益气化湿通痹方治疗气虚湿瘀互结型糖尿病周围神经病变疗效观察

Clinical Observation on Yiqi Huashi Tongbi Recipe in Treating Diabetes Peripheral Neuropathy of Qi Deficiency and Dampness Stagnation

目的分析益气化湿通痹方治疗气虚湿瘀互结型糖尿病周围神经病变(DPN)的疗效。方法本次进行对照试验,纳入气虚湿瘀互结型DPN患者90例,全部配合完成治疗。按照等比例随机数字表分3组,分别为西药组、中药组和中西结合组,每组有30例。西药组采用甲钴胺片;中药组采用益气化湿通痹方;中西结合组采用益气化湿通痹方联合甲钴胺片。所有患者用药期为2个月,评估临床疗效,测定多伦多临床评分系统(TCSS)、中医证候积分和神经传导速度。结果与治疗前比,3组治疗后症状评分、反射评分和感觉检测评分下降(P<0.05);并且治疗后症状评分、反射评分和感觉检测评分,中西结合组和中药组均低于西药组,差异有统计学意义(P<0.05)。与治疗前比,3组治疗1个月、治疗2个月中医证候积分下降(P<0.05);并且治疗1个月、治疗2个月中医证候积分,中西结合组和中药组均低于西药组,差异有统计学意义(P<0.05)。与治疗前比,3组治疗后尺神经和腓总神经MCV、正中神经和胫后神经SCV升高(P<0.05);并且治疗后尺神经和腓总神经MCV、正中神经和胫后神经SCV,中西结合组和中药组均高于西药组,差异有统计学意义(P<0.05)。中西结合组总有效率(86.7%)和中药组总有效率(80.00%),高于西药组(46.7%),差异有统计学意义(P<0.05)。结论益气化湿通痹方对于气虚湿瘀互结型DPN的疗效显著,进一步改善临床症状及中医证候、神经传导速度,值得临床推广。

Objective To analyze the therapeutic effect of Yiqi Huashi Tongbi Recipe on diabetes peripheral neuropathy(DPN)with qi deficiency and dampness stasis.Methods A controlled trial was conducted in this study,involving 90 patients with DPN of Qi deficiency,dampness,and stasis type,all of whom cooperated to complete the treatment.Divide into three groups according to an equal proportion random number table,namely the Western medicine group,the Chinese medicine group,and the combination of Chinese and Western medicine group,with 30 cases in each group.The Western medicine group received methylcobalamin;The traditional Chinese medicine group was treated with the Yiqi Huashi Tongbi formula;The combination of traditional Chinese and Western medicine group used Yiqi Huashi Tongbi formula combined with mecobalamin.All patients were treated for a period of 2 months,and their clinical efficacy was evaluated.The Toronto Clinical Scoring System(TCSS),Traditional Chinese Medicine Syndrome Score,and nerve conduction velocity were measured.Results Compared with before treatment,the symptom score,reflex score,and sensory test score of the three groups decreased after treatment(P<0.05).And after treatment,the symptom score,reflex score,and sensory test score of the combination of Chinese and Western medicine group and the traditional Chinese medicine group were lower than those of the Western medicine group,with statistically significant differences(P<0.05).Compared with before treatment,the TCM syndrome scores of the three groups decreased after 1 month and 2 months of treatment(P<0.05);And the TCM syndrome scores in the combination of traditional Chinese and Western medicine group and the TCM group were lower than those in the Western medicine group after treatment for 1 month and 2 months,with a statistically significant difference(P<0.05).Compared with before treatment,the MCV of the ulnar and common peroneal nerves,as well as the SCV of the median and posterior tibial nerves increased in the three groups after treatment(P<0.05);And after treatment,the MCV of the ulnar nerve and common peroneal nerve,the SCV of the median nerve and posterior tibial nerve in the combination of traditional Chinese and Western medicine group were higher than those in the traditional Chinese medicine group,with a statistically significant difference(P<0.05).The total effective rate of the combination of traditional Chinese and Western medicine group(86.70%)and the traditional Chinese medicine group(80.00%)was higher than that of the Western medicine group(46.70%),with a statistically significant difference(P<0.05).Conclusion The Yiqi Huashi Tongbi Formula has a significant therapeutic effect on DPN with Qi deficiency,dampness and blood stasis,further improving clinical symptoms,traditional Chinese medicine syndromes,and nerve conduction velocity,which is worthy of clinical promotion.