中药涂擦联合营养神经活血药物治疗糖尿病下肢周围神经病变及对血小板聚集功能的影响
|
摘要
目的:观察中药涂擦联合营养神经活血药物治疗糖尿病下肢周围神经病变的疗效,并探讨其及对患者血液流变学水平和血小板聚集功能(PAgT)的影响。方法:选取医院收治糖尿病下肢周围神经病变患者共80例,按随机数字表法分为对照组和观察组,每组40例。对照组予下肢红外线照射(1次/d,7次/周);α-硫辛酸注射液静脉滴注,1次/d;灯盏花素注射液静脉滴注,1次/d。观察组在对照组基础上予中药涂擦约5 min,1次/d。两组连续治疗4周。比较两组多伦多临床评分系统(TCSS)评分、双侧腓肠神经的感觉神经传导速度(SNCV)和双侧腓总神经的运动神经传导速度(MNCV)以及临床疗效。检测两组血液流变学水平和血小板聚集功能(PAgT)。结果:治疗后,观察组患者的TCSS(神经症状、感觉功能以及神经反射)评分明显低于对照组,腓肠神经SNCV和腓总神经MNCV显著高于对照组(P<0.01)。观察组总有效率为77.50%,显著高于对照组(52.50%)(P<0.05)。治疗后,观察组血液流变学指标水平和PAgT明显低于对照组(P<0.01)。结论:中药涂擦联合营养神经活血药物治疗糖尿病下肢周围神经病变疗效显著,其改善患者的血液流变学水平和PAgT可能与其疗效有关。
Objective:To observe the efficacy of Chinese medicine inunction combined with nutritional nerve and blood activating drugs in treating diabetic peripheral neuropathy of lower extremity,and investigate its effect on platelet agglutination test(PAgT). Method: Eighty cases with diabetic peripheral neuropathy of lower extremity were selected and randomly divided into observation group and control group with 40 patients in each group. Control group was treated with lower extremity infrared irradiation(once a day,7 times/week),intravenous infusion of α-lipoic acid injection(once a day),and breviscapine injection intravenous drip(once a day). On basis of control group,the observation group was treated with Chinese medicine inunction for 5 min(once a day). Both groups were treated for 4 weeks. Score of toronto Clinical scoring system(TCSS),the sensory nerve conduction velocity(SNCV) of the gastrocnemius and the motor nerve conduction velocity of the peroneal nerve(MNCV) and efficacy were compared in two groups. Hemorheology and platelet agglutination test(PAgT) were detected in two groups. Result:After treatment,scores of TCSS(neurological symptoms,sensory functions and nerve reflexes) of treatment group were obviously lower,while SNCV and MNCV were remarkably higher than those of the control group(P<0.01). Total effective rate of observation group was 77.50%,which was obviously higher than the control group's 52.50%(P<0.05). After treatment, hemorheology and PAgT of treatment group were obviously lower than those of the control group(P<0.01). Conclusion: Efficacy of Chinese medicine inunction combined with nutritional nerve and blood activating drugs in treating diabetic peripheral neuropathy of lower extremity is significant and improvement of hemorheology and PAgT may be related to the efficacy.
Objective:To observe the efficacy of Chinese medicine inunction combined with nutritional nerve and blood activating drugs in treating diabetic peripheral neuropathy of lower extremity,and investigate its effect on platelet agglutination test(PAgT). Method: Eighty cases with diabetic peripheral neuropathy of lower extremity were selected and randomly divided into observation group and control group with 40 patients in each group. Control group was treated with lower extremity infrared irradiation(once a day,7 times/week),intravenous infusion of α-lipoic acid injection(once a day),and breviscapine injection intravenous drip(once a day). On basis of control group,the observation group was treated with Chinese medicine inunction for 5 min(once a day). Both groups were treated for 4 weeks. Score of toronto Clinical scoring system(TCSS),the sensory nerve conduction velocity(SNCV) of the gastrocnemius and the motor nerve conduction velocity of the peroneal nerve(MNCV) and efficacy were compared in two groups. Hemorheology and platelet agglutination test(PAgT) were detected in two groups. Result:After treatment,scores of TCSS(neurological symptoms,sensory functions and nerve reflexes) of treatment group were obviously lower,while SNCV and MNCV were remarkably higher than those of the control group(P<0.01). Total effective rate of observation group was 77.50%,which was obviously higher than the control group's 52.50%(P<0.05). After treatment, hemorheology and PAgT of treatment group were obviously lower than those of the control group(P<0.01). Conclusion: Efficacy of Chinese medicine inunction combined with nutritional nerve and blood activating drugs in treating diabetic peripheral neuropathy of lower extremity is significant and improvement of hemorheology and PAgT may be related to the efficacy.
引文
[1] 陈明月,蔡慧敏,陈江云,等.密歇根糖尿病神经病变评分和多伦多临床评分系统在糖尿病周围神经病变中的诊断价值研究[J].中国全科医学,2017,20(4):427-431.
[2] 张立芳.中药浴足配合刮痧在糖尿病周围神经病变合并坏疽感染患者中的应用效果[J].中华医院感染学杂志,2017,27(9):1997-2000.
[3] 陈丹,於佶.弥可保穴位注射治疗糖尿病下肢周围神经病变的临床疗效观察[J].针灸临床杂志,2015,31(10):39-42.
[4] 苏晓娟,吴岚.马来酸桂哌齐特联合甲钴胺治疗糖尿病周围神经病变疗效的Meta分析[J].中国老年学杂志,2015(2):338-341.
[5] 张倩,梁晓春,王超,等.660例糖尿病周围神经病变患者中医证型及临床特点分析[J].中国中西医结合杂志,2017,37(1):62-67.
[6] 徐胥,胡祝红,罗艳.中药涂擦联合TDP治疗糖尿病周围神经病变疗效观察[J].山东中医药大学学报,2015,39(4):325-329.
[7] 吴捷,邹大进.2010年美国糖尿病学会指南推行用糖化血红蛋白筛查和诊断糖尿病的背景[J].中华糖尿病杂志,2010,2(3):226-228.
[8] Morales-Vidal S,Morgan C,McCoyd M,et al.Diabetic peripheral neuropathy and the management of diabetic peripheral neuropathic pain[J].Postgrad Med,2012,124(4):145-153.
[9] 中华中医药学会.糖尿病周围神经病变中医防治指南[S].中国中医药现代远程教育,2011,9(22):119-121.
[10] Barei DP,O’Mara TJ,Taitsman LA,et al.Frequency and fracture morphology of the posteromedial fragment in bicondylar tibial plateau fracture patterns[J].J Orthop Trauma,2008,22(3):176-182.
[11] 郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:233-237.
[12] Zhong H,Guo A,Wang H,et al.Discussion of acupuncture for diabetic peripheral neuropathy based on blood stasis theory[J].Zhongguo Zhen Jiu,2017,37(2):199-201.
[13] 何培文.电针加红外线照射联合黄芪桂枝五物汤糖尿病痛性周围神经病变疗效观察[J].现代中西医结合杂志,2017,26(1):71-73.
[14] 朱志良,刘嘉悦,李丹丹.α-硫辛酸治疗老年糖尿病周围神经病变患者的疗效及作用机制[J].中国老年学杂志,2017,37(8):1908-1910.
[15] 张文锦,赵进东,郭呈林,等.荟萃分析灯盏花素联合甲钴胺治疗糖尿病周围神经病变的安全性与有效性[J].中成药, 2016,38(5):996-1005.
[16] 郑全成,符海燕,符永鋆.针灸联合中药治疗糖尿病周围神经病变临床疗效的Meta 分析[J].中国中医基础医学杂志,2017,23(3):384-386.
[17] 钟欢,呙安林,汪厚莲,等.从“瘀”论糖尿病周围神经病的针灸治疗[J].中国针灸,2017,37(2):199-201.
[18] 虞春华.中药涂擦配合微波治疗糖尿病0级足35例疗效观察[J].浙江中医杂志,2015,50(8): 575.
[19] 张季,王巧晗,毛春芹,等.莪术油及其包合物对急性血瘀证大鼠血液流变学和凝血功能的影响[J].中成药, 2016,38(12):2680-2683.
[20] 穆晓红,刘铜华,秦灵灵,等.从血液流变学和坐骨神经传导速度评价中药糖痹康对大鼠糖尿病周围神经病变的影响[J].中华中医药杂志,2012,27(2):378-381.
[21] 郑传柱,贾梅,张丽,等.胶艾汤与四物汤对血瘀模型大鼠活血功效的比较研究[J].中草药,2014,45(18):2652-2657.
[22] 闫冰,刘晓娜,杨明,等.单穴与合募配穴对糖尿病便秘影响随机对照研究[J].辽宁中医杂志,2018,45(9):1944-1946.
[23] 邓小敏,陈兰,郭超峰,等.中药有效成分多靶点调控治疗糖尿病肾病研究进展[J].辽宁中医杂志,2018,45(9):1998-2001.
[24] 卢绮韵,陈本坚,范冠杰.范冠杰“动-定序贯”论治糖尿病前期的经验总结[J].辽宁中医杂志,2018,45(8):1599-1601.
[25] 吕树泉,张淑芳,宋慧丽,等.“健脾固肾化瘀组方联合前列地尔治疗临床期糖尿病肾病临床应用[J].辽宁中医杂志,2018,45(8):1644-1646.
[26] 侯丽,冷锦红.痛性糖尿病周围神经病变中医证候学分析[J].辽宁中医药大学学报,2017,19(7):110-112.
[27] 宋莉丽,李静.益气养阴解毒祛浊中药抗糖尿病大鼠大血管病变之抗低度炎症机理研究[J].辽宁中医药大学学报,2017,19(8):23-27.
[2] 张立芳.中药浴足配合刮痧在糖尿病周围神经病变合并坏疽感染患者中的应用效果[J].中华医院感染学杂志,2017,27(9):1997-2000.
[3] 陈丹,於佶.弥可保穴位注射治疗糖尿病下肢周围神经病变的临床疗效观察[J].针灸临床杂志,2015,31(10):39-42.
[4] 苏晓娟,吴岚.马来酸桂哌齐特联合甲钴胺治疗糖尿病周围神经病变疗效的Meta分析[J].中国老年学杂志,2015(2):338-341.
[5] 张倩,梁晓春,王超,等.660例糖尿病周围神经病变患者中医证型及临床特点分析[J].中国中西医结合杂志,2017,37(1):62-67.
[6] 徐胥,胡祝红,罗艳.中药涂擦联合TDP治疗糖尿病周围神经病变疗效观察[J].山东中医药大学学报,2015,39(4):325-329.
[7] 吴捷,邹大进.2010年美国糖尿病学会指南推行用糖化血红蛋白筛查和诊断糖尿病的背景[J].中华糖尿病杂志,2010,2(3):226-228.
[8] Morales-Vidal S,Morgan C,McCoyd M,et al.Diabetic peripheral neuropathy and the management of diabetic peripheral neuropathic pain[J].Postgrad Med,2012,124(4):145-153.
[9] 中华中医药学会.糖尿病周围神经病变中医防治指南[S].中国中医药现代远程教育,2011,9(22):119-121.
[10] Barei DP,O’Mara TJ,Taitsman LA,et al.Frequency and fracture morphology of the posteromedial fragment in bicondylar tibial plateau fracture patterns[J].J Orthop Trauma,2008,22(3):176-182.
[11] 郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:233-237.
[12] Zhong H,Guo A,Wang H,et al.Discussion of acupuncture for diabetic peripheral neuropathy based on blood stasis theory[J].Zhongguo Zhen Jiu,2017,37(2):199-201.
[13] 何培文.电针加红外线照射联合黄芪桂枝五物汤糖尿病痛性周围神经病变疗效观察[J].现代中西医结合杂志,2017,26(1):71-73.
[14] 朱志良,刘嘉悦,李丹丹.α-硫辛酸治疗老年糖尿病周围神经病变患者的疗效及作用机制[J].中国老年学杂志,2017,37(8):1908-1910.
[15] 张文锦,赵进东,郭呈林,等.荟萃分析灯盏花素联合甲钴胺治疗糖尿病周围神经病变的安全性与有效性[J].中成药, 2016,38(5):996-1005.
[16] 郑全成,符海燕,符永鋆.针灸联合中药治疗糖尿病周围神经病变临床疗效的Meta 分析[J].中国中医基础医学杂志,2017,23(3):384-386.
[17] 钟欢,呙安林,汪厚莲,等.从“瘀”论糖尿病周围神经病的针灸治疗[J].中国针灸,2017,37(2):199-201.
[18] 虞春华.中药涂擦配合微波治疗糖尿病0级足35例疗效观察[J].浙江中医杂志,2015,50(8): 575.
[19] 张季,王巧晗,毛春芹,等.莪术油及其包合物对急性血瘀证大鼠血液流变学和凝血功能的影响[J].中成药, 2016,38(12):2680-2683.
[20] 穆晓红,刘铜华,秦灵灵,等.从血液流变学和坐骨神经传导速度评价中药糖痹康对大鼠糖尿病周围神经病变的影响[J].中华中医药杂志,2012,27(2):378-381.
[21] 郑传柱,贾梅,张丽,等.胶艾汤与四物汤对血瘀模型大鼠活血功效的比较研究[J].中草药,2014,45(18):2652-2657.
[22] 闫冰,刘晓娜,杨明,等.单穴与合募配穴对糖尿病便秘影响随机对照研究[J].辽宁中医杂志,2018,45(9):1944-1946.
[23] 邓小敏,陈兰,郭超峰,等.中药有效成分多靶点调控治疗糖尿病肾病研究进展[J].辽宁中医杂志,2018,45(9):1998-2001.
[24] 卢绮韵,陈本坚,范冠杰.范冠杰“动-定序贯”论治糖尿病前期的经验总结[J].辽宁中医杂志,2018,45(8):1599-1601.
[25] 吕树泉,张淑芳,宋慧丽,等.“健脾固肾化瘀组方联合前列地尔治疗临床期糖尿病肾病临床应用[J].辽宁中医杂志,2018,45(8):1644-1646.
[26] 侯丽,冷锦红.痛性糖尿病周围神经病变中医证候学分析[J].辽宁中医药大学学报,2017,19(7):110-112.
[27] 宋莉丽,李静.益气养阴解毒祛浊中药抗糖尿病大鼠大血管病变之抗低度炎症机理研究[J].辽宁中医药大学学报,2017,19(8):23-27.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |