糖尿病周围神经病变血瘀证素与神经肌电图的关系

Relationship between blood stasis syndrome element and electromyogram in diabetic peripheral neuropathy

目的:探讨糖尿病周围神经病(DPN)血瘀证素与神经肌电图(EMG)的关系。方法:选择277例DPN患者进行中医辨证,EMG测定正中神经、尺神经、腓总神经、胫神经的运动神经传导速度(MCV)及振幅(CMAP)和感觉神经传导速度(SCV)和振幅(AMP)。比较血瘀证素与EMG的关系。结果:DPN本虚证中,气虚证素132例次,占比47.7%,其次为阴虚证素112例次,占比40.4%;标实证中血瘀证素124例次,最高44.9%。2~4个证素共存患者群中,血瘀证素所占比例分别为42.2%(46/109)、53.1%(43/81)、93.8%(30/32)。血瘀证组腓总神经CMAP低于非血瘀证组(P<0.05),其余结果均无统计学意义。结论:血瘀证素是DPN病机关键,EMG不是DPN血瘀证的独立危险因素,年龄、病程、BMI、合并证素数目是DPN血瘀证发生的独立危险因素。

Objective:To explore the relationship between blood stasis syndrome element and electromyogram(EMG)in diabetic peripheral neuropathy(DPN).Methods:A total of 277 patients with DPN were selected and differentiated according to syndrome differentiation method.The motor and sensory conduction velocities and amplitudes of median nerve,ulnar nerve,common peroneal nerve and tibial nerve were measured by EMG.According to blood stasis syndrome element,it was divided into two groups to study the relationship between blood stasis syndrome element and EMG.Results:Among the DPN,qi deficiency syndrome was the highest,accounting for 132 cases(47.7%)and yin deficiency syndrome was the second,accounting for 112 cases(40.4%);blood stasis syndrome in empirical symptoms,accounting for 124 cases(44.9%).Among the patients with nonunique syndrome elements,blood stasis syndrome elements still accounted for the largest proportion.Among the patients with 2~4 syndrome elements,blood stasis syndrome elements accounted for 42.2%(46/109),53.1%(43/81),93.8%(30/32).Compared with the non-blood stasis syndrome group,the CMAP in common peroneal nerve of blood stasis syndrome group increased(P<0.05),the other results were negative.Conclusion:Blood stasis syndrome is the key pathogensis of DPN,EMG data are not independent risk factors for blood stasis syndrome in DPN.Age,course of disease,BMI and number of combined syndrome elements are independent risk factors for blood stasis syndrome of DPN.