摘要
【目的】探讨桃红四物汤加味内服、外用治疗糖尿病周围神经病变(DPN)的临床疗效。【方法】将126例DPN患者随机分为中医组和对照组,每组各63例。2组患者均给予糖尿病基础治疗,对照组同时给予硫辛酸注射液治疗,中医组在对照组的基础上加用桃红四物汤加味内服和熏洗治疗,连续治疗3周。观察2组患者治疗前后中医证候评分、多伦多临床评分系统(TCSS)评分、神经病变主观症状问卷(TSS)评分、正中神经和腓总神经运动(MNCV)和感觉(SNCV)传导速度、血液流变学指标[全血高切黏度(HSV)、全血低切黏度(LSV)、血浆黏度(PV)、血细胞比容(HCT)、血小板聚集率]和丙二醛(MDA)、超氧化物歧化酶(SOD)、总抗氧化能力(T-AOC)、谷氨酰转肽酶(GGT)、谷胱甘肽过氧化物(GSH-Px)水平的变化情况,并评价2组的临床疗效。【结果】(1)治疗3周后,中医组的总有效率为90.48%,对照组为77.78%,组间比较,中医组的疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的中医证候评分、TCSS评分、TSS评分,以及HSV、LSV、PV、HCT、血小板聚集率等血液流变学指标和血清MDA、GGT水平均较治疗前明显降低(P<0.05),而MNCV、SNCV和血清SOD、T-AOC、GSH-Px水平均较治疗前明显升高(P<0.05),且中医组在改善上述指标方面均明显优于对照组,差异均有统计学意义(P<0.05)。【结论】桃红四物汤加味治疗DPN可以提高神经传导速度,抑制氧化应激反应,从而能改善症状,提高疗效。
Objective To study the effects of modified Taohong Siwu Decoction in the treatment of diabetic peripheral neuropathy(DPN). Methods A total of 126 patients with DPN were randomly divided into Chinese medicine group and control group,63 cases in each group. The patients in the two groups were given routine basic treatment for diabetes mellitus,and additionally,the control group was given intravenous injection of Thioctic Acid Injection while Chinese medicine group was given oral use and fumigation administration of modified Taohong Siwu Decoction plus intravenous injection of Thioctic Acid Injection. The treatment lasted for 3 continuous weeks.Before and after treatment,we observed the scores of traditional Chinese medicine(TCM)syndrome,the scores evaluated with Toronto clinical scoring system(TCSS)and total symptoms scores(TSS)of neuropathy subjective symptoms, motion nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of the median nerve and common peroneal nerve, hemorheological indexes of whole blood high-shear viscosity(HSV)and low-shear viscosity(LSV),plasma viscosity(PV),hematocrit(HCT),and platelet aggregation rate,and the levels of malondialdehyde(MDA), superoxide dismutase(SOD), total antioxidant capacity(T-AOC),gamma-glutamyltranspeptidase(GGT)and glutathione peroxide(GSH-Px). And after treatment, the clinical efficacy of the two groups was evaluated. Results (1)After treatment for 3 weeks, the total effective rate of Chinese medicine group was 90.48%,significantly higher than that(77.78%)of the control group(P < 0.05).(2)After treatment, the observation indexes of TCM syndrome scores, TCSS scores, TSS, HSV, LSV, PV,HCT, platelet aggregation rate, MDA and GGT were decreased significantly as compared with those before treatment(P<0.05),while the MNCV,SNCV,and the levels of SOD,T-AOC and GSH-Px were increased significantly(P < 0.05),the improvement of the above indexes in Chinese medicine group being superior to that in the control group(P < 0.05). Conclusion Modified Taohong Siwu Decoction exerts enhancing effect for DPN by relieving symptoms through increasing nerve conduction velocity,and inhibiting oxidative stress.
引文
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