活血通络乳膏治疗糖尿病周围神经病变的疗效及对神经电生理的影响

Curative effect of Huoxue Tongluo Cream on diabetic peripheral neuropathy and how to impact on nerve electrophysiology

目的 观察活血通络乳膏治疗糖尿病周围神经病变(DPN)的疗效及对神经电生理的影响。方法 将80例DPN患者按照随机数字表法分为2组,对照组40例予依帕司他片治疗,治疗组40例在对照组治疗基础上予活血通络乳膏治疗。2组均治疗3个月。比较2组治疗前后胫神经运动神经传导速度(MCV)、腓神经MCV、腓肠神经感觉神经传导速度(SCV)、胫神经H反射、中医证候评分、多伦多临床评分系统(TCSS)评分、空腹血糖(FPG)、餐后2 h血糖(2 hPG)水平及不良反应发生情况,并统计2组疗效。结果 治疗组总有效率92.50%(37/40),对照组总有效率75.00%(30/40),治疗组临床疗效优于对照组(P<0.05)。2组治疗后胫神经MCV、腓神经MCV、腓肠神经SCV均较本组治疗前升高(P<0.05),胫神经H反射水平均降低(P<0.05),且治疗组治疗后胫神经MCV、腓神经MCV、腓肠神经SCV均高于对照组(P<0.05),胫神经H反射水平低于对照组(P<0.05)。2组治疗后中医证候各项评分及总分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后FPG、2 hPG水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后TCSS评分均较本组治疗前降低(P<0.05),且治疗组治疗后低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 在DPN患者中应用活血通络乳膏效果显著,可有效改善患者神经电生理和中医证候,降低血糖指标,提高神经功能,安全有效,适于推广。

Objective To observe the curative effect of Huoxue Tongluo Cream on diabetic peripheral neuropathy(DPN) and how to impact on nerve electrophysiology.Methods DPN patients(n=80) were randomly assigned to the treatment group(n=40) and the control group(n=40). All patients were managed by Epalrestat Tablets, and those in the treatment group were additionally treated with Huoxue Tongluo Cream. A 3-month treatment was performed to compare motor conduction velocity(MCV) of tibial nerve, MCV of peroneal nerve, sensory conduction velocity(SCV) of sural nerve, tibial nerve H-reflex, traditional Chinese medicine(TCM) syndrome score, the Toronto Clinical Neuropathy Scoring System(TCSS), fasting plasma glucose(FPG), 2-h postprandial glucose(2 hPG);the adverse reaction and curative effect were assessed. Results The overall effective rate was 92.50%(37/40) in the treatment group, higher than that of 75.00%(30/40) in the control group(P<0.05). After treatment, increased MCV of tibial nerve and peroneal nerve, SCV of sural nerve, and decreased tibial nerve H-reflex were detected in the both groups(all P<0.05);higher MCV of tibial nerve and peroneal nerve, SCV of sural nerve, and lower tibial nerve H-reflex were detected in the treatment group than those of the control group(all P<0.05);TCM symptom scores in the both groups were decreased(P<0.05), which were decreased in the treatment group compared with the control group(P<0.05);FPG and 2 hPG in the both groups were decreased(P<0.05), the treatment group was more common relative to the control group(P<0.05);TCSS in the both groups was decreased(P<0.05), the reduction in the treatment group was more prevalent(P<0.05). The difference was not statistically significant in the incidence of adverse reactions between groups(P>0.05).Conclusion For DPN patients, Huoxue Tongluo Cream has a remarkable effect, which can effectively improve nerve electrophysiology and TCM syndrome, reduce blood glucose index, improve neurological function, with safety and efficacy, and worthy of promotion.