中药熏药联合穴位贴敷治疗糖尿病周围神经病变疗效及对神经修复的影响

Effect of Traditional Chinese Medicine Fumigation combined with Acupoint Application on Diabetic Peripheral Neuropathy and its Effect on Nerve Repair

目的观察中药熏药联合穴位贴敷治疗糖尿病周围神经病变的疗效及对神经修复的影响。方法将120例符合纳入标准的糖尿病周围神经病变患者按照就诊顺序分为观察组和对照组各60例。对照组在糖尿病常规治疗的基础上予以α-硫辛酸0.6 g加入250 mL生理盐水中,静滴,治疗2周。观察组在对照组基础上加用中药熏洗联合穴位贴敷治疗。熏洗方乃我科协定方,益气通络方(黄芪60 g,川芎30 g,透骨草30 g,艾叶60 g,苏木15 g,赤芍10 g,红花10 g,当归10 g,牛膝15 g,地龙15 g),加水煎煮前先浸泡1 h,加水2000 mL,浓煎成250 mL,采用智能中药熏洗机熏蒸患肢,30 min/次,1次/d。穴位贴敷选择双侧足三里、三阴交、血海,熏洗方研磨成末后用姜汁调成糊状,取适量置于无妨纱布,贴于上述穴位,4 h/次,1次/d。治疗2周。观察两组治疗后临床疗效、治疗前后两组胫神经、腓总神经感觉神经传导速度(SNVC)和运动神经传导速度(MNVC),多伦多临床评分系统评分(TCSS),中医证候。结果治疗后,观察组总有效率高于对照组(P<0.05);治疗后,两组SNVC、MNVC均有提高(P<0.05),观察组高于对照组(P<0.05);两组TCSS均有降低(P<0.05),观察组低于对照组(P<0.05);两组中医证候积分均有降低(P<0.05),观察组低于对照组(P<0.05)。结论中药熏药联合穴位贴敷治疗糖尿病周围神经病变,可提高治疗效果,促进神经传导速度的恢复,改善临床症状,改善气虚血瘀的证候表现,值得推广。

Objective To observe the curative effect of traditional Chinese medicine fumigation combined with Acupoint Application on diabetic peripheral neuropathy and its effect on nerve repair.Methods 120 diabetic peripheral neuropathy patients were divided into observation group and control group according to the order of treatment.In the control group,add 0.6 g ofα-lipoic acid into 250 mL of normal saline for intravenous drip,1 times/d,treatment for 2 weeks.On the basis of the control group,the observation group was treated with fumigation and washing of traditional Chinese medicine combined with acupoint application.Fumigating and washing formula(Astragalus 60 g,Chuanxiong 30 g,Tougucao 30 g,mugwort 100 g,Sumu 15,red peony 10 g,safflower 10 g,angelica 10 g,Achyranthes bidentata 15 g,earthworm 15 g),ground into powder,add water 2000 mL,boil and wait until the water temperature drops to about 37℃,fumigate the affected limb with intelligent Chinese medicine fumigating and washing machine,30 min/time,twice/d.For acupoint application,select Zusanli,Sanyinjiao and Xuehai on both sides,grind the fumigation and washing formula into paste with ginger juice,take a proper amount of it and put it on the above acupoint,for 4 h/time,once a day.Treatment for 2 weeks.Before and after treatment,snvc,mnvc,TCSs and TCM syndromes were observed.Results After treatment,the total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,snvc and mnvc in both groups were increased(P<0.05),the observation group was higher than the control group(P<0.05)In both groups,TCSs decreased(P<0.05),the observation group was lower than the control group(P<0.05)The scores of TCM syndromes in both groups were decreased(P<0.05),the observation group was lower than the control group(P<0.05).Conclusion Traditional Chinese medicine fumigation combined with acupoint application can improve the therapeutic effect of diabetic peripheral neuropathy,promote the recovery of nerve conduction velocity,improve clinical symptoms,improve the syndrome performance of Qi deficiency and blood stasis,which is worth popularizing.