．0）mmol／L，餐后2h血糖稳定在（5．0～11．0）mmol／L范围。2组治疗前血液流变学指标比较，差异无显著性意义（P〉0.05）；2组治疗后均明显改善，与本组治疗前比较，差异均有显著性意义（P〈0．05）。2组治疗前神经传导速度比较，差异均无显著性意义（P〉0．05）；治疗后2组各项指标均明显改善，与本组治疗前比较，差异有显著性意义（P〈0．05）；2组治疗后比较，差异也有显著性意义（P〈0．05）。治疗组有3例、对照组有2例谷丙转氨酶增高；治疗组有3例、对照组有2例肌酐轻度增高。余无异常发现。结论：黄芪桂枝五物汤加减联合α-硫辛酸及高压氧治疗DPN疗效显著，不良反应少。

Objective： To observe the effects of modified Huangqi Guizhi Wuwu decoction combined with alpha lipoic acid and hyperbaric oxygen for the treatment of diabetic peripheral neuropathy. Methods. Seventy inpatients were randomly divided into two groups, the control group was given alpha lipoic acid and conventional therapy the treatment group was given modified Huangqi Guizhi Wuwu decoction with alpha lipoic acid and hyperbaric oxygen, on the basis of the treatment of the control group. The treatment course lasted 15 days. Before and after treatment, the changes of clinical symptoms （including subjective symptoms）, nerve conduction velocity, Achilles tendon reflex, knee jerk reflex and muscle strength, hemorheology, adverse reaction, routine examination indexes for blood, urine and stool routine, and cardiac, hepatic and renal function were observed. Results： The total effective rate was 82.9% in the treatment group and was 62.9% in the control group, and the difference was statistically significant （P 〈 0.05）. Fasting blood glucose （FBG） was stabilized at 4.5-7.0 mmol/L, 2-hour postprandial blood glucose （P2hBG）was stabilized at 5.0-11.0 mmol/L during the treatment. The indexes of hemorheology were similar in both groups before treatment （P 〉 0.05）, and then were improved after treatment （P 〈 0.05）. The nerve conduction velocity was similar in both groups before treatment （P 〉 0.05）, and then was improved after treatment（P 〈 0.05）, the difference after treatment being statistically significant（P 〈 0.05）.The increase of aminotransferase （ALT） occurred in 3 cases of treatment group and the increase of creatinine（SCr）occurred in 2 cases of the control group. No other adverse reaction was found in both groups. Conclusion： Modified Huangqi Guizhi Wuwu decoction combined with alpha lipoic acid and hyperbaric oxyigen is effective and safe for the treatment of diabetic peripheral neuropathy.