益气养阴活血法治疗糖尿病周围神经病变临床探讨

The clinical discussion of the methods of supplementing qi, nourishing yin and activating blood circulation to treat diabetic peripheral neuropathy

关键词:  糖尿病周围神经病变  益气养阴活血法  神经传导速度  TCSS评分  临床疗效

Key words:  diabetic peripheral neuropathy  methods of supplementing qi,nourishing yin and activating blood circulation  nerve conduction velocity  TCSS grade  clinical effect

摘要:

[目的]观察益气养阴活血法治疗糖尿病周围神经病变（DPN）的临床效果。[方法]选取90例确诊DPN的2型糖尿病（T2DM）患者，随机分为治疗组和对照组；两组均进行饮食、运动、常规降糖及口服甲钴胺分散片营养周围神经等基础方案治疗，治疗组在对照组的基础上加用芪棱汤。连续治疗8周，比较两组患者治疗前后正中神经和腓总神经的感觉神经传导速度（MCV）、运动神经传导速度（SCV）、多伦多临床评分（TCSS）及临床疗效。[结果]治疗前，治疗组和对照组的空腹血糖（FPG）、糖化血红蛋白（HbA1c）、MCV、SCV及TCSS，差异无统计学意义（P>0.05）；治疗后，治疗组和对照组各组的正中神经和腓总神经MCV、SCV、TCSS均较治疗前有所改善，且治疗组较对照组改善更明显，差异有统计学意义（P<0.05）；对临床疗效比较，治疗组有效率为93.33%，对照组为73.33%，两组差异有统计学意义（P<0.01）。[结论]基础方案联合益气养阴活血法治疗DPN可增加神经传导速度、减轻临床症状及提高临床疗效。

Abstract:

[Obejective] To observe the clinical effects of Qileng decoction via supplementing qi, nourishing yin and activating blood circulation to treat diabetic peripheral neuropathy (DPN).[Methods] A total of 90 patients with type 2 diabetes (T2DM) and PDN were enrolled in this study and randomly divided into testing group and control group, both of them received the basic therapeutic schedules including the dietary, exercise, routine blood sugar regulation and nourising peripheral neuropathy by oral mecobalamine, on that basis, the testing group took Qileng decoction additionally. All patients were treated for eight weeks, and then compared their nerve conduction velocity of median nerve and common peroneal nerve, TCSS grade of and clinical effects.[Results] Before the treatment, there was no difference of FPG, HbAlc, MCV, SCV and TCSS grades between the two groups(P>0.05). After treatment, MCV, SCV, and TCSS of the median and total peroneal nerves in the testing group and the control group were all improved compared to the pre-treatment group, and the improvement of the testing group was more obvious than that of the control group. The difference was statistically significant(P<0.05).Clinical effects were siginificant both in two groups (testing group for 93.33% and control group for 73.33%), but the testing group gained a better therapeutic effects in MCV, SCV and TCSS grades (P<0.01).[Conclusion] Qileng decoction via supplementing qi, nourishing yin and activating blood circulation to treat diabetic peripheral neuropathy could expedite the nerve conduction velocity, reducing clinical symptom and improving clinical effects.