阳和汤内服联合通络散足浴治疗阳虚寒凝型糖尿病周围神经病变的临床研究

Clinical study on treating diabetic peripheral neuropathy of syndrome of Yang deficiency and cold congealing with the Yanghe decoction plus Tongluo San foot bath

目的:观察阳和汤内服联合通络散足浴治疗阳虚寒凝型糖尿病周围神经病变的临床疗效。方法:选取2019年6月-2020年6月在福州市中医院内分泌科住院的2型糖尿病周围神经病变患者90例,按随机数字表法随机分为对照组和试验组各45例,对照组予以甲钴胺注射液足三里穴位注射,试验组在对照组的基础上,加用阳和汤内服和通络散足浴。两组疗程均为1个月,观察临床症状积分、神经病变积分及血液流变学指标变化情况。结果:试验组的临床疗效显著优于对照组,差异有统计学意义(P<0.05);治疗后,两组临床症状积分、神经病变积分均显著减少(P<0.05),且试验组低于对照组(P<0.05);治疗后,两组全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原水平均显著降低(P<0.05),且试验组低于对照组(P<0.05)。结论:阳和汤内服联合通络散足浴可明显改善阳虚寒凝型糖尿病周围神经病变患者症状、体征及血液流变学指标,其治疗效果优于单纯甲钴胺穴位注射,其机制可能与阳和汤内服联合通络散足浴治疗可增强温阳散寒、通络止痛效果,提高糖尿病周围神经病变患者的神经传导速度和血管微循环的作用有关,故有益于改善患者的生活质量和促进其神经功能恢复等,具有重要的临床应用价值。

Objective:To observe the clinical effect of the Yanghe decoction(阳和汤)plus Tongluo San(通络散)foot bath on peripheral neuropathy of Yang(阳)deficiency cold coagulation type diabetes mellitus.Methods:From June 2019 to June 2020,90 patients with type 2 diabetic peripheral neuropathy who were hospitalized in the Department of Endocrinology of Fuzhou Traditional Chinese Medicine Hospital were randomly divided into the control group and the test group by random digital table method.The control group was injected with methylcobalamin injection Zusanli(足三里)acupoint.On the basis of the control group,the test group added the Yanghe decoction and Tongluo San foot bath.The clinical symptom score,neuropathy score and hemorheology index were observed for 1 month.Results:Clinical efficacy was significantly better than the control group(P<0.05);the clinical symptom score and neuropathy score in the two groups decreased significantly after treatment(P<0.05),and the experimental group was lower than the control group(P<0.05);the whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and fibrin raw water decreased significantly in the two groups after treatment(P<0.05),and the experimental group was lower than the control group(P<0.05).Conclusion:The Yanghe decoction plus Tongluo San foot bath can obviously improve the symptoms,signs and hemorheological indexes of patients with peripheral neuropathy of Yang deficiency cold coagulation type diabetes mellitus,and its therapeutic effect is obviously better than that of simple acupoint injection of methylcobalamin,the mechanism may be related to the effect that the Yanghe decoction plus Tongluo San foot bath can enhance the effect of warming Yang and dispersing cold and relieving pain,and enhance the nerve conduction velocity and vascular microcirculation in diabetic peripheral neuropathy patients.Therefore,it is beneficial to improve the quality of life and promote the recovery of nerve function.