中药熏洗联合甲钴胺胶囊对糖尿病周围神经病变的随机对照观察

The research of the TCM scheme in diagnosis and treatment of diabetic peripheral neuropathy

目的:研究中药熏洗联合口服甲钴胺胶囊对糖尿病周围神经病变气阴两虚、瘀血阻滞证型的临床疗效。方法:选择糖尿病周围神经病变气阴两虚、瘀血阻滞证型患者138例,随机分为对照组和治疗组,对照组给予基础干预+口服甲钴胺胶囊(0.5 mg,3次/d),治疗组给予基础干预+口服甲钴胺胶囊(0.5 mg,3次/d)和中药熏洗(30 min/次,1次/d),共治疗8周,观察治疗前后的NSS评分、肌电图指标变化,中医症状积分变化,评价中医证候疗效。结果:共入选138例,其中脱落3例,剔除4例,实际完成131例,其中治疗组65例,对照组66例。疾病疗效显效率、总有效率治疗组分别为30.76%、75.38%,对照组分别为16.67%、53.03%;治疗后两组患者神经症状评分均明显改善,差异有统计学意义(P<0.01),且治疗组优于对照组,差异有统计学意义(P<0.01)。治疗后两组正中神经、腓总神经感觉神经传导速度运动神经传导速度均明显改善,差异有统计学意义(P<0.01),且对照组优于对照组,差异有统计学意义(P<0.01);治疗后两组运动神经传导速度较治疗前比较,差异无统计学意义(P>0.01),组间比较,差异无统计学意义(P>0.01)。试验过程中,未见明显不良反应。结论:中药熏洗联合口服甲钴胺胶囊能够较好的改善患者的临床症状;并有效改善感觉神经传导速度,值得临床推广。

Objective To discuss the the TCM scheme in diagnosis and treatment of diabetic peripheral neuropathy（Qi and Yin deficiency,Stagnation of blood stasis syndrome） and evaluate the therapeutic efficiency.Method The trial design was randomized controlled.138 patients of diabetic peripheral neuropathy（Qi and Yin deficiency,Stagnation of blood stasis syndrome）were treated for 8 weeks,3 cases shed and 4 cases excluded During the trial,131 cases were involved in the analysis（test group65 cases and control group 66 cases）.Results The efficiency of curative effects in experiment group was 30.76%,the total effective rate was 75.38%,the efficiency rate of curative effects in Chinese medicine syndrome was 44.61%,the total effective rate was 86.15%.Between the two groups of curative effects and curative effects in Chinese medicine syndrome,there were statistically significant in difference（P〈0.01）,experiment group was better than the control group.There was statistically significant difference by self-comparison before and after the treatment in nerve conductive velocity（P〈0.01）.There was statistically significant difference between experiment group and control group in nerve conductive velocity after the treatment（P〈0.01）.During the trial,no obvious adverse reactions（P〈0.05）.Conclusion The TCM treatment on diabetic peripheral neuropathy can improve the patient＇s clinical symptoms and conduction velocity of sensory and motor nerve,curative effect is distinct,worth clinical promotion.