中医综合疗法治疗糖尿病周围神经病变临床研究

Clinical Study on Comprehensive Therapy of Traditional Chinese Medicine in Treatment of Diabetic Peripheral Neuropathy

目的:观察加味芍药甘草汤合桃红四物汤联合穴位贴敷、中药浴足治疗糖尿病周围神经病变的临床疗效。方法:选择糖尿病周围神经病变患者90例,按随机数字表法分为对照组、治疗1组、治疗2组各30例。三组患者均予基础降糖治疗,在此基础上,对照组患者采用甲钴胺治疗,治疗1组患者采用加味芍药甘草汤合桃红四物汤治疗,治疗2组患者采用加味芍药甘草汤合桃红四物汤联合穴位贴敷、中药浴足治疗,三组均连续治疗12周(1个疗程)。比较三组患者多伦多临床评分系统(TCSS)评分、震动感觉阈值、神经传导速度、临床疗效、中医症状积分、氧化应激水平。结果:治疗后,三组患者TCSS评分、震动感觉阈值、中医症状积分均较治疗前降低(P<0.05),腓总神经、正中神经传导速度均较治疗前加快(P<0.05),血清丙二醛(MDA)、晚期糖基化终末产物(AGE)水平均较治疗前降低(P<0.05),血清超氧化物歧化酶(SOD)水平较治疗前升高(P<0.05)。组间比较,治疗2组患者治疗后上述指标水平均优于对照组和治疗1组(P<0.05),治疗总有效率高于对照组和治疗1组,临床疗效优于对照组和治疗1组(P<0.05)。结论:加味芍药甘草汤合桃红四物汤联合穴位贴敷、中药浴足治疗糖尿病周围神经病变能改善患者临床症状,促进神经功能恢复,调节机体氧化应激水平,疗效确切。

Objective:To observe the clinical curative efficacy of Modified Shaoyao Gancao Decoction(加味芍药甘草汤)and Taohong Siwu Decoction(桃红四物汤)combined with acupoint application and foot bath with Chinese medicine in the treatment of diabetic peripheral neuropathy(DPN).Methods:A total of 90 patients with DPN were divided into control group,treatment group 1 and treatment group 2 according to the random number table method,with 30 cases in each group.On the basis of basic glucose-lowering treatment given to all the three groups,patients in the control group were treated with methylcobalamin,patients in the treatment group 1 were treated with Modified Shaoyao Gancao Decoction and Taohong Siwu Decoction,and patients in the treatment group 2 were treated with Modified Shaoyao Gancao Decoction and Taohong Siwu Decoction combined with acupoint application and foot bath.All the three groups were treated for 12 weeks(1 course of treat-ment).The Toronto Clinical Scoring System(TCSS)score,vibration sensation threshold,nerve conduction velocities,clinical curative efficacy,traditional Chinese medicine(TCM)symptom scores,and oxidative stress level were compared among the three groups.Results:After treatment,in the patients in all the three groups,the TCSS score,vibration sensation threshold,and TCM symptom score were lower than those before treatment(P<0.05),the conduction velocities of common peroneal nerve and median nerve were faster than those before treatment(P<0.05),the levels of serum malondialdehyde(MDA)and advanced glycation end products(AGE)were lower than those before treatment(P<0.05),and the level of serum superoxide dismutase(SOD)was higher than that before treatment(P<0.05).In comparison among the three groups,the levels of the above indicators in treatment group 2 were better than those in the control group and treatment group 1 after treatment(P<0.05),and the total effective rate in treatment group 2 was higher than that in the control group and treatment group 1,indicating the clinical curative efficacy in treatment group 2 was better than that in the control group and treatment group 1(P<0.05).Conclusions:For patients with DPN,Modified Shaoyao Gancao Decoction and Taohong Siwu Decoction combined with acupoint application and foot bath with Chinese medicine can relieve the clinical symptoms,promote the recovery of nerve function,and regulate the oxidative stress level,with definite curative efficacy.