当归四逆汤加味方浴足与辣椒碱乳膏超声穴位导入联合治疗糖尿病周围神经病变的临床研究

Clinical Study on Treatment of Diabetes Peripheral Neuropathy by Combination of Foot Bath with Modified Danggui Sini Decoction and Capsaicin

目的分析当归四逆汤加味方浴足与辣椒碱乳膏超声穴位导入联合治疗糖尿病周围神经病变(阳虚寒凝证)患者的临床疗效。方法选取2022年6月—2023年12月厦门大学附属第一医院内分泌糖尿病科收治的80例糖尿病周围神经病变患者为研究对象,根据治疗方法的不同分为两组,各40例。两组在控制血糖等基础治疗上,对照组予甲钴胺注射液+硫辛酸注射液,观察组在对照组基础上予当归四逆汤加味方浴足与辣椒碱乳膏超声穴位导入联合治疗,疗程2周。对比两组血糖水平(空腹血糖、餐后2 h血糖)、中医证候积分、多伦多临床评分量表(Toronto Clinical Scoring System,TCSS)、临床疗效、症状改善开始时间、神经传导速度(感觉神经传导速度、运动神经传导速度)。结果治疗后,观察组空腹血糖及餐后2 h血糖均低于对照组,差异有统计学意义(P均<0.05)。观察组治疗总有效率为(95.0%)(38/40)高于对照组(75.00%)(30/40),差异有统计学意义(P<0.05)。治疗后,观察组的中医证候积分和TCSS积分较治疗前降低,且观察组低于对照组,差异有统计学意(P均<0.05);治疗后,观察组神经传导速度优于对照组;症状改善开始时间短于对照组,差异有统计学意义(P均<0.05)。结论当归四逆汤加味方浴足联合辣椒碱乳膏超声穴位导入联合治疗糖尿病周围神经病变能有提高神经传导速度、缩短药物起效时间,改善患者的临床症状。

Objective To analyze the clinical efficacy of the combination of foot bath with modified Danggui Sini De-coction and capsaicin cream in the treatment of diabetes peripheral neuropathy(Yang Xu Han Ning syndrome).Methods A total of 80 patients with diabetic peripheral neuropathy admitted to the Department of Endocrine diabetes,the First Affiliated Hospital of Xiamen University from June 2022 to December 2023 were selected as the research ob-jects.According to different treatment methods,they were divided into two groups,with 40 cases in each group.On the basis of basic treatment such as blood glucose control,the control group was treated with mecobalamin injection+lipoic acid injection,and the observation group was treated with modified Danggui Sini Decoction bath foot combined with capsaicin cream ultrasonic acupoint introduction on the basis of the control group.The course of treatment was 2 weeks.The blood glucose level(fasting blood glucose,2-hour postpranpranal blood glucose),Traditional Chinese Medicine syndrome score,Toronto Clinical Scoring System(TCSS),clinical efficacy,onset time of symptom improve-ment and nerve conduction velocity(sensory nerve conduction velocity and motor nerve conduction velocity)of the two groups were compared.Results After treatment,fasting blood glucose and 2-hour postprandial blood glucose in the observation group were lower than those in the control group,and the differences were statistically significant(both P<0.05).The total effective rate of treatment in the observation group was 95.0%(38/40),which was higher than 75.00%(30/40)of the control group,and the difference was statistically significant(P<0.05).After treatment,the Traditional Chinese Medicine syndrome score and TCSS score of the observation group were lower than those before treatment,and the observation group was lower than the control group,and the differences were statistically significant(both P<0.05).After treatment,the nerve conduction velocity of the observation group was better than that of the control group;the starting time of symptom improvement was shorter than that of the control group,and the difference was statisti-cally significant(both P<0.05).Conclusion The combination of Danggui Sini Decoction plus foot bath and capsaicin cream in the treatment of diabetes peripheral neuropathy can improve the nerve conduction speed,shorten the drug onset time,and improve the clinical symptoms of patients.