高天舒治疗糖尿病周围神经病变临床表现及用药规律系统综述

Systematic Review of the Clinical Manifestations and Medication Principles of GAO Tianshu(高天舒) in the Treatment of Diabetic Peripheral Neuropathy

[主要目的]分析高天舒治疗糖尿病周围神经病变临床表现及用药规律。[资料来源]在辽宁中医药大学附属医院病案室选择慢病内分泌科住院病历。[选择文献量及依据](1)研究类型:临床观察。(2)符合糖尿病周围神经病变诊断标准;知情同意,签署知情同意书。排除信息不全、方药组成不完整,临床疗效不显著,未按要求坚持服汤药。[数据提炼规则及应用方法]根据《中药学》《中医内科学》规范统一药名及术语。SPSS22.0统计软件、Excel2003软件,计量资料采用均值±标准差(±s)表示,计数资料采用χ~2检验;统计药味频次,主要症状、舌象、脉象排序,聚类分析高频药物、药对。[数据综合得出结果与结论]口渴多饮100例,尿频量多99例,疲乏无力96例,大便正常69例,寐佳65例,双下肢麻木疼痛63例,纳可61例,双目视物不清53例,多食易饥42例,寐差28例,胸闷26例,头晕23例,气短22例,自汗18例,大便干14例,胸痛12例,头痛12例,双上肢麻木疼痛12例,心悸11例;舌质暗58例,舌质暗红37例,舌质红3例,舌质紫黯1例,舌质淡1例,舌下络脉紫黯1例,苔少44例,苔薄白30例,苔黄16例,苔白7例,苔白腻1例,苔黄少1例,苔白腻厚1例;脉细27例,脉沉细27例,脉沉25例,脉沉涩5例,脉细数3例,脉细无力3例,脉沉细无力3例,脉沉无力2例,脉滑2例,脉细涩1例,脉弦细1例,脉滑数1例;聚类方(使用频率>20%药物)(1)桑叶、桑白皮、乌梅、五味子、桑椹、知母、枸杞子、玉竹、山茱萸、女贞子;(2)半夏、炙甘草、黄连、生地黄。常用药对:女贞子-玉竹、生地黄-知母、桑椹-桑白皮、山茱萸-桑叶、枸杞子-乌梅。[未来展望]扩大样本、多中心协调配合,得出更确切的结果。

[Objective] To analyze the clinical manifestations medication principles of Tianshu Gao in the treatment of diabetic peripheral neuropathy. [Data sources] Medical records of patients in the Department of chronic diseases/endocrinology of Affiliated Hospital of Liaoning University of Traditional Chinese Medicine. [Documents selection criteria] ①Type of study： clinical observation. ②Meet the diagnostic criteria of diabetic peripheral neuropathy; informed consent, signed informed consent. Exclusion of incomplete information, incomplete prescription, no significant clinical effect, not required to keep taking medicine. [Data extraction methods] Standardized nomenclature and terminology of ＂Chinese material medica＂ and ＂internal medicine of Traditional Chinese Medicine＂. SPSS22.0 statistical software, Excel2003 software, the measurement data using mean standard deviation （x±s）, count data using χ2 test; statistically analyze drug frequency, main symptoms, tongue and pulse nature, clustering analysis of high frequency drugs and couplet drugs. [Data synthesis, results and conclusions] 100 cases of polydipsia, urinary frequency in 99 cases, fatigue and weakness in 96 cases, normal stool in 69 cases, good sleep in 65 cases, 63 cases of numbness and pain of lower limbs, good diet in 61 cases, unclear binocular vision in 53 cases, good appetite in 42 cases, poor sleep in 28 cases, 26 cases of chest tightness, dizziness in 23 cases, shortness of breath in 22 cases, 18cases of spontaneous sweating, dry stool in 14 cases, 12 cases of chest pain, headache in 12 cases, 12 cases of numbness and pain in the upper extremities, 11 cases of palpitation; dark tongue in 58 cases, 37 cases of dark red tongue, red tongue in 3 cases, 1 case of dark purple tongue, pale tongue in 1 case, dark purple sublingual vein in 1, 44 cases of little fur, 30 cases of thin white fur, 16 cases of yellow fur, 7 cases of white fur, 1 case of white greasy fur, 1 case of yellowish fur, 1 case of thick white greasy fur; thready pulse in 27 cases, 27 cases of deep thready pulse, deep pulse in 25 cases, deep rough pulse in 5 cases, thready rapid pulse in 3 cases, 3 cases of weak thready pulse, deep thready weak pulse in 3 cases, 2 cases of deep weak pulse, 2 cases of slippery pulse, 1 case of thready rough pulse, wiry pulse in 1 case, rapid slippery pulse in 1 case. Clustering （frequency〉20% of drugs）①mulberry leaves, mulberry bark, dark plum, schisandra chinensis, mulberry, zhimu, fruit of Chinese wolfberry, polygonatum, dogwood, ligustrum lucidum;②banxia, licorice, coptis chinensis, rehmannia glutinosa. Commonly used drugs： ligustrum lucidum-polygonatum, rehmannia glutinosa-zhimu, mulberry-mulberry bark, dogwood-mulberry leaves, fruit of Chinese wolfberry-dark plum. [Future outlook] To get more accurate results large sample size, multi-center coordination are required.