叶氏足浴方联合甲钴胺治疗尿毒症性周围神经病变疗效观察

Therapeutic effect of Ye's foot bath decoction combined with mecobalamin on uremic peripheral neuropathy

目的观察叶氏足浴方足浴联合甲钴胺肌肉注射治疗尿毒症性周围神经病变的临床效果。方法将60例维持性透析尿毒症性周围神经病变患者随机分为3组,每组20例。3组均给予常规血液透析及对症处理,在此基础上,温水足浴组给予温水足浴、甲钴胺组给予温水足浴+甲钴胺肌肉注射,叶氏足浴方组给予叶氏足浴方足浴联合甲钴胺肌肉注射,3组均以15 d为1个疗程,间隔15 d后重复下一个疗程,共治疗3个疗程。观察3组治疗后主观症状及神经传导速度变化情况。结果治疗3个疗程后,叶氏足浴方组总有效率明显高于温水足浴组和甲钴胺组(P均<0. 05),甲钴胺组总有效率有高于温水足浴组的趋势,但差异无统计学意义(P> 0. 05)。温水足浴组治疗后SCV、MCV、胫神经F波潜伏期均无明显变化(P均> 0. 05);甲钴胺组除了胫后神经的SCV与治疗前比较有明显提高外(P <0. 05),其他指标也无明显变化(P均> 0. 05);叶氏足浴方组中SCV、MCV均明显加快(P均<0. 05),胫神经F波潜伏期明显缩短(P <0. 05)。3组均无明显不良反应发生。结论叶氏足浴方足浴联合甲钴胺肌肉注射治疗尿毒症性周围神经病变效果更好,可明显改善患者主观症状和神经传导速度。

Objective It is to observe the clinical effect of Ye’s foot bath decoction combined with intramuscular injection of mecobalamin in the treatment of uremic peripheral neuropathy.Methods Sixty patients uremic peripheral neuropathy treated with maintenance dialysis were randomly divided into 3 groups,20 cases in each group.All the 3 groups were treated with routine hemodialysis and symptomatic treatment.On this basis,warm water foot bath group was given warm water foot bath,mecobalamin group was given warm water foot bath+mecobalamin intramuscular injection,and Ye’s foot bath group was given Ye's foot bath decoction for foot bath combined with mecobalamin by intramuscular injection.15 days as a course of treatment,after the interval of 15 days,the next course of treatment was repeated for a total of 3 courses.The changes of subjective symptoms and nerve conduction velocity after treatment in the three groups were observed.Results After 3 courses of treatment,the total effective rate of Ye’s foot bath group was significantly higher than that of the other two groups(P<0.05).The total effective rate of mecobalamin group was higher than that of warm water foot bath group,but the difference was not statistically significant(P>0.05).There was no significant change in the latency of SCV,MCV,and sacral nerve F wave after treatment in warm water foot bath group(P>0.05).The SCV of the meconium group was significantly higher than that before treatment(P<0.05),there was no significant change in the other indexes(P>0.05).The SCV and MCV in the Ye's foot bath group were significantly accelerated(P<0.05),and the latency of the sacral nerve F wave was significantly shortened(P<0.05).No significant adverse reactions occurred in the 3 groups.Conclusion Ye's foot bath decoction combined with mecobalamin by intramuscular injection has better curative effect on uremic peripheral neuropathy,which can significantly improve the subjective symptoms and nerve conduction velocity.