糖痛外洗方改良皮贴治疗寒凝血瘀型痛性糖尿病周围神经病变的临床观察

Clinical Observation of Tangtong Waixi Decoction Modified Skin Patch(糖痛外洗方改良皮贴)Treating Painful Diabetic Peripheral Neuropathy of Cold Coagulation and Blood Stasis Type

目的探讨糖痛外洗方改良皮贴治疗寒凝血瘀型痛性糖尿病周围神经病变(PDPN)的临床效果。方法将60例寒凝血瘀型PDPN患者按随机数字表法分为治疗组和对照组各30例。两组患者均予以糖尿病基础治疗措施,包括糖尿病知识宣教、控制饮食、运动治疗、血糖监测等措施,对照组患者在常规治疗基础上予以普瑞巴林胶囊口服治疗,治疗组在对照组基础上增用糖痛外洗方熏洗联合改良皮贴治疗。比较两组临床疗效,观察两组治疗前后的数字模拟疼痛(NRS)评分、临床症状评分、多伦多临床评分系统(TCSS)、胫神经、腓总神经感觉神经传导速度(SNCV)和运动神经传导速度(MNCV)的差异性。结果治疗组临床总有效率为93.33%,明显高于对照组的73.33%(P<0.05)。治疗组治疗后NRS评分、临床症状评分明显低于对照组(P<0.05)。治疗组治疗后神经症状、感觉试验和TCSS总分评分明显低于对照组(P<0.05)。治疗组治疗后胫神经、腓总神经SNCV和MNCV水平明显高于对照组(P<0.05)。结论对寒凝血瘀型PDPN患者采取糖痛外洗方熏洗联合改良皮贴进行治疗,有助于提高治疗效果,改善患者疼痛和临床症状,延缓病情进展速度,促进神经传导速度的恢复。

Objective To explore the clinical effect of Tangtong Waixi Decoction Modified Skin Patch(糖痛外洗方改良皮贴)in the treatment of painful diabetic peripheral neuropathy(PDPN)of cold coagulation and blood stasis type.Methods According to the random number table,60 cases of PDPN patients with cold coagulation and blood stasis type were divided into treatment group and control group with 30 cases each.Both groups were given basic diabetes treatment measures,including extreme diabetes knowledge education,diet control,exercise therapy,blood glucose monitoring and other measures.The control group was given oral Pregabalin Capsules on the basis of conventional treatment,and the treatment group added Tangtong Waixi Formula(糖痛外洗方)for fumigation and washing based on the control group.The clinical efficacy of the two groups was compared.The digital analog pain(NRS)score,clinical symptom score,Toronto clinical scoring system(TCSS),tibial nerve,common peroneal nerve sensory nerve conduction velocity(SNCV)and motor nerve conduction velocity(MNCV)were observed before and after treatment.Results The total clinical effective rate of the treatment group was 93.33%,which was significantly higher than that(73.33%)of the control group(P<0.05).After treatment,the NRS score and clinical symptom score of the treatment group were significantly lower than those of the control group(P<0.05).After treatment,the neurological symptoms,sensory test and TCSS total score of the treatment group were significantly lower than those of the control group(P<0.05).After treatment,the levels of SNCV and MNCV of tibial nerve and common peroneal nerve in the treatment group were significantly higher than those in the control group(P<0.05).Conclusion For patients with PDPN of cold coagulation and blood stasis type,the treatment of fumigation with Tangtong Waixi Formula combined with modified skin patch is helpful to improve the treatment effect,the patients'pain and clinical symptoms,delay the progression of the disease and promote the recovery of nerve conduction velocity.