中医综合疗法治疗气阴两虚血瘀型糖尿病周围神经病变的临床疗效

Impacts of comprehensive treatment with traditional Chinese medicine on diabetic peripheral neuropathy

目的研究中医综合疗法治疗气阴两虚血瘀型糖尿病周围神经病变(DPN)的临床疗效及作用机制。方法将110例气阴两虚血瘀型DPN患者随机分为对照组和治疗组,每组55例。对照组和治疗组分别给予口服甲钴胺片和益气养阴活血解毒方联合通络外洗方浴足治疗。对比两组治疗后临床疗效,多伦多临床评分系统(TCSS)评分,右下肢腓总神经和胫神经的运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)及神经营养因子[血清胰岛素样生长因子(IGF-1)和脑源性营养因子(BNDF)]改善情况。结果治疗组和对照组总有效率分别为94.0%和74.0%,两组比较差异有统计学意义(P<0.05)。治疗组各神经传导速度较对照组显著加快,TCSS评分较对照组明显降低(P<0.05),差异有统计学意义。治疗组IGF-1、BNDF均较对照组有大幅度的增加(P<0.05),差异有统计学意义。结论中医综合疗法可明显改善DPN患者的临床症状,加快神经传导速度,疗效优于单纯口服甲钴胺片,其作用机制可能与增加DPN患者的IGF-1和BNDF表达,从而修复受损神经有关。

Objective To explore the clinical effects of the comprehensive therapy with traditional Chinese medicine on diabetic peripheral neuropathy(DPN)and the effect mechanism.Methods A total of 110 DPN patients with qi and yin deficiency and blood stagnation were randomized into a control group and a treatment group,55 cases in each one.In the control group,mecobalamine tablets were prescribed for oral administration.In the treatment group,the oral administration of yiqi yangyin huoxue jiedu formula and the foot bath with tongluo formula were used.After treatment,the clinical effects,TCSS score,MNCV,SNCV and neurotrophic factors(IGF-1 and BNDF)were compared between the two groups.Results The total effective rate was 94.0%in the treatment group and was 74.0%in the control group,indicating the significant difference(P<0.05).IGF-1 and BNDF were increased in large amplitude in the treatment group as compared with the control group(P<0.05).Conclusion The comprehensive therapy with traditional Chinese medicine obviously relieves the clinical symptoms of DPN and accelerates nerve conduction velocity.The effects are better than the simple oral administration with mecobalamine tablets.The effect mechanism is probably related to the increased expressions of IGF-1 and BNDF and the repair of damaged nerves in the patients with DPN.