补泻同施、调节平衡法内外合治糖尿病下肢周围神经病变患者临床观察

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英文篇名：Clinical Observation on Combined Internal-External Therapy of Reinforcing-Reducing and Adjusting the Balance in Treating Diabetic Lower Limb Peripheral Neuropathy 作者：李峻辉 ; 罗志红 ; 宁亚功 ; 李富强 ; 张华 ; 张崇耀 ; 杨璐璐 英文作者：LI Junhui;LUO Zhihong;NING Yagong;LI Fuqiang;ZHANG Hua;ZHANG Chongyao;YANG Lulu;Department of Traditional Chinese Medicine,the Affiliated Hospital of Traditional Chinese Medicine of No.920 Hospital of the Joint Logistics Support Force of the People's Liberation Army; 关键词：糖尿病下肢周围神经病变 ; 黄地吉仙汤 ; 温通泡浴散 ; 中医药疗法 ; 内外合治 英文关键词：diabetic lower limb peripheral neuropathy;;Huangdi Jixian decoction;;Wentong Paoyu powder;;therapy of TCM;;combined internal and external treatment 中文刊名：GMZY 英文刊名：Guangming Journal of Chinese Medicine 机构：中国人民解放军联勤保障部队第九二○医院附属中医院中医科; 出版日期：2019-03-26 出版单位：光明中医 年：2019 期：v.34;No.319 基金：全军中医药重大专项课题资助项目(No.10ZYZ119) 语种：中文; 页：GMZY201906020 页数：4 CN：06 ISSN：11-1592/R 分类号：56-59

摘要

目的观察补泻同施、调节平衡法内外合治对糖尿病下肢周围神经病变患者TCSS评分、神经传导速度影响及临床疗效。方法将64例糖尿病下肢周围神经病变患者随机分为2组(每组32例),治疗组患者每天口服黄地吉仙汤并温通泡浴散浴足,补泻同施、调节平衡法内外合治;对照组患者每天口服甲钴胺片并温水浴足,12周后测定腓肠神经、腓总神经、胫神经传导速度、TCSS评分及临床有效率。结果 2组患者腓肠神经、腓总神经、胫神经传导速度、TCSS评分,治疗前后对比差异具有统计学(P <0. 05);治疗组腓肠神经、腓总神经、胫神经传导速度分别为(46. 48±3. 21)、(48. 68±4. 87)、(46. 65±2. 76) m/s,显著高于对照组的(40. 43±3. 24)、(42. 89±4. 05)、(41. 32±3. 53) m/s(P <0. 05);治疗组TCSS评分(8. 35±1. 15),显著低于对照组的(11. 12±1. 63)(P <0. 05);治疗组总有效率为71. 88%,显著高于对照组的59. 38%(P <0. 05)。结论补泻同施、调节平衡法内外合治,可以降低TCSS评分、增加神经传导速度、有效改善症状并提高临床疗效。
        Objective To investigate the TCSS score,nerve conduction velocity and clinical curative effect with combined internal-external therapy of"reinforcing-reducing and adjusting the balance"on the diabetic lower limb peripheral neuropathy. Methods 64 cases of diabetic lower limb peripheral neuropathy were randomly divided into the treatment group and the control group. The treatment group was treated by oral Huangdi Jixian decoction on every day while bathing feet in Wentong Paoyu powder solution. The control group were treated by oral Mecobalamin on every day while bathing feet in warm water. The therapeutic effect was evaluated by measuring the conduction velocity of sural nerve,common peroneal nerve and tibial nerve,TCSS grade and the effective rate. Results Clinical symptoms amelioration were observed in two groups,however,the total effective rate( 71. 88%) in the treatment group were higher than that( 59. 38%) in the control group( P < 0. 05). Sural nerve conduction velocity( 46. 48 ± 3. 21 m/s),common peroneal nerve conduction velocity( 48. 68 ± 4. 87 m/s)and tibial nerve conduction velocity( 46. 65 ± 2. 76 m/s) in the treatment group were higher than Sural nerve conduction velocity( 40. 43 ±3. 24 m/s),common peroneal nerve conduction velocity( 42. 89 ± 4. 05 m/s) and tibial nerve conduction velocity( 41. 32 ± 3. 53 m/s) in the control group respectively( P < 0. 05). TCSS grade( 8. 35 ± 1. 15) in the treatment group were lower than that( 11. 12 ± 1. 63) in the control group( P < 0. 05). Conclusion Combined internal-external therapy of "reinforcing-reducing and adjusting the balance"could effectively reduce TCSS score,increase nerve conduction velocity and improve clinical symptoms.

引文

[1] XU Y,WANG L,He J,et al. 2010 China Noncommunicable Disease Surveillance Group. Prevalence and control of diabetes in Chinese adults[J]. JAMA,2013,310:948-959.
    [2]郭强,赵欢,雷星星,等.丹红注射液联合常规疗法治疗糖尿病合并脑梗死患者临床疗效及安全性Meta分析[J].中医杂志,2016,57(2):131-135.
    [3]秦婧.中医综合疗法辨治糖尿病周围神经病变的临床疗效观察[J].世界最新医学信息文摘,2016,16(1):183-184.
    [4]李静,乔小磊.综合疗法治疗糖尿病周围神经病变临床疗效观察[J].中医临床研究,2015,7(22):58-60.
    [5]中国2型糖尿病防治指南(2010年版)[J].中国糖尿病杂志,2012,20(1):81-117.
    [6]中华人民共和国卫生部.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2005:5.
    [7] CALLAGHAN BC,CHENG HT,STABLES CL,et al. Diabetic neuropathy:clinical manifestations and current treatments[J]. Lancet Neurol,2012,11:521-534.
    [8]朱雅楠,陈清光,金龙珍等.参蝎止痛胶囊治疗糖尿病周围神经病病变的临床疗效评价[J].中国医学创新,2016,13(32):1-4.
    [9]屈岭,梁晓春.筋脉通治疗糖尿病周围神经病变[J].协和医学杂志,2016,7(6):439-444.
    [10]中华医学会神经病学分会肌电图与临床神经电生理学组,中华医学会神经病学分会神经肌肉病学组.糖尿病周围神经病诊断和治疗共识[J].中华神经科杂志,2013,46(11):787-789.
    [11]郭华.复方芪藤通络汤联合依帕司他治疗老年2型糖尿病周围神经病变临床研究[J].中医学报,2016,31(12):1874-1879.
    [12]胡玉焕,肖燕,张景芸,等.宁亚功教授治疗糖尿病周围神经病变的经验[J].国医论坛,2013,28(2):12-13.
    [13]张弘,马力,吴瑞.中西医结合治疗气虚血瘀型糖尿病周围神经病变疗效观察[J].中国临床医生,2013,41(8):44-45.
    [14]杨丽娜,张景芸,苏红梅,等.“补泻同施,调节平衡”疗法治疗2型糖尿病的实验研究[J].光明中医,2014,29(2):260-261.
    [15]麦美琪,刘宇翔,林泽宏.祛痰活血通络方联合西药治疗糖尿病周围神经病变50例[J].中医研究,2016,29(5):10-12.
    [16]李金娥.丹红注射液联合甲钴胺对糖尿病周围神经病变的疗效观察[J].光明中医,2014,29(4):775-777.
    [17]白亚娟,方桂珍,胡祝红.两种评分系统在糖尿病周围神经病变筛查中的应用价值[J].浙江实用医学,2014,19(5):368-370.
    [18]陈瑛,姚政,徐隽斐,等.糖神方联合参蝎止痛胶囊治疗肝肾亏虚型糖尿病周围神经病变的临床疗效观察[J].时珍国医国药,2011,22(4):953-955.
    [19]王云华,宁亚功,李俊辉,等.中西医结合治疗对军事训练疲劳综合症的疗效评价[J].云南中医学院学报,2014,37(5):77-79.
    [20] AMERICAN DIABETES ASSOCIATION. Standards of medical care in diabetes,2013[J]. Diabetes Care,2013,36(Suppl):S11-66.
    [21] BRIL V. Treatments for diabetic neuropathy[J]. J Peripher New Syst,2012,17(Suppl 2):22-27.