黄芪桂枝五物汤联合甲钴胺治疗糖尿病周围神经病变临床观察

Huangqi Guizhi Wuwu Decoction Combined with Mecobalamin in the Treatment of Diabetes Peripheral Neuropathy

目的探讨糖尿病周围神经病变(DPN)患者应用黄芪桂枝五物汤联合甲钴胺的治疗效果。方法采用随机数字表法将2020年3月—2022年5月于乐平市中医医院就诊的98例DPN患者分为两组,每组49例。对照组口服甲钴胺,观察组在对照组的基础上加服黄芪桂枝五物汤,均连续治疗8周。比较两组临床疗效、病情严重程度、氧化应激指标、神经传导速度及不良反应。结果治疗后,观察组临床总有效率为95.92%(47/49),高于对照组的81.63%(40/49);多伦多临床评分系统(TCSS)评分、丙二醇(MDA)水平低于对照组;超氧化物歧化酶(SOD)、总抗氧化能力(TAOC)水平及腓总神经、正中神经的运动神经传导速度(MNCV)和感觉神经传导速度(SNCV)高于对照组,差异均有统计学意义(P<0.05)。两组均未见明显不良反应。结论DPN患者应用黄芪桂枝五物汤联合甲钴胺治疗,可加快神经传导速度,提高抗氧化能力,促进疾病好转,效果显著,安全可靠,值得推广。

Objective To explore the effect of Huangqi Guizhi Wuwu decoction combined with mecobalamin in the treatment of diabe-tes peripheral neuropathy(DPN).Methods Ninety-eight patients with DPN in Leping Hospital of Traditional Chinese Medicine from March 2020 to May 2022 were randomly divided into two groups,with 49 patients in each group.The control group was treated with mecobalamin orally,and the observation group was treated with Huangqi Guizhi Wuwu decoction on the basis of the control group for 8 consecutive weeks.The clinical efficacy,severity,oxidative stress index,nerve conduction velocity and adverse reactions of the two groups were compared.Results After treatment,the total clinical effective rate of the observation group was 95.92%(47/49),which was higher than that of the control group(81.63%,40/49).Toronto clinical neuropathy score(TCSS)and propylene glycol(MDA)levels were lower than those of control group.The levels of superoxide dismutase(SOD),total antioxidant capacity(TAOC),motor nerve con-duction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of common peroneal nerve and median nerve were higher than those of control group,and the differences were statistically significant(P<0.05).No obvious adverse reactions were observed in both groups.Conclusion Huangqi Guizhi Wuwu decoction combined with mecobalamin in the treatment of DPN can accelerate the nerve conduction velocity,improve the antioxidant capacity,and promote the improvement of the disease.The effect is significant,safe and reliable,which is worthy of promotion.