针刺联合桃红四物汤治疗糖尿病周围神经病变随机对照研究

A randomized controlled trial of acupuncture combined with Taohong Siwu Tang(桃红四物汤) in the treatment of diabetic peripheral neuropathy

目的观察针刺联合桃红四物汤治疗糖尿病周围神经病变的临床疗效。方法将90例糖尿病周围神经病变患者采用随机数字表法分为对照组、治疗组1和治疗组2,各30例。3组均给予基础治疗,同时对照组予依帕司他片口服,治疗组1予桃红四物汤口服,治疗组2予针刺联合桃红四物汤口服,3组均以2周为1个疗程,治疗2个疗程后比较3组的临床疗效,治疗前后腓总神经、正中神经的传导速度,中医证候积分。结果对照组、治疗组1、治疗组2的总有效率分别为53.33%,73.33%,96.67%,3组组间比较差异均有统计学意义(P<0.05);治疗后3组腓总神经、正中神经的传导速度均较同组治疗前明显加快,中医证候积分均较同组治疗前明显降低,差异有统计学意义(P<0.05),且治疗组1、治疗组2对各项指标的改善作用明显优于对照组(P<0.05),治疗组2对各项指标的改善作用明显优于治疗组1(P<0.05)。结论针刺联合桃红四物汤既能改善糖尿病周围神经病变患者的临床症状,又能提高腓总神经和正中神经的传导速度,疗效显著,且无明显不良反应,值得临床推广应用。

Objective To observe the clinical efficacy of acupuncture combined with Taohong Siwu Tang(桃红四物汤) in the treatment of diabetic peripheral neuropathy(DPN).Methods Ninety patients of DPN were divided into control group,treatment group 1 and treatment group 2 according to random number table,with 30 cases in each.The 3 groups were all given basic treatment,meanwhile the control group was given ipastar tablets orally,the treatment group 1 was given Taohong Siwu Tang orally,the treatment group 2 was given acupuncture combined with Taohong Siwu Tang.A course of treatment was 2 weeks for 3 groups.After 2 courses of treatment,the clinical efficacy,the conduction velocity of common peroneal nerve and median nerve before and after treatment,TCM symptom scores of the 3 groups were compared.Results The total effective rates of the control group,the treatment group 1 and the treatment group 2 were 53.33%,73.33% and 96.67%,respectively,there were statistically significant differences among the three groups(P<0.05).The conduction velocity of common peroneal nerve and median nerve of the 3 groups after treatment was significantly faster than that of the same group before treatment,TCM symptom scores were all significantly lower than those of the same group before treatment,there were statistically significant differences(P<0.05).And the treatment group 1 and the treatment group 2 had significant improvement in all indicators than the control group(P<0.05),the treatment group 2 had significant improvement in all indicators than the treatment group 1(P<0.05).Conclusion Acupuncture combined with Taohong Siwu Tang in the treatment of patients with DPN not only improves the clinical symptoms,but also increases the conduction velocity of common peroneal nerve and median nerve,with significant clinical efficacy and very few noticeable adverse reactions,which deserves clinical promotion and application.