益气通络汤治疗糖尿病周围神经病变气虚血瘀证的临床观察

发布时间：2017-12-31 14:43

本文关键词：益气通络汤治疗糖尿病周围神经病变气虚血瘀证的临床观察　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:采用临床随机对照研究方法,运用中医学理论和现代检查检验技术,通过观察益气通络汤治疗糖尿病周围神经病变气虚血瘀证患者的临床疗效,为治疗糖尿病周围神经病变气虚血瘀证提供有效方药。方法:本研究将60例符合DPN的气虚血瘀证分型的患者,随机分为治疗组和对照组,各30例。在控制血压、血糖等一般治疗基础上,对照组给予甲钴铵片500ug,口服,每日三次;在对照组的治疗基础上,治疗组加用益气通络汤口服,每日早餐后及午餐后各一次。疗程12周。对比两组治疗前后中医证候积分、神经电生理、血流变、血脂等指标差异,进行疗效分析和安全性评估。结果:糖尿病周围神经病变气虚血瘀证患者60例,随机分为2组。治疗组与对照组各30例,治疗前两组在性别、年龄等方面无显著差异,具有均衡可比性。治疗后:①证候疗效比较:治疗组总有效率为76.60%,对照组为50.00%,经卡方检验P0.05,说明治疗组优于对照组;②临床症状及积分比较:治疗组组内比较P0.05,对照组组内比较P0.05,治疗后组间比较P0.05,治疗组疗效优于对照组。③神经传导速度比较:左、右腓总神经及左、右胫神经的运动传导速度,治疗组组内比较P0.05,对照组组内比较P0.05,治疗后组间比较P0.05,治疗组疗效优于对照组。左、右腓浅神经的感觉传导速度,治疗组组内比较P0.05,对照组组内比较P0.05,治疗后组间比较P0.05,说明在改善神经感觉传导速度方面两组疗效相近。④血液流变学比较:全血低切还原黏度、全血高切还原黏度、血浆黏度,治疗组组内比较P0.05,对照组组内比较P0.05,治疗后组间比较P0.05,治疗组疗效优于对照组。红细胞聚集指数和红细胞变形指数,治疗组组内比较P0.05,对照组组内比较P0.05,治疗后组间比较P0.05,说明在改善红细胞聚集指数、红细胞变形指数方面两组疗效相近。⑤血脂比较:胆固醇和低密度脂蛋白,治疗组内比较P0.05,对照组组内比较P0.05,治疗后组间比较P0.05,治疗组疗效优于对照组。高密度脂蛋白、甘油三酯:治疗组组内比较P0.05,对照组组内比较P0.05,治疗后组间比较P0.05,说明在改善高密度脂蛋白及甘油三酯方面两组疗效相近。⑥安全性比较:所有病例在治疗过程中均未发现不良反应事件。一般体格检查、血尿粪常规、心电图、肝肾功能检查均未见异常。结论:从本次研究结果分析,益气活血通络汤合用甲钴铵治疗糖尿病周围神经病变气虚血瘀证,可明显改善患者的临床证候疗效、症状及积分;在西医学检测指标方面,益气通络汤能够改善神经运动传导速度、血液流变学、血脂等。其应用前景广泛且安全有效,值得进一步深入研究。
[Abstract]:Objective: a randomized controlled clinical research methods, theory and modern inspection technology used by Chinese medicine, to observe the clinical effect of Yiqi Tongluo Decoction in the treatment of diabetic peripheral neuropathy patients with Qi deficiency and blood stasis, provide effective prescriptions for the treatment of diabetic peripheral neuropathy with Qi deficiency and blood stasis syndrome. Methods: this study will be divided into type DPN 60 cases with Qi deficiency blood stasis syndrome patients were randomly divided into treatment group and control group, 30 cases in each group. In the control of blood pressure, blood sugar and so on the basis of general treatment, the control group was given Mecobalamin tablets 500ug, oral, three times a day; treatment based on the control group, the treatment group was treated with Yiqi Tongluo Decoction, daily after breakfast and after lunch each time. The course of treatment was 12 weeks. Two groups were compared before and after treatment of TCM syndrome integral, neural electrophysiology, blood rheology, difference of lipids and other indicators, analysis of efficacy and safety evaluation. Results: diabetic peripheral neuropathy 60 cases of patients with Qi deficiency and blood stasis, were randomly divided into 2 groups. The treatment group and the control group with 30 cases in each group, the two groups before treatment, no significant differences in gender, age and so on, have balanced comparability after treatment: comparison of syndrome curative effect: the total effective rate of treatment group was 76.60%, control group was 50%. The chi square test P0.05, shows that the treatment group than the control group; the clinical symptoms and score: the treatment group compared P0.05, control group P0.05 after treatment group P0.05, treatment group than the control group. The comparison of the nerve conduction velocity of left and right common peroneal nerve and left movement the right tibial nerve conduction velocity, the treatment group P0.05, control group P0.05 after treatment group P0.05, treatment group than the control group. The left and right peroneal nerve sensory conduction velocity, the treatment group compared P0.05 group than in control group, compared with the P0.05 group after treatment comparison between P0.0 5, that improve the nerve conduction velocity of two groups were similar. The effect of blood rheology comparison: whole blood reduction viscosity, high shear reduced viscosity, plasma viscosity, the treatment group P0.05, control group P0.05 after treatment group P0.05, treatment group than the control group. Erythrocyte aggregation index and erythrocyte deformation index, the treatment group P0.05, control group P0.05 after treatment, comparison between groups P0.05, indicating improvement in erythrocyte aggregation index, erythrocyte deformation index of the two groups. Compare the curative effect close blood fat, cholesterol and low density lipoprotein in the treatment group. Comparison of P0.05 and control group P0.05 after treatment group P0.05, treatment group than the control group. High density lipoprotein, triglyceride: treatment group P0.05, control group P0.05 after treatment between two groups of P0.05, said The improvement in HDL and triglycerides on the efficacy of the two groups were similar. Compared the safety of all patients during treatment were not found adverse events. The general physical examination, urine stool, ECG, liver and kidney function tests were normal. Conclusion: from the results of this study analysis, combination of Yiqi Huoxue Tongluo Decoction with Mecobalamin in treating diabetic peripheral neuropathy with Qi deficiency and blood stasis syndrome clinical curative effect, can significantly improve the patient's symptoms, and integral; in western medicine detection index, Yiqi Tongluo Decoction can improve nerve conduction velocity, hemorheology, blood lipid and so on. Its wide application prospect is safe and effective, which is worthy of further research.

【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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