补阳还五汤化裁方联合穴位注射治疗糖尿病周围神经病变的临床研究(1)
摘 要：目的 观察补阳还五汤化裁方内服联合VB12注射液穴位注射治疗糖尿病周围神经病变的临床疗效。方法 选择2016年8月～2018年8月我院内分泌科40例辨证为气虚血瘀型的DPN患者，随机分为对照组和治疗组，各20例。两组均接受血糖控制治疗，对照组予硫辛酸注射液静滴，治疗组在其基础上采用补阳还五汤化裁方内服联合VB12注射液穴位注射治疗。观察治疗前后患者临床疗效，肌电图检测腓总神经和正中神经的运动神经、感觉神经传导速度。结果 治疗组有效率为90.00%，高于对照组的60.00%，差异有统计学意义(P<0.05)；治疗后，两组患者腓总神经、正中神经MCV及SCV均较治疗前提高，差异有统计学意义(P<0.05)；且治疗组腓总神经、正中神经MCV及SCV高于对照组，差异有统计学意义(P<0.05)。结论 补阳还五汤化裁方内服联合VB12注射液穴位注射治疗糖尿病周围神经病变可有效改善患者腓总神经、正中神经的运动神经传导速度及感觉神经传导速度，提高临床疗效。
关键词：糖尿病周围神经病变；气虚血瘀型；加味补阳还五汤；穴位注射
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中图分类号：R587.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.20.043
文章编号：1006-1959(2018)20-0142-04
Abstract：Objective To observe the clinical efficacy of Buyang Huanwu Decoction and oral injection of VB12 injection in the treatment of diabetic peripheral neuropathy.Methods From August 2016 to August 2018，40 patients with DPN who were diagnosed as qi deficiency and blood stasis in our hospital were randomly divided into control group and treatment group，20 cases each.Both groups received blood glucose control treatment，and the control group received intravenous infusion of lipoic acid.The treatment group was treated by acupoint injection of Buyang Huanwu decoction combined with VB12 injection on this basis.The clinical effect and motor nerve and sensory nerve conduction velocity of common peroneal nerve and median nerve were measured by electromyography before and after treatment.Results The effective rate of the treatment group was 90.00%，which was higher than that of the control group 60.00%，the difference was statistically significant (P<0.05).After treatment，the MCV and SCV of the common peroneal nerve and median nerve in both groups were higher than those before treatment，the difference was statistically significant(P<0.05).The MCV and SCV of the common peroneal nerve and median nerve in the treatment group were higher than those in the control group，the difference was statistically significant(P<0.05).Conclusion The treatment of diabetic peripheral neuropathy with Buyang Huanwu Decoction and oral injection of VB12 injection can effectively improve the motor nerve conduction velocity and sensory nerve conduction velocity of the common peroneal nerve and median nerve， and improve the clinical efficacy.
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Key words：Diabetic peripheral neuropathy；Qi deficiency and blood stasis type；Jiawei Buyang Huanwu Decoction；Acupoint injection
糖尿病周圍神经病变(diabetic peripheral neuropathy，DPN)占糖尿病总人群中的40%～60%[1]，是糖尿病最常见的并发症，临床表现为双侧对称性神经病变及自主神经病变[2]。无论2型糖尿病或1型糖尿病，糖尿病周围神经病变发病率无明显差异[3]。DPN多发生在下肢，上肢发生较少，主要表现为感觉障碍，少数表现为运动障碍，糖尿病周围神经病变如果不及时治疗，严重者可出现肌萎缩，甚至出现下肢溃烂不愈等[4]。糖尿病周围神经病变病机尚不明确，目前考虑与糖脂代谢紊乱、氧化应激反应、神经因子减少等造成的微血管病变及神经系统损伤密切相关[5]。目前DPN的治疗仍存在一定的困难，西医主要以控制血糖、营养神经、改善循环、抗氧化等治疗为主，如发生外伤且合并感染或因受其他因素诱发时，病情会明显加重，最终导致坏疽甚或截肢的后果。传统医学在治疗DPN方面经验由来已久，随着近年中医药技术不断发展，中药化学成分及其药理机制研究日益增多，中医药治疗DPN临床疗效佳，患者痛苦少。本次研究采用补阳还五汤化裁方内服联合VB12注射液穴位注射治疗DPN，临床效果较好，现报道如下。, 百拇医药(吴青 毛奇 陈永华)
关键词：糖尿病周围神经病变；气虚血瘀型；加味补阳还五汤；穴位注射
, http://www.100md.com
中图分类号：R587.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.20.043
文章编号：1006-1959(2018)20-0142-04
Abstract：Objective To observe the clinical efficacy of Buyang Huanwu Decoction and oral injection of VB12 injection in the treatment of diabetic peripheral neuropathy.Methods From August 2016 to August 2018，40 patients with DPN who were diagnosed as qi deficiency and blood stasis in our hospital were randomly divided into control group and treatment group，20 cases each.Both groups received blood glucose control treatment，and the control group received intravenous infusion of lipoic acid.The treatment group was treated by acupoint injection of Buyang Huanwu decoction combined with VB12 injection on this basis.The clinical effect and motor nerve and sensory nerve conduction velocity of common peroneal nerve and median nerve were measured by electromyography before and after treatment.Results The effective rate of the treatment group was 90.00%，which was higher than that of the control group 60.00%，the difference was statistically significant (P<0.05).After treatment，the MCV and SCV of the common peroneal nerve and median nerve in both groups were higher than those before treatment，the difference was statistically significant(P<0.05).The MCV and SCV of the common peroneal nerve and median nerve in the treatment group were higher than those in the control group，the difference was statistically significant(P<0.05).Conclusion The treatment of diabetic peripheral neuropathy with Buyang Huanwu Decoction and oral injection of VB12 injection can effectively improve the motor nerve conduction velocity and sensory nerve conduction velocity of the common peroneal nerve and median nerve， and improve the clinical efficacy.
, http://www.100md.com
Key words：Diabetic peripheral neuropathy；Qi deficiency and blood stasis type；Jiawei Buyang Huanwu Decoction；Acupoint injection
糖尿病周圍神经病变(diabetic peripheral neuropathy，DPN)占糖尿病总人群中的40%～60%[1]，是糖尿病最常见的并发症，临床表现为双侧对称性神经病变及自主神经病变[2]。无论2型糖尿病或1型糖尿病，糖尿病周围神经病变发病率无明显差异[3]。DPN多发生在下肢，上肢发生较少，主要表现为感觉障碍，少数表现为运动障碍，糖尿病周围神经病变如果不及时治疗，严重者可出现肌萎缩，甚至出现下肢溃烂不愈等[4]。糖尿病周围神经病变病机尚不明确，目前考虑与糖脂代谢紊乱、氧化应激反应、神经因子减少等造成的微血管病变及神经系统损伤密切相关[5]。目前DPN的治疗仍存在一定的困难，西医主要以控制血糖、营养神经、改善循环、抗氧化等治疗为主，如发生外伤且合并感染或因受其他因素诱发时，病情会明显加重，最终导致坏疽甚或截肢的后果。传统医学在治疗DPN方面经验由来已久，随着近年中医药技术不断发展，中药化学成分及其药理机制研究日益增多，中医药治疗DPN临床疗效佳，患者痛苦少。本次研究采用补阳还五汤化裁方内服联合VB12注射液穴位注射治疗DPN，临床效果较好，现报道如下。, 百拇医药(吴青 毛奇 陈永华)