复方芪藤通络汤联合依帕司他治疗老年2型糖尿病周围神经病变临床研究

Clinical Research of the Patients with Type 2 Diabetic Peripheral Neuropathy in the Elderly Treated by Compound Qiteng Tongluo Tang Combined Epalrestat

目的:观察复方芪藤通络汤联合依帕司他对老年2型糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)患者临床体征及症状、神经传导速度及糖代谢水平等的影响。方法:102例DPN患者按照随机数字表法分为观察组和对照组,各51例。对照组给予常规控制血压、血糖、血脂治疗,并每次口服依帕司他50 mg,3次·d-1。观察组对照组基础上加用复方芪藤通络汤。两组均治疗3个疗程。比较两组患者临床疗效及治疗前后中医证候评分、多伦多临床评分、血液流变学、神经传导速度和糖代谢水平变化情况。结果:治疗3个疗程后观察组有效率86.27%,显著高于对照组68.63%,差异有统计学意义(P<0.05);两组中医证候积分较治疗前明显降低,差异有统计学意义(P<0.05),且观察组明显优于对照组,差异有统计学意义(P<0.05);治疗前,两组多伦多临床评分、血液流变学各指标、神经传导速度各项指标及糖代谢水平对比,差异无统计学意义(P>0.05),经治疗,两组各项指标均有所改善,且观察组显著优于对照组,差异有统计学意义(P<0.05)。结论:复方芪藤通络汤联合依帕司他治疗老年2型DPN患者可有效改善其临床体征与症状,提高临床疗效,同时可提高神经传导速度,改善血液流变学及糖代谢各项指标水平。

Objective： To explore the influence of clinical sign and symptom,nerve conduction velocity and glucose metabolism states of the patients with type 2 diabetic peripheral neuropathy（ DPN） in the elderly treated by compound Qiteng Tongluo Tang combined Epalrestat. Methods： 102 cases of patients were randomly divided into the combination group and convention group as the random number table,each 51 cases. The two groups were given the routine control of blood pressure,blood glucose and blood fat,and given the 50 mg per time of Epalrestat,3 times a day,the combination group was added using compound Qiteng Tongluo Tang based on the routine treatment. The two groups were treated for 3 course of treatment. Compared the clinical effect and Chinese medicine symptom complex score,Toronto clinical scores,hemorheology,nerve conduction velocity and the changes of glucose me-tabolism states at pretherapy and post-treatment. Results： The effective rate of the combination group was 86. 27% after 3 course of treatment,that was significantly greater than the convention group,there was statistical significance by rank sum test（ P〈0. 05）.Before treatment,compared Chinese medicine symptom complex score of the two groups,there was no statistical significance（ P〈0. 05）. After treatment,the Chinese medicine symptom complex score was significantly lower than that before treatment,there was statistical significance（ P〈0. 05）,and the combination group was significantly better than the convention group,there was statistical significance（ P〈0. 05）. Before treatment,compared the Toronto clinical scores,hemorheology,various index of nerve conduction velocity and the glucose metabolism states of the two groups,there was no statistical significance（ P〉0. 05）. After treatment,the various index of the two groups were improved,and the combination group was significantly better than the convention group,there was statistical significance（ P〈0. 05）. Conclusion： Compound Qiteng Tongluo Tang combined Epalrestat can effective improve the clinical sign and symptom of the patients with type 2 diabetic peripheral neuropathy（ DPN） in the elderly,improve the treatment effect,meantime able to improve the nerve conduction velocity,improve the hemorheology and various index of glycometabolism.