黄芪桂枝五物汤联合鼠神经生长因子治疗糖尿病周围神经病变临床观察

Clinical Observation of Huangqi Guizhi Wuwu Tang Combined with Rat Nerve Growth Factor for Diabetic Peripheral Neuropathy

目的:观察黄芪桂枝五物汤联合鼠神经生长因子治疗糖尿病周围神经病变临床疗效。方法:将纳入标准的76例患者均分为2组各38例。2组患者均接受糖尿病的基础治疗,包括糖尿病宣教、控制饮食、适当运动和控制血糖。西药组予2 mL灭菌注射用水加注射用鼠神经生长因子18μg肌肉注射,每天1次。中西药组在西药组治疗方案的基础上辨证加减使用黄芪桂枝五物汤,2组患者的治疗疗程均为8周。观察2组临床疗效、腓肠神经感觉神经传导速度(SNCV)、腓总神经运动神经传导速度(MNCV)及多伦多临床评分系统(TCSS)评分。结果:治疗后,2组临床疗效比较,差异有统计学意义(P<0.05);2组8周治疗结束后,MNCV均较前改善,前后比较,差异均有统计学意义(P<0.01,P<0.05);治疗后,2组SNCV均较前改善,前后比较,差异均有统计学意义(P<0.01);治疗后,2组组间SNCV、MNCV比较,差异均无统计学意义(P>0.05)。2组8周治疗结束后,TCSS评分均有降低,前后比较,差异均有统计学意义(P<0.01),中西药组治疗后TCSS评分比西药组降低更明显,2组间比较,差异有统计学意义(P<0.05)。结论:中西药组与西药组均有良好的临床疗效,均能改善神经传导速度,且黄芪桂枝五物汤联合鼠神经生长因子治疗糖尿病周围神经病变的中西药组在临床疗效、改善TCSS评分方面优于西药组。

Objective：To observe the clinical effect of Huangqi Guizhi Wuwu tang combined with rat nerve growth factor for diabetic peripheral neuropathy. Methods ：Divided 76 cases of patients according with standards into two groups randomly,38 cases in each group. Both groups received the fundamental treatment for diabetic,including popularization and education of diabetic, diet control, proper exercises and blood glucose control. Western medicine group was treated with 2 mL of sterile water for injection and 18μg of rat nerve growth factor for intramuscular injection once per day. On the basis of the treatment of western medicine group,the combination group was treated with modified Huangqi Guizhi Wuwu tang. Both groups received treatment for 8 weeks. Observed the clinical effect,sensory nerve conductive velocity（SNCV）,motor nerve conductive velocity（MNCV） and score of Toronto clinical scoring system（TCSS） in both groups. Results：Compared the clinical effect in both groups, the difference being significant（P〈0.05）. After 8 weeks of treatment,MNCV in both groups were improved when compared with those before treatment, the difference being significant（P〈0.01, P〈0.05）. SNCV in both groups after treatment were improved, comparing with those before treatment, the difference being significant（P〈0.01）.After treatment,there was no significant difference being found in the comparison of SNCV,MNCV between two groups（P〈0.05）. After 8 weeks of treatment, TCSS scores in both groups were decreased when compared with those before treatment,the difference being significant（P〈0.01）. The decrease of TCSS score in the combination group was more obvious than that in the western medicine group,the difference being significant（P〈0.01）. Conclusion：The combination group and western medicine group both have good clinical effect and can improve the nerve conductive velocity. The clinical effect and improvement of TCSS of the therapy of Huangqi Guizhi Wuwu tang combined with rat nerve growth factor for diabetic peripheral neuropathy in the combination group are superior to those in the western medicine group.