芪精丹兰汤对脾虚湿蕴型2型糖尿病患者神经电生理及肾功能的影响

Effects of Qijing Danlan decoction on electrophysiology and renal function in patients with type 2 diabetes mellitus with stagnation of dampness deficiency of the spleen type

目的:探讨达格列净联合甲钴胺、芪精丹兰汤对脾虚湿蕴型2型糖尿病(T2DM)患者神经电生理及肾功能的影响。方法:选取2018年7月至2021年12月在厦门市中医院内分泌科诊治的T2DM合并周围神经病变患者74例作为研究对象,性别不限,年龄42~77岁,糖尿病病程2~14年。以随机数字表法分为对照组与研究组,各37例。对照组给予二甲双胍联合甲钴胺治疗,观察组给予达格列净联合甲钴胺和芪精丹兰汤治疗。比较两组正中神经、尺神经、腓总神经和胫神经的运动传导速度(MNCV)、运动末端潜伏期(DML)和复合肌肉动作电位(CMAP),及正中神经、尺神经和腓肠神经的感觉传导速度(SNCV)和感觉神经动作电位(SNAP),并比较肾功能指标尿素氮(BUN)、血肌酐(Scr)及24 h尿蛋白。结果:治疗后,两组患者正中神经、尺神经、腓总神经和胫神经的MNCV和CMAP升高,DML下降(P均<0.05),正中神经、尺神经、腓肠神经的SNCV和SNAP升高(P<0.05);与对照组比较,研究组MNCV、CMAP、SNCV和SNAP升高更明显,DML下降更明显(P均<0.05)。治疗后两组BUN、Scr、24 h尿蛋白与治疗前比较均降低(P<0.05),且研究组降低更明显(P<0.05)。结论:脾虚湿蕴型T2DM合并周围神经病变患者采用达格列净联合甲钴胺和芪精丹兰汤治疗可有效改善神经电生理指标和肾功能。

Objective:To investigate the effects of Qijing Danlan decoction on electrophysiology and renal function in patients with type 2 diabetes mellitus(T2DM)with stagnation of dampness deficiency of the spleen type.Methods:A total of 74 T2DM patients with peripheral neuropathy diagnosed and treated in Xiamen Hospital of Traditional Chinese Medicine from July 2018 to December 2021 were randomly divided into control group and study group by random number table,37 cases in each group,with both of sexes,aged 42-77 years old,and diabetes course of 2 to 14 years.Patients was treated with metformin combined with mecobalamine in the control group,dapagliflozin combined with mecobalamine and Qijing Danlan decoction in the study group.The motor nerve conduction velocity(MNCV),distal motor latency(DML)and compound muscle action potential(CMAP)of median nerve,ulnar nerve,common peroneal nerve and tibial nerve,and the sensory nerve conduction velocity(SNCV)and sensory nerve action potential(SNAP)of median nerve,ulnar nerve and sural nerve were compared between the two groups.The blood urea nitrogen(BUN),serum creatinine(Scr),24-hour urinary protein were compared between the two groups.Results:After the treatment,MNCV and CMAP of median nerve,ulnar nerve,common peroneal nerve and tibial nerve increased,DML decreased(all P<0.05),and SNCV and SNAP of median nerve,ulnar nerve and sural nerve increased(P<0.05).Compared with the control group,MNCV,CMAP,SNCV and SNAP in the study group increased more significantly,and DML decreased more significantly(P<0.05).After the treatment,BUN,Scr and 24-hour urinary protein in the two groups were decreased compared with before the treatment(P<0.05),and the decrease was more obvious in the study group(P<0.05).Conclusion:Dapagliflozin combined with mecobalamin and Qijing Danlan decoction can effectively improve neuroelectrophysiological indexes and renal function in T2DM patients with stagnation of dampness deficiency of the spleen type.