血塞通定向透药导入疗法联合甲钴胺治疗糖尿病周围神经病变疗效观察

Observation on the curative effect of Xuesaitong directional permeabilization therapy combined with mecobalamin on diabetic peripheral neuropathy

目的观察血塞通定向透药导入疗法联合甲钴胺治疗糖尿病周围神经病变的临床疗效。方法选择2018年9月—2019年9月辽宁中医药大学附属医院内分泌康复科收治的糖尿病周围神经病变患者70例,采用随机数字表法分为试验组和对照组,每组35例。对照组给予糖尿病基础治疗及口服甲钴胺片,试验组在对照组治疗基础上给予血塞通定向透药导入治疗,2组观察周期均为4周。比较2组患者中医症状积分、多伦多临床评分(TCSS)、神经传导速度、血液流变学(血浆黏度、高切黏度、低切黏度、血细胞比容)、炎症相关因子水平[同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)]及临床疗效,同时进行安全性评估。结果治疗后,2组中医症状积分、TCSS评分及血液流变学各指标均明显降低(P均<0.05),且试验组均明显低于对照组(P均<0.05);2组胫神经、腓总神经的感觉传导速度及运动神经传导速度均加快(P均<0.05),且试验组均快于对照组(P均<0.05);2组血清Hcy及hs-CRP水平均明显降低(P均<0.05),但组间比较差异无统计学意义(P>0.05)。试验组总有效率为88.6%(31/35),对照组为66.7%(23/35),试验组明显高于对照组(P<0.05);2组均无明显不良反应发生。结论血塞通定向透药导入疗法联合甲钴胺治疗糖尿病周围神经病变疗效显著优于单纯西药治疗,有保护神经功能、改善血液循环、减轻炎症反应的作用,且安全。

Objective It is to observe the clinical effect of Xuesaitong directional permeabilization therapy combined with mecobalamin in the treatment of diabetic peripheral neuropathy.Methods Seventy patients with diabetic peripheral neuropathy admitted to the Department of Endocrinology and Rehabilitation of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from September 2018 to September 2019 were selected and randomly divided into the experimental group and the control group,with 35 cases in each group.The control group was given basic treatment for diabetes and oral mecobalamin tablets.The experimental group was given Xuesaitong directional permeabilization treatment based on the control group.The observation period of the two groups was 4 weeks.The scores of TCM symptoms,Toronto Clinical Score(TCSS),nerve conduction velocity,hemorheology(plasma viscosity,high shear viscosity,low shear viscosity,hematocrit),inflammation-related factor levels[homocysteine(Hcy),high-sensitivity C-reactive protein(hs-CRP)]and clinical efficacy were compared between the two groups,safety assessment was performed at the same time.Results After treatment,the scores of TCM symptoms,TCSS scores and every indexes of hemorheology were significantly reduced in the two groups(P<0.05),and the experimental group was significantly lower than the control group(P<0.05);the sensory conduction velocity and motor nerve conduction velocity of the tibial nerve and common peroneal nerve were all accelerated in the two groups(P<0.05),and the experimental group was faster than the control group(P<0.05);the levels of serum Hcy and hs-CRP were significantly reduced in the two groups(P<0.05),but the difference between the groups was not statistically significant(P>0.05).The total effective rate of the experimental group was 88.6%(31/35),and that of the control group was 66.7%(23/35),the experimental group was significantly higher than the control group(P<0.05);there were no obvious adverse reactions in the two groups.Conclusion Xuesaitong directional permeabilization therapy combined with mecobalamin is significantly more effective than western medicine in the treatment of diabetic peripheral neuropathy.It can protect nerve function,improve blood circulation,and reduce inflammation with good safety.