独活寄生汤对气虚血瘀型糖尿病周围神经病变的疗效观察
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摘要
目的观察经方独活寄生汤治疗气虚血瘀型糖尿病周围神经病变患者的临床疗效。方法选取门诊和住院治疗的气虚血瘀型糖尿病周围神经病变患者187例,在常规降糖治疗的基础上,按随机数字表法分为3组:中药口服治疗组62例给予独活寄生汤口服,每日1剂,水煎取汁400 ml,日2次温服;中药熏蒸治疗组66例给予独活寄生汤熏蒸治疗,1剂/d,水煎取汁1 000 ml,2次/d外用熏蒸治疗;对照组59例给予甲钴胺片0. 5 mg,3次/d口服;维生素B1片20 mg,3次/d口服。3组均以10 d为1个疗程,3个疗程后观察其临床疗效及感觉神经电流阈值CPT变化情况。结果中药口服治疗组总有效率与中药熏蒸治疗组比较差异无统计学意义(P> 0. 05),2组总有效率均明显高于对照组,差异有统计学意义(P <0. 01),且治疗期间未发生药物不良反应。中药口服治疗组与中药熏蒸治疗组治疗前、后比较,感觉神经电流阈值(CPT值)均明显降低(P值均<0. 05),对照组治疗前、后CPT值虽有所下降,但差异无统计学意义(P> 0. 05)。中药口服治疗组、中药熏蒸治疗组与对照组比较,治疗后3组CPT值均有不同程度降低(P <0. 01);中药口服治疗组和熏蒸组感觉神经电流阈值(CRT值)与对照组比较,差异有统计学意义(P <0. 01),而中药口服治疗组与熏蒸组比较差异无统计学意义(P> 0. 05)。结论经方独活寄生汤能够显著改善气虚血瘀型糖尿病周围神经病变患者的临床症状,疗效确切,值得推广应用。
Objective To observe the therapeutic effects of Duhuojisheng decoction on Qi deficiency and blood stasis type diabetic peripheral neuropathy. Methods A total of 187 patients with Qi deficiency and blood stasis type diabetic peripheral neuropathy who were hospitalized and treated in our hospital were enrolled in the study. Based on conventional hypoglycemic therapy,these patients were divided into three groups according to the random number table: 62 patients in Chinese medicine oral treatment group were given Duhuojisheng decoction,one dose a day,400 ml once,teice a day; the 66 patients in Chinese medicine fumigation treatment group were treated by Duhuojisheng decoction external fumigation,one dose a day,decoction juice 1,000 ml,twice a day; the other 59 patients in control group were treated by oral mecobalamin tablets,0. 5mg,three times a day,and vitamin B1 tablets 20 mg,three times a day,with a treatment course of 10 days for the three groups. After three courses of treatment,the clinical curative effects and sensory nerve current threshold CPT were observed and compared among the three groups. Results The total effective rate was 83. 9% in Chinese medicine oral treatment group and 86. 4% in Chinese medicine fumigation treatment group,there was no significant difference between the two groups( P >0. 05),but the total effective rate in both groups was significantly higher than that( 52. 5%) in control group( P < 0. 01),and no adverse drug reactions were observed during the treatment. After treatment the CPT values in Chinese medicine oral treatment group and Chinese medicine fumigation treatment group were significantly decreased( P < 0. 05),moreover,there were significant differences in CPT values between Chinese medicine oral treatment group,Chinese medicine fumigation treatment group and control group( P < 0. 01),however,there were no significant differences in CPT values between Chinese medicine oral treatment group and Chinese medicine fumigation treatment group( P > 0. 05). Conclusion Duhuojisheng decoction can significantly improve the clinical symptoms of patients with Qi deficiency and blood stasis type diabetic peripheral neuropathy,with definite curative effects,therefore,it is worthy of popularization and application.
Objective To observe the therapeutic effects of Duhuojisheng decoction on Qi deficiency and blood stasis type diabetic peripheral neuropathy. Methods A total of 187 patients with Qi deficiency and blood stasis type diabetic peripheral neuropathy who were hospitalized and treated in our hospital were enrolled in the study. Based on conventional hypoglycemic therapy,these patients were divided into three groups according to the random number table: 62 patients in Chinese medicine oral treatment group were given Duhuojisheng decoction,one dose a day,400 ml once,teice a day; the 66 patients in Chinese medicine fumigation treatment group were treated by Duhuojisheng decoction external fumigation,one dose a day,decoction juice 1,000 ml,twice a day; the other 59 patients in control group were treated by oral mecobalamin tablets,0. 5mg,three times a day,and vitamin B1 tablets 20 mg,three times a day,with a treatment course of 10 days for the three groups. After three courses of treatment,the clinical curative effects and sensory nerve current threshold CPT were observed and compared among the three groups. Results The total effective rate was 83. 9% in Chinese medicine oral treatment group and 86. 4% in Chinese medicine fumigation treatment group,there was no significant difference between the two groups( P >0. 05),but the total effective rate in both groups was significantly higher than that( 52. 5%) in control group( P < 0. 01),and no adverse drug reactions were observed during the treatment. After treatment the CPT values in Chinese medicine oral treatment group and Chinese medicine fumigation treatment group were significantly decreased( P < 0. 05),moreover,there were significant differences in CPT values between Chinese medicine oral treatment group,Chinese medicine fumigation treatment group and control group( P < 0. 01),however,there were no significant differences in CPT values between Chinese medicine oral treatment group and Chinese medicine fumigation treatment group( P > 0. 05). Conclusion Duhuojisheng decoction can significantly improve the clinical symptoms of patients with Qi deficiency and blood stasis type diabetic peripheral neuropathy,with definite curative effects,therefore,it is worthy of popularization and application.
引文
1中华医学会糖尿病学分会主编.中国糖尿病防治指南.北京:北京大学医学出版社,2014. 138-143.
2 钟玲,吴世和,郭常辉,等.尼莫通治疗糖尿病周围神经病变疗效观察.中国糖尿病杂志,1999,7:48-49.
3 赵飞.糖尿病周围神经病变临床进展.医学与哲学,2006,27:83-85.
4 朱禧星主编.现代糖尿病学.第1版.上海:复旦大学出版社,2012.333-346.
5 中华人民共和国卫生部主编.中药新药临床研究指导原则(试行).北京:中国医药科技出版社,2002. 233-237.
6 中国中医药学会内科学会消渴病专业委员会.消渴病(糖尿病)中医分期辩证与疗效评定标准.中国医药学报,1993,8:54-56.
7 陈莉峰,李小强.硫辛酸联合单唾液酸四己糖神经节苷脂钠治疗糖尿病末梢神经病变效果观察.现代中西医结合杂志,2013,22:3934-3935.
8 Tesfaye S,Vileikyte L,Rayman G,et al. Painful diabetic peripheral neuropathy:consensus recommendations on diagnosis,assessment and management. Diabetes Metab Res Rev,2011,27:629-638.
9 孙冬梅,王艳滨. 2型糖尿病伴周围神经病变胫神经的超声特征.中国医学影像学杂志,2014,22:781-782.
10 陈伟峰.糖尿病周围神经病变的中西医结合治疗体会.中国实用神经疾病杂志,2012,15:51-53.
11 Brenaut E,Marcorelles P,Genestet S,et al. Pruritus:an underrecognized symptom of small-fiber neuropathies. J Am Acad Dermatol,2015,72:328-332.
12 潘晓丽,叶红莲,冯雪梅.电流感觉阈值测试在2型糖尿病小纤维神经病变的早期诊断价值.中国神经免疫学和神经病学杂志,2016,23:398-400.
13 葛红霞.从虚、瘀论治糖尿病周围神经病变.河北中医,2009,31:209-2101.
14 范红梅,罗斌,于李.补肾活血中药足浴治疗糖尿病下肢周围神经病变的临床观察.辽宁中医杂志,2011,38:507-509.
15 胡绍清,郭瑞林主编.实用糖尿病学.第1版.北京:人民军医出版社,1998. 2271-2281.
2 钟玲,吴世和,郭常辉,等.尼莫通治疗糖尿病周围神经病变疗效观察.中国糖尿病杂志,1999,7:48-49.
3 赵飞.糖尿病周围神经病变临床进展.医学与哲学,2006,27:83-85.
4 朱禧星主编.现代糖尿病学.第1版.上海:复旦大学出版社,2012.333-346.
5 中华人民共和国卫生部主编.中药新药临床研究指导原则(试行).北京:中国医药科技出版社,2002. 233-237.
6 中国中医药学会内科学会消渴病专业委员会.消渴病(糖尿病)中医分期辩证与疗效评定标准.中国医药学报,1993,8:54-56.
7 陈莉峰,李小强.硫辛酸联合单唾液酸四己糖神经节苷脂钠治疗糖尿病末梢神经病变效果观察.现代中西医结合杂志,2013,22:3934-3935.
8 Tesfaye S,Vileikyte L,Rayman G,et al. Painful diabetic peripheral neuropathy:consensus recommendations on diagnosis,assessment and management. Diabetes Metab Res Rev,2011,27:629-638.
9 孙冬梅,王艳滨. 2型糖尿病伴周围神经病变胫神经的超声特征.中国医学影像学杂志,2014,22:781-782.
10 陈伟峰.糖尿病周围神经病变的中西医结合治疗体会.中国实用神经疾病杂志,2012,15:51-53.
11 Brenaut E,Marcorelles P,Genestet S,et al. Pruritus:an underrecognized symptom of small-fiber neuropathies. J Am Acad Dermatol,2015,72:328-332.
12 潘晓丽,叶红莲,冯雪梅.电流感觉阈值测试在2型糖尿病小纤维神经病变的早期诊断价值.中国神经免疫学和神经病学杂志,2016,23:398-400.
13 葛红霞.从虚、瘀论治糖尿病周围神经病变.河北中医,2009,31:209-2101.
14 范红梅,罗斌,于李.补肾活血中药足浴治疗糖尿病下肢周围神经病变的临床观察.辽宁中医杂志,2011,38:507-509.
15 胡绍清,郭瑞林主编.实用糖尿病学.第1版.北京:人民军医出版社,1998. 2271-2281.