中医药综合治疗糖尿病周围神经病变临床研究

Clinical Research on Combining Therapy of Traditional Chinese Medicine in Treating Diabetic Peripheral Neuropathy

目的:观察中医药综合治疗糖尿病周围神经病变(DPN)的临床疗效及对神经功能和氧化应激的影响。方法:80例DPN患者随机平均分为观察组和对照组。对照组给予甲钻胺片,每次0.5 mg,每天3次。观察组给予筋骨痛消丸,每次6 g,每天3次,口服;杞菊地黄丸,每次9 g,每天3次,口服;针灸疗法(体针和梅花针);中药熏洗。两组总疗程均为3个月。治疗后进行多伦多临床评分系统(TCSS)评分,检测治疗前后正中神经和腓总神经运动传导速度(MNCV)和感觉传导速度(SNCV);检测血清总抗氧化能力(TAOC)、超氧化物歧化酶(SOD)、丙二醛(MDA)。结果:治疗后观察组TCSS各维度评分(神经症状、神经反射、感觉功能评分)及总分均低于对照组(P<0.01);治疗后观察组腓总神经以及正中神经MNCV、SNCV较治疗前提高,且优于对照组(P<0.01);观察组有效率为90.0%,优于对照组的67.5%(P<0.05);治疗后观察组TAOC、SOD水平较治疗前明显升高,并高于对照组(P<0.01),MDA水平显著下降,并低于对照组(P<0.01)。结论:中医药综合疗法治疗DPN疗效显著,能改善DPN患者TCSS评分,改善MNCV和SNCV,其作用机制可能与减轻氧化应激损伤有关。

Objective：To observe curative effect of combining therapy of traditional Chines medicine in treating diabetic peripheral neu- ropathy（DPV） and influences to nervous function and oxidative stress. Methods：Eighty cases with DPV were randomly divided into the control group（40 cases） and the observation group（40 cases）. Patients in the control group were received meeobalamin tablets ,0.5 mg per time ,3 times per day. Patients in the observation group were received Jingu Tongxiao pills ,6 g per time ,3 times per day, taken orally and Qiju Dihunag pills ,9 g per time,3 times per day, taken orally, acupuncture and moxibustion （body acupuncture and plum acupunc- ture）, and fuming-washing of traditional chines medicine. The total course of treatment in two groups were 3 mouths. Before and after treatment,Toronto clinical scoring system（TCSS） was used, motor nerve conduction velocity（MNCV） and sensory nerve conduction ve- locity（SNCV） of median nerve and nervous peroneus communis were detected, and total anti oxidation capacity （TAOC）, superoxide dismutase （ SOD ） and methane dicarboxylic aldehyde （MDA） were detected. Results ： After treatment, dimension scores of TCSS （ nervous symptom, nervous reflex and scores of sensory function）and the total scores in the observation group were lower than those in control group（ P 〈0.01 ）. Compared with the time before treatment,MNCV and SNCV of nervous peroneus communis and median nerve in the observation group increased and the amelioration in the observation group was superior to control group（ P 〈 0.01 ）. The total effective rate in the observation group was 90.0% superior to 67.5% in the control group（P 〈0.05）. The level of TAOC and SOD in the obser- vation group increased obviously and which were higher than those in the control group（ P 〈 0.01 ） , and the level of MDA in the obser- vation group decreased obviously and which was lower than in the control group（ P 〈 0. O1 ）. Conclusion：Combining therapy of tradition- al Chines medicine ameliorated scores of TCSS of patients with DPV, motor nerve conduction velocity and sensory nerve conduction ve- locity, and there was a significant clinical curative effect,and the mechanism of action may be related to reducing oxidative stress.