黄芪桂枝五物汤治疗2型糖尿病末梢神经炎48例

Forty-Eight Cases of Peripheral Neuritis of Type Ⅱ Diabetes Treated with Astragalus and Cinnamon Twig Five Substances Decoction

目的:观察黄芪桂枝五物汤治疗2型糖尿病末梢神经炎的临床疗效。方法:将96例2型糖尿病末梢神经炎患者随机分为对照组和观察组,每组各48例。对照组给予甲钴胺注射液治疗,观察组在对照组的基础上给予黄芪桂枝五物汤。比较两组患者的临床疗效,记录两组患者治疗前后中医证候积分变化情况,比较两组患者治疗前后正中神经、腓总神经运动传导速度(motor nerve conduction velocity,MNCV)及感觉传导速度(sural nerve conduction velocity,SNCV)。检测两组患者治疗前后空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin,HbAlc)、丙二醛(malonaldehyde,MDA)、超氧化物歧化酶(serum superoxide dismutase,SOD)等水平。结果:观察组有效率为93.75%,对照组有效率为77.08%,两组患者临床疗效比较,差异有统计学意义(P <0.05)。两组患者治疗后疼痛感、麻木感、烧灼感等中医证候评分低于治疗前,且观察组低于对照组,差异均有统计学意义(P <0.05)。两组患者治疗后正中神经、腓总神经MNCV、SNCV快于对照组,且观察组快于对照组,差异均有统计学意义(P <0.05)。两组患者治疗后FBG,HbAlc水平低于治疗前,差异具有统计学意义(P <0.05),观察组低于对照组,但差异无统计学意义(P> 0.05)。两组患者治疗后MDA水平低于治疗前、SOD高于治疗前且观察组均较对照组变化更为明显,差异均有统计学意义(P <0.05)。结论:黄芪桂枝五物汤治疗2型糖尿病末梢神经炎疗效确切,可降低氧化应激反应,加快神经传导速度,促进症状缓解。

Objective： To observe the clinical curative effect of Astragalus and Cinnamon Twig Five Substances Decoction on peripheral neuritis of type Ⅱ diabetes.Methods： Ninety-six patients with type Ⅱ diabetic peripheral neuritis were randomly divided into the control group and the observation group,with 48 cases in each group.The ones in the control group were treated with Mecobalamin Injection,while the ones in the observation group were additionally treated with Astragalus and Cinnamon Twig Five Substances Decoction on the basis of the control group.The clinical efficacies of the two groups were compared,and the changes of TCM syndrome integral before and after the treatment were recorded.The median nerve,motor nerve conduction velocity（ MNCV）and sural nerve conduction velocity（ SNCV） of the two groups were compared before and after the treatment.The serum levels of fasting blood glucose（ FBG）,glycosylated hemoglobin（ HbAlc）,malonaldehyde（ MDA）,superoxide dismutase（ SOD） were measured before and the after treatment.Results： The effective rate of the observation group was 93.75%,and that of the control group was 77.08%.The clinical efficacy of the two groups was significantly different（ P 〈 0.05）.The scores of pain,numbness and burning in the two groups were lower than those before the treatment,and the scores in the observation group were lower than those in the control group（ P 〈 0.05）,and the differences between them had significance（ P 〈 0.05）.After the treatment,the median nerve,MNCV and SNCV of the peroneal nerve were faster in the two groups than in the control group,and the observation group was faster than the control group,the differences were statistically significant（ P 〈 0.05）.After the treatment,the levels of FBG and HbAlc in the two groups were significantly lower than those before the treatment（ P 〈 0.05）,and the differences between them had significance（ P 〈 0.05）.Besides,those in the observation group were significantly lower than those in the control group（ P 〉 0.05）,but the differences between them had no statistical significance（ P 〉 0.05）.After the treatment,the level of MDA was lower than that before the treatment and SOD was higher than that before the treatment,and the changes in the observation group were more obvious than those in the control group,the differences were statistically significant（ P 〈 0.05）.Conclusion：Astragalus and Cinnamon Twig Five Substances Decoction has a remarkable clinical curative effect on peripheral neuritis of type Ⅱ diabetes,can reduce oxidative stress,speed up nerve conduction velocity and promote symptom relief.