中医内外同治辅助依帕司他治疗糖尿病周围神经病变的临床观察
Clinical observation of epalrestat assisted by internal and external treatment of traditional Chinese medicine in the treatment of diabetic peripheral neuropathy
曹燕 1梁枫 1夏卫明 1夏伟 1刘春辉 1邹雨1
作者信息
- 1. 启东市中医院内科,江苏启东 226200
- 折叠
摘要
目的 观察中医内外同治辅助依帕司他治疗糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的临床效果.方法 将我院气阴两虚兼血瘀证DPN患者132例随机分为甲、乙、丙组,删除失访者,最终每组各42例.甲组予依帕司他,乙组在甲组治疗基础上予身痛逐瘀散,丙组在乙组治疗基础上予养阴通络方,3组疗程均为30 d.观察治疗前后3组空腹血糖(fasting blood glucose,FBG)、餐后 2 h 血糖(2-hour postprandial blood glucose,2hPBG)、同型半胱氨酸(homocysteine,Hcy)及超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平,以及正中神经和腓总运动神经传导速度(motor nerve conduction velocity,MCV)、健康状况调查问卷(36-item short-form,SF-36)评分、多伦多临床评分系统(Toronto clinical scoring system,TCSS)评分、中医证候积分,并评价中医内外同治临床疗效及安全性.结果 治疗后,3组FBG、2hPBG及Hcy较前均降低(P＜0.05),且乙、丙组Hcy水平较甲组差异显著(P＜0.05).3组双侧正中神经和腓总MCV均较前增快(P＜0.05),且乙、丙组快于甲组(P＜0.05).3组SF-36评分较前均提高,hs-CRP水平、TCSS评分、中医证候积分较前均降低(P＜0.05),且乙、丙组较甲组差异显著(P＜0.05),丙组较乙组差异显著(P＜0.05).乙组临床有效率高于甲组(76.19％vs 64.29％,P＞0.05);丙组临床有效率高于乙组(83.33％vs 76.19％,P＞0.05),丙组较甲组差异显著(83.33％vs 64.29％,P＜0.05).结论 中医内外同治较单药依帕司他/联合外治法对DPN临床疗效更佳.
Abstract
Objective To observe the clinical effect of internal and external treatment of traditional Chinese medicine(TCM)with the aid of epalrestat in the treatment of diabetic peripheral neuropathy(DPN).Methods A total of 132 DPN patients with Qi Yin deficiency combined with blood stasis syndrome in our hospital were randomly divided into group A,group B and group C,and the missing patients were deleted,with 42 cases in each group.Group A was treated with epalrestat,group B was treated with Shentong Zhuyu powder on the basis of group A,group C was treated with Yangyin Tongluo prescription on the basis of group B.The treatment course of the 3 groups was 30 days.Fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPBG),homocysteine(Hcy),hypersensitive C-reactive protein(hs-CRP),median nerve and common peroneal motor nerve conduction velocity(MCV),36-item short-form(SF-36)score,Toronto clinical scoring system(TCSS)score and TCM syndrome score of the 3 groups were observed before and after treatment,and clinical efficacy and safety of internal and external TCM treatment were compared before and after treatment.Results After treatment,FBG,2hPBG and Hcy in 3 groups were decreased compared with before treatment(P＜0.05),and the Hcy level in groups B and C was significantly different from that in group A(P＜0.05).The median nerve and common peroneal MCV in 3 groups were faster than before treatment(P＜0.05),and group B and C were faster than that of group A(P＜0.05).The SF-36 score of 3 groups was increased compared with before,and the hs-CRP level,TCSS score and TCM syndrome score were decreased compared with before(P＜0.05),and groups B and C had significant differences compared with group A(P＜0.05),and group C had significant differences compared with group B(P＜0.05).The clinical effective rate of group B was higher than that of group A(76.19％vs 64.29％,P＞0.05),and the clinical effective rate of group C was higher than that of group B(83.33％vs 76.19％,P＞0.05),and the difference between group C and group A was significant(P＜0.05).Conclusion Internal and external treatment of TCM is more effective than epalrestat or combined external treatment for DPN.
关键词
中医内外同治/依帕司他/糖尿病周围神经病变/气阴两虚兼血瘀证Key words
traditional Chinese medicine internal and external treatment/epalrestat/diabetic peripheral neuropathy/Qi Yin deficiency combined with blood stasis syndrome引用本文复制引用
基金项目
南通卫生健康委科研指导性课题(青年课题)(QNZ2022088)
出版年
2024
NETL
NSTL
万方数据