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目的探讨周围神经松解术配合中医辨证治疗糖尿病周围神经病(DPN)的临床疗效。方法将343例下肢DPN患者随机分为三组。研究组114例,应用补阳还五汤或四妙勇安汤配合周围神经松解术治疗;对照组115例,单纯进行周围神经松解术治疗;常规组114例,只给予应用补阳还五汤或四妙勇安汤等中药活血化瘀、利湿、止痛、换药及对症治疗。观察比较三组治疗后麻木症状、胫腓神经传导速度、VAS评分改善情况。结果研究组94.7%的患者的疼痛缓解、97.4%的患者感觉恢复,胫腓神经传导速度为(45±4)m/s,(49±4)m/s,VAS评分由术前7.6±1.6降至1.8±0.8,疗效明显。对照组93%的患者的疼痛缓解、78.9%的患者感觉恢复,神经传导速度为(41±4)m/s,(43±4)m/s,VAS评分由术前7.5±1.5降至术后2.1±0.9,疗效好。常规组只有18.45%的患者的疼痛缓解、22.85%的患者感觉恢复,神经传导速度为(33.2±4)m/s,(36±4)m/s,VAS评分由术前7.3±1.5降至7.1±0.9,疗效差,症状无明显缓解。结论周围神经松解术配合补阳还五汤或四妙勇安汤可以明显改善DPN下肢麻木、下肢疼痛症状,提高神经传导速度。
Objective To investigate the clinical effect of peripheral nerve release combined with traditional Chinese medicine in the treatment of diabetic peripheral neuropathy (DPN). Methods 343 DPN patients with lower limbs were randomly divided into three groups. The study group consisted of 114 cases treated with Buyang Huanwu Decoction or Simiao Yongan Decoction in combination with peripheral nerve lysis; 115 cases in the control group were treated with peripheral nerve lysis alone; 114 cases in the conventional group were given only buoyang Wu Tang or four wonderful Yongan Tang and other traditional Chinese medicine blood circulation, dampness, pain, dressing and symptomatic treatment. Observation and comparison of three groups after treatment numbness symptoms, tibiofibula nerve conduction velocity, VAS score to improve the situation. Results The pain relief was found in 94.7% of patients in study group and in 97.4% of patients in the study group. The tibial and peroneal nerve conduction velocity was (45 ± 4) m / s and (49 ± 4) m / s respectively. Down to 1.8 ± 0.8, significant effect. Pain was relieved in 93% of the patients in the control group, sensory recovery was found in 78.9% of the patients, and nerve conduction velocity was (41 ± 4) m / s and (43 ± 4) m / s, respectively. VAS score decreased from 7.5 ± 1.5 After 2.1 ± 0.9, good effect. Only 18.45% of the patients in the conventional group had pain relief, 22.85% of the patients had sensory recovery, the nerve conduction velocity was (33.2 ± 4) m / s and (36 ± 4) m / s, and the VAS score decreased from 7.3 ± 1.5 7.1 ± 0.9, poor efficacy, symptoms no significant relief. Conclusion Peripheral nerve release combined with Buyang Huanwu Decoction or Simiao Yong’an Decoction can significantly improve the numbness and leg pain symptoms of the lower extremities of DPN and improve the nerve conduction velocity.