蒙药珍宝丸治疗糖尿病周围神经病变痰瘀互阻证54例临床观察
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摘要
目的评价蒙药珍宝丸干预糖尿病周围神经病变(DPN)痰瘀互阻证的临床疗效。方法将120例DPN患者随机分为治疗组和对照组各60例,两组患者均进行糖尿病基础治疗,包括饮食控制、运动治疗、药物控制血糖及对症治疗。治疗组口服珍宝丸,每次3. 0 g,每日2次,对照组口服硫辛酸胶囊,每次0. 6 g,每日1次,两组疗程均为24周。观察两组患者治疗前后中医证候积分、密歇根糖尿病神经病变积分(MDNS)、双侧正中神经和腓总神经的感觉神经传导速度(SNCV)和运动神经传导速度(MNCV)以及血糖、血脂水平。结果与本组治疗前比较,治疗后两组中医证候积分、MDNS积分均明显降低(P <0. 05),且治疗组中医证候积分、MDNS积分显著低于对照组(P <0. 05)。与本组治疗前比较,治疗组正中神经、腓总神经MNCV和SNCV明显提高(P <0. 05),与对照组治疗后比较,治疗组正中神经、腓总神经MNCV和SNCV明显提高(P <0. 05)。两组治疗前后及治疗后血糖、血脂水平比较差异均无统计学意义(P>0. 05)。结论蒙药珍宝丸能明显改善DPN患者症状,提高正中神经和腓总神经神经的传导速度。
Objective To evaluate the clinical efficacy of Mongolian medicine Zhenbao Pills( 珍宝丸) in the intervention of diabetic peripheral neuropathy( DPN) with phlegm and static blood syndrome. Methods A total of120 DPN patients were randomly divided into a treatment group and a control group,with 60 cases in each group. All patients were treated with diabetes basic treatment,including diet control,exercise therapy,blood sugarcontrol with drug and symptomatic treatment. The treatment group received oral Zhenbao Pills,3. 0 g each time,2 times a day,while the control group received oral lipoic acid capsules,0. 6 g each time,once a day. The treatment course of both groups was 24 weeks. The traditional Chinese medicine( TCM) syndrome scores before and after treatment,the michigan diabetic neuropathy score( MDNS),the sensory nerve conduction velocity( SNCV) and motor nerve conduction velocity( MNCV) of the bilateral median and common peroneal nerves,and blood glucose and blood lipid levels were observed. Results Compared with before treatment,the TCM syndrome scores and MDNS scores of both groups were significantly lower after treatment( P < 0. 05),and the TCM syndrome scores and MDNS scores of the treatment group were significantly lower than those of the control group( P < 0. 05). Compared with before treatment,the MNCV and SNCV of the median nerve and common peroneal nerve in the treatment group were significantly increased( P < 0. 05). After treatment,compared with the control group,the MNCV and SNCV of the median nerve and common peroneal nerve in the treatment group were significantly increased( P < 0. 05). There were no significant differences in blood glucose and blood lipid levels between two groups before and after treatment( P > 0. 05). Conclusion Mongolian Medicine Zhenbao Pillss can significantly improve the symptoms of DPN patients,the conduction velocity of median nerve and common peroneal nerve.
Objective To evaluate the clinical efficacy of Mongolian medicine Zhenbao Pills( 珍宝丸) in the intervention of diabetic peripheral neuropathy( DPN) with phlegm and static blood syndrome. Methods A total of120 DPN patients were randomly divided into a treatment group and a control group,with 60 cases in each group. All patients were treated with diabetes basic treatment,including diet control,exercise therapy,blood sugarcontrol with drug and symptomatic treatment. The treatment group received oral Zhenbao Pills,3. 0 g each time,2 times a day,while the control group received oral lipoic acid capsules,0. 6 g each time,once a day. The treatment course of both groups was 24 weeks. The traditional Chinese medicine( TCM) syndrome scores before and after treatment,the michigan diabetic neuropathy score( MDNS),the sensory nerve conduction velocity( SNCV) and motor nerve conduction velocity( MNCV) of the bilateral median and common peroneal nerves,and blood glucose and blood lipid levels were observed. Results Compared with before treatment,the TCM syndrome scores and MDNS scores of both groups were significantly lower after treatment( P < 0. 05),and the TCM syndrome scores and MDNS scores of the treatment group were significantly lower than those of the control group( P < 0. 05). Compared with before treatment,the MNCV and SNCV of the median nerve and common peroneal nerve in the treatment group were significantly increased( P < 0. 05). After treatment,compared with the control group,the MNCV and SNCV of the median nerve and common peroneal nerve in the treatment group were significantly increased( P < 0. 05). There were no significant differences in blood glucose and blood lipid levels between two groups before and after treatment( P > 0. 05). Conclusion Mongolian Medicine Zhenbao Pillss can significantly improve the symptoms of DPN patients,the conduction velocity of median nerve and common peroneal nerve.
引文
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[2]于满柱,石桩,巴达拉胡,等.蒙药珍宝丸对周围神经损伤修复术后功能恢复的临床疗效观察[J].内蒙古民族大学学报(自然科学版),2012,27(5):567-569.
[3]喜杰,敖强.蒙药珍宝丸药物血清对雪旺细胞增殖的影响[J].中成药,2012,34(4):625-628.
[4]侯改灵.蒙药珍宝丸对大鼠血瘀证模型血液流变学的影响[J].内蒙古民族大学学报(自然科学版),2008,23(2):103-104.
[5]云学英.蒙药珍宝丸中黄酮类化合物含量分析[J].光谱学与光谱分析,2004,24(1):90-91.
[6]POP-BUSUI R,BOULTON AJ,FELDMAN,et al. Diabetic neuropathy:a position statement by the American Diabetes Association[J]. Diabetes Care,2017,40(1):136-154.
[7]中华中医药学会.糖尿病周围神经病变中医防治指南[J].中国中医药现代远程教育,2011,9(21):119-121.
[8]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:234-237.
[9]廖二元.内分泌代谢病学[M].北京:人民卫生出版社,2012:1380-1381.
[10]SINGH R,LALIT K,NAVPREET K,et al. Diabetic peripheral neuropathy:current perspective and future directions[J]. Pharmacol Res,2014,80:21-35. doi. org/10.1016/j. phrs. 2013. 12. 005.
[11]刘莎莎,王旭.中医药治疗糖尿病周围神经病变研究概述[J].中医杂志,2008,49(3):276-278.
[12]AMETOV AS,BARINOV A,DYCK PJ,et al. The sensorysymptoms of diabetic polyneuropathy are improved withalpha-lipociacid:the sydney trial[J]. Diabetes Care,2003,26(3):770-776.
[13]王巴达日呼.蒙药额日敦-乌日勒的研究进展[J].内蒙古民族大学学报(自然科学版),2013,28(3):316-318.
[14]张亮,潘卫东,吴晓华,等.蒙药珍宝丸与扎冲十三味丸治疗脑梗死后遗症的临床疗效[J].中西医结合心脑血管病杂志,2015,13(7):874-877.
[15]额尔敦朝鲁,包春生,周铁宝,等.蒙药额日敦乌日勒对大鼠周围神经损伤早期c-fos表达及神经功能的影响[J].吉林中医药,2015,35(11):1151-1154.
[16]乌查日拉图,喜杰.蒙药珍宝丸对大鼠坐骨神经挤压损伤的修复作用研究[J].中国民族医药杂志,2011,17(4):48-50.
[17]张建宇,王海生,武瑞兵,等.珍宝丸对大鼠脊髓损伤后RhoA的调节作用[J].内蒙古医学杂志,2015,47(3):270-272.
[18]孟根花,李浩军,乌仁图雅.珍珠丸对兔视网膜缺血再灌注的神经保护作用及Bcl-2基因的表达[J].中国民族医药杂志,2007,13(1):42-46.
[19]张艳,石博,黄可欣,等.珍宝丸对缺氧性脑损伤新生鼠脑组织中p53蛋白表达的影响[J].中国妇幼保健,2014,29(8):1258-1260.
[2]于满柱,石桩,巴达拉胡,等.蒙药珍宝丸对周围神经损伤修复术后功能恢复的临床疗效观察[J].内蒙古民族大学学报(自然科学版),2012,27(5):567-569.
[3]喜杰,敖强.蒙药珍宝丸药物血清对雪旺细胞增殖的影响[J].中成药,2012,34(4):625-628.
[4]侯改灵.蒙药珍宝丸对大鼠血瘀证模型血液流变学的影响[J].内蒙古民族大学学报(自然科学版),2008,23(2):103-104.
[5]云学英.蒙药珍宝丸中黄酮类化合物含量分析[J].光谱学与光谱分析,2004,24(1):90-91.
[6]POP-BUSUI R,BOULTON AJ,FELDMAN,et al. Diabetic neuropathy:a position statement by the American Diabetes Association[J]. Diabetes Care,2017,40(1):136-154.
[7]中华中医药学会.糖尿病周围神经病变中医防治指南[J].中国中医药现代远程教育,2011,9(21):119-121.
[8]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:234-237.
[9]廖二元.内分泌代谢病学[M].北京:人民卫生出版社,2012:1380-1381.
[10]SINGH R,LALIT K,NAVPREET K,et al. Diabetic peripheral neuropathy:current perspective and future directions[J]. Pharmacol Res,2014,80:21-35. doi. org/10.1016/j. phrs. 2013. 12. 005.
[11]刘莎莎,王旭.中医药治疗糖尿病周围神经病变研究概述[J].中医杂志,2008,49(3):276-278.
[12]AMETOV AS,BARINOV A,DYCK PJ,et al. The sensorysymptoms of diabetic polyneuropathy are improved withalpha-lipociacid:the sydney trial[J]. Diabetes Care,2003,26(3):770-776.
[13]王巴达日呼.蒙药额日敦-乌日勒的研究进展[J].内蒙古民族大学学报(自然科学版),2013,28(3):316-318.
[14]张亮,潘卫东,吴晓华,等.蒙药珍宝丸与扎冲十三味丸治疗脑梗死后遗症的临床疗效[J].中西医结合心脑血管病杂志,2015,13(7):874-877.
[15]额尔敦朝鲁,包春生,周铁宝,等.蒙药额日敦乌日勒对大鼠周围神经损伤早期c-fos表达及神经功能的影响[J].吉林中医药,2015,35(11):1151-1154.
[16]乌查日拉图,喜杰.蒙药珍宝丸对大鼠坐骨神经挤压损伤的修复作用研究[J].中国民族医药杂志,2011,17(4):48-50.
[17]张建宇,王海生,武瑞兵,等.珍宝丸对大鼠脊髓损伤后RhoA的调节作用[J].内蒙古医学杂志,2015,47(3):270-272.
[18]孟根花,李浩军,乌仁图雅.珍珠丸对兔视网膜缺血再灌注的神经保护作用及Bcl-2基因的表达[J].中国民族医药杂志,2007,13(1):42-46.
[19]张艳,石博,黄可欣,等.珍宝丸对缺氧性脑损伤新生鼠脑组织中p53蛋白表达的影响[J].中国妇幼保健,2014,29(8):1258-1260.