摘要
【目的】观察黄帝内针联合温阳健步汤治疗虚寒型痛性糖尿病周围神经病变的临床疗效及安全性。【方法】将60例虚寒型痛性糖尿病周围神经病变患者随机分为治疗组和对照组,每组各30例。2组患者均给予常规治疗,包括饮食治疗、降血糖治疗等,同时,对照组给予普瑞巴林口服治疗,治疗组给予黄帝内针联合温阳健步汤治疗,2组均治疗24周。治疗24周后,评价2组患者的西医临床疗效与中医证候疗效,观察2组患者治疗前后中医证候积分的变化情况,以及正中神经、腓总神经的运动神经传导速度(SNCV)、感觉神经传导速度(MNCV)的变化情况,比较2组患者治疗前后炎症因子白细胞介素6(IL-6)、可溶性血管细胞黏附分子1(sVCAM-1)的变化情况。并评价2组的安全性。【结果】(1)治疗组西医临床总有效率为83.33%(25/30),对照组为60.00%(18/30)。治疗组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的中医证候积分明显改善(P<0.05),且治疗组在改善中医证候积分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗组中医证候总有效率为86.67%(26/30),对照组为53.33%(16/30)。治疗组疗效优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的正中神经、腓总神经的神经传导速度SNCV、MNCV明显改善(P<0.05),且治疗组在改善正中神经、腓总神经的神经传导速度SNCV、MNCV方面明显优于对照组,差异有统计学意义(P<0.05)。(5)治疗后,2组患者的IL-6、sVCAM-1水平明显改善(P<0.05),且治疗组在改善IL-6、sVCAM-1水平方面明显优于对照组,差异有统计学意义(P<0.05)。(6)治疗期间,2组患者均无明显不良反应,且患者的生命体征(体温、心率、呼吸、血压)和血常规、大便常规、肝功能等均未见明显异常。【结论】黄帝内针联合温阳健步汤治疗虚寒型痛性糖尿病周围神经病变,能明显改善患者的临床症状,疗效显著,能有效改善患者的神经传导速度,其机制可能与降低IL-6、sVCAM-1等炎症因子水平有关。
Objective To observe the clinical efficacy and safety of Huangdi Internal Acupuncture combined with Wenyang Jianbu Decoction in treating painful diabetic peripheral neuropathy of deficiency-cold type.Methods Sixty patients with painful diabetic peripheral neuropathy of deficiency-cold type were randomly divided into treatment group and control group,30 patients in each group.Both groups were given conventional treatment including dietary therapy and hypoglycaemic therapy,while the control group was given oral use of Pregabalin and the treatment group was given Huangdi Internal Acupuncture combined with Wenyang Jianbu Decoction.And both groups were treated for 24 weeks.After 24 weeks of treatment,the clinical efficacy of western medicine and the efficacy of traditional Chinese medicine(TCM)syndrome were evaluated in the two groups,and the changes in the Chinese medicine syndrome score,as well as the changes in motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of the median nerve and common peroneal nerve were observed before and after treatment.The changes of inflammatory cytokines such as interleukin 6(IL-6)and soluble vascular cell adhesion molecule 1(s VCAM-1)in two groups were compared before and after treatment,and the safety of the two groups was also evaluated.Results(1)The total clinical efficiency of western medicine was 83.33%(25/30)in the treatment group,compared with 60.00%(18/30)in the control group.The efficacy of the treatment group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the TCM syndrome scores of patients in the two groups were improved significantly(P<0.05),and the treatment group was significantly superior to the control group in improving TCM syndrome scores,the difference being statistically significant(P<0.05).(3)The total effective rate of TCM syndrome scores in the treatment group was 86.67%(26/30),compared with 53.33%(16/30)in the control group.The efficacy of the treatment group was superior to that of the control group,the difference being statistically significant(P<0.05).(4)After treatment,the SNCV and MNCV of the median nerve and common peroneal nerve in the two groups were significantly improved(P<0.05),and the improvement of the treatment group was significantly superior to that of the control group,the difference being statistically significant(P<0.05).(5)After treatment,the levels of IL-6 and sVCAM-1 in the two groups were significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving IL-6 and sVCAM-1 levels,the difference being statistically significant(P<0.05).(6)During the treatment,there were no significant adverse reactions in the two groups,and there were no significant abnormalities in vital signs(body temperature,heart rate,respiration and blood pressure)and blood routine,stool routine and liver function were found.Conclusion Huangdi Internal Acupuncture combined with Wenyang Jianbu Decoction for the treatment of painful diabetic peripheral neuropathy with deficiency-cold type can significantly improve the clinical symptoms of patients with remarkable efficacy.It has significant effect in improving the nerve conduction velocity of patients,and the mechanism of which may be related to the reduction of inflammatory factors such as IL-6 and s VCAM-1 levels.
作者
刘剑文
潘伟钰
彭良岳
罗理云
肖静
梁嘉朗
LIU Jian-Wen;PAN Wei-Yu;PENG Liang-Yue;LUO Li-Yun;XIAO-Jing;LIANG Jia-Lang(Dept.of Endocrinology,Guangdong Integrated Traditional Chinese Medicine and Western Medicine Hospital,Foshan 528200 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2022年第5期1090-1096,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
佛山市卫生健康局医学科研课题(编号:20200416)
关键词
黄帝内针
温阳健步汤
虚寒型
痛性
糖尿病周围神经病变
炎症因子
疗效观察
Huangdi Internal Acupuncture
Wenyang Jianbu Decoction
deficiency-cold type
pain
diabeticperipheral neuropathy
inflammatory factors
clinical observation
作者简介
刘剑文(1985-),男,主治中医师,E-mail:ljwmnpo@163.com
