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目的观察温阳活血通痹方联合西药治疗糖尿病性周围神经病变(DPN)阳虚寒凝血瘀证临床疗效。方法将60例DPN患者随机分为治疗组和对照组各30例。两组均接受降血糖基础治疗,对照组在此基础上加用甲钴胺片,每次0.5 mg,每日3次。治疗组在对照组治疗基础上配合服用温阳活血通痹方,每日1剂。两组均治疗4周为1个疗程,共2个疗程。疗程结束后观察两组患者临床疗效,并观察两组患者治疗前后临床症状评分,胫神经、腓肠神经、腓总神经传导速度和血浆同型半胱氨酸(Hcy)变化。结果治疗组临床总有效率为70.0%,对照组为46.5%,治疗组优于对照组(P<0.01)。治疗后治疗组和对照组各项临床症状评分及Hcy均有明显下降,各神经传导速度较治疗前均有明显提高,与治疗前比较差异均有统计学意义(P<0.05或P<0.01),且治疗组均优于对照组(P<0.05)。结论温阳活血通痹方联合西药可改善DPN阳虚寒凝血瘀证临床症状及患者神经传导速度和血浆Hcy,是治疗DPN的有效方剂。
Objective To observe the clinical efficacy of Wenyang Huoxue Tongbi Decoction combined with Western medicine in treatment of diabetic peripheral neuropathy (DPN) Yang Deficiency and Blood Stasis Syndrome. Methods Sixty DPN patients were randomly divided into treatment group and control group, 30 cases each. Both groups received basic hypoglycemic treatment, and on the basis of this, the control group received mecobalamin 0.5 mg once daily for 3 times. The treatment group was treated on the basis of the control group with the administration of Wenyang Huoxue Tongbi Formula, a day. Two groups were treated for 4 weeks for a course of treatment, a total of 2 courses. After treatment, the clinical efficacy of the two groups were observed. The clinical symptom score, tibial nerve, sural nerve, common peroneal nerve conduction velocity and plasma homocysteine (Hcy) were observed before and after treatment. Results The total clinical effective rate was 70.0% in the treatment group and 46.5% in the control group, and the treatment group was superior to the control group (P <0.01). After treatment, the scores of clinical symptoms and Hcy of the treatment group and the control group were significantly decreased, the nerve conduction velocity was significantly increased compared with that before treatment, the difference was statistically significant (P <0.05 or P <0.01) , And the treatment group were better than the control group (P <0.05). Conclusion Wenyang Huoxue Tongbi Decoction combined with western medicine can improve clinical symptoms of DPN yang deficiency and cold coagulation and blood stasis, as well as the nerve conduction velocity and plasma Hcy in patients. It is an effective prescription for the treatment of DPN.