指迷茯苓丸合黄芪桂枝五物汤加减治疗糖尿病周围神经病变痰瘀阻络证临床研究

Clinical Study on Modified Zhimi Fuling Pills Combined with Huangqi Guizhi Wuwu Tang for Diabetic Peripheral Neuropathy with Phlegm Stasis Obstructing the Collaterals Syndrome

目的:观察指迷茯苓丸合黄芪桂枝五物汤加减治疗糖尿病周围神经病变(DPN)痰瘀阻络证的临床疗效。方法:选取DPN痰瘀阻络证患者86例,按随机数字表法分对照组和观察组各43例。2组根据指南予常规治疗措施,对照组给予甲钴胺片口服,观察组在对照组基础上给予指迷茯苓丸合黄芪桂枝五物汤加减治疗,2组连续治疗4周。比较2组治疗前后下肢震动感觉阈值、多伦多临床评分系统(TCSS)评分、中医证候评分变化,并评价2组临床疗效。结果:观察组总有效率为76.74%,显著高于对照组53.49%,差异有统计学意义(P<0.05)。治疗前,2组下肢震动感觉阈值比较,差异无统计学意义(P>0.05)。治疗后,2组下肢震动感觉阈值较治疗前降低(P<0.05),且观察组下肢震动感觉阈值显著低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组TCSS、中医证候评分比较,差异无统计学意义(P>0.05)。治疗后,2组TCSS、中医证候评分较治疗前降低,且观察组TCSS、中医证候评分低于对照组,差异均有统计学意义(P<0.05)。结论:在西医常规治疗基础上,给予指迷茯苓丸合黄芪桂枝五物汤加减治疗DPN痰瘀阻络证,能进一步改善患者的临床症状,疗效更佳。

Objective:To observe the clinical effect of modified Zhimi Fuling pills combined with Huangqi Guizhi Wuwu tang for diabetic peripheral neuropathy(DPN)with phlegm stasis obstructing the collaterals syndrome.Methods:A total of86 cases of DPN patients with phlegm stasis obstructing the collaterals syndrome were divided into the control group and the observation group according to the random number table method,with 43 cases in each group.Both groups were given routine treatment measures based on the guideline;the control group was given oral administration of mecobalamin tablets,and the observation group was additionally treated with modified Zhimi Fuling pills combined with Huangqi Guizhi Wuwu tang based on the treatment of the control group.Both groups were treated for four weeks.Before and after treatment,the changes in lower extremities vibration perception thresholds,and the scores of Toronto Clinical Scoring System(TCSS)and Chinese medicine syndromes in the two groups were compared.The clinical effects in the two groups were evaluated.Results:The total effective rate was 76.74%in the observation group,significantly higher than that of 53.49%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of lower extremities vibration perception thresholds between the two groups(P>0.05).After treatment,the lower extremities vibration perception thresholds in the two groups were decreased when compared with those before treatment(P<0.05),and the one in the observation group was significantly lower than that in the control group,differences being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of the scores of TCSS and Chinese medicine syndromes between the two groups(P>0.05).After treatment,the scores of TCSS and Chinese medicine syndromes were decreased when compared with those before treatment,and the scores in the observation group were lower than those in the control group,differences being significant(P<0.05).Conclusion:Based on routine treatment of western medicine,the additional application of modified Zhimi Fuling pills combined with Huangqi Guizhi Wuwu tang for DPN with phlegm stasis obstructing the collaterals syndrome can further improve the clinical symptoms of patients with better curative effect.