加味黄连温胆汤对糖尿病周围神经病变患者神经功能的保护作用观察

Protective Effect of Modified Huanglian Wendan Decoction on Neurological Function in Patients with Diabeitic Peripheral Neuropathy

目的观察黄连温胆汤对糖尿病周围神经病变(diabeitic peripheral neuropathy,DPN)患者神经功能的保护作用。方法选择88例糖尿病周围神经病变患者,随机分为观察组与对照组各44例。两组均口服降糖药或胰岛素控制血糖,对照组口服甲钴胺片,观察组在对照组基础上联合黄连温胆汤治疗,疗程均4周。比较两组治疗前后的中医证候积分、正中神经与腓总神经的运动神经传导速度(MNCV)和感觉神经传导速度(SNCV)、治疗总有效率及不良反应总发生率。结果治疗后两组主症积分、次症积分与总积分较治疗前均下降,且观察组低于对照组,差异有统计学意义(P<0.05或P<0.01)。两组治疗后的正中神经与腓总神经的MNCV与SNCV均较治疗前升高(P<0.05或P<0.01),观察组治疗后的正中神经的MNCV与SNCV为(52.14±4.20)m/s和(44.28±4.01)m/s,高于对照组(50.04±3.97)m/s和(42.35±3.96)m/s;腓总神经的MNCV与SNCV为(47.58±3.99)m/s和(42.77±4.05)m/s,高于对照组(45.46±4.17)m/s和(40.34±3.92)m/s,差异均有统计学意义(P<0.05或P<0.01)。观察组总有效率为81.82%,高于对照组61.36%,差异有统计学意义(P<0.05)。两组不良反应总发生率分别为9.09%和4.55%,差异无统计学意义(P>0.05)。结论黄连温胆汤具有益气活血、通脉清热作用,治疗DPN有助于改善患者中医证候并提高神经传导速度,疗效佳且安全性高,值得推广。

Objective To observe the protective effect of Huanglian Wendan decoction on neurological function in patients with diabetic peripheral neuropathy(DPN).Methods Eighty-eight cases of DPN patients were randomly divided into the observation group and control group,44 cases in both group.Both groups were orally administrated with hypoglycemic agents or insulin to control blood glucose.The control group was treated with mecobalamin tablets.The observation group was treated with Huanglian Wendan decoction on the basis of the control group,the course of treatment were for 4 weeks.The TCM syndromescores,the motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of median nerve and peroneal nerve before and after treatment,the total effective rate of treatment and the total incidence of adverse reactions were compared between the two groups.Results After treatment,the primary syndrome score,secondary syndrome score,total syndrome score decreased before treatment in both groups(P<0.05)and the indicators in observation group were lower than those in the observation group(P<0.05 or P<0.01).The levels of MNCV and SNCV in the median nerve and peroneal nerve after treatment increased than before treatment in both groups(P<0.05 or P<0.01).The MNCV and SNCV of median nerve after treatment in observation group were(52.14±4.20)m/s and(44.28±4.01)m/s,which were higher than(50.04±3.97)m/s and(42.35±3.96)m/s in control group(P<0.05).The MNCV and SNCV of peroneal nerve after treatment in observation group were(47.58±3.99)m/s and(42.77±4.05)m/s,which were significantly higher than(45.46±4.17)m/s and(40.34±3.92)m/s in control group(P<0.05 or P<0.01).The total effective rate was 81.82%in the observation group,which was higher than 61.36%in the control group(P<0.05).The overall incidence of adverse reactions in two groups were 9.09%and 4.55%(P>0.05).Conclusion The Huanglian Wendan decoction shows the effects of Yiqi Huoxue(benefiting Qi for activating blood circulation)and Tongmsi Qingre(Tongmai and clearing heat).It can improve the TCM symptoms and the nerve conduction speed in the treatment of DPN patients,with good efficacy and high safety,worthy of promoting.