硫辛酸联合中药足浴治疗血瘀型糖尿病周围神经病变的临床研究

发布时间：2018-03-08 13:55

本文选题：糖尿病周围神经病变　切入点：硫辛酸　出处：《湖北中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的观察硫辛酸联合中药足浴治疗血瘀型DPN的临床疗效,并探讨二者中西医结合治疗本病的作用机制和优势。方法选择收集2014年3月一2015年8月在武汉市第三医院中医科及内分泌科住院诊治的血瘀型DPN患者80例,随机分为2组(对照组、治疗组)。两组均行一般治疗,对照组行西药硫辛酸(600mg,配0.9%Na Cl250m L静脉滴注,每天1次)治疗;治疗组在对照组的基础上加用中药足浴,每天1次,两组疗程均为2周。分别记录两组患者治疗前后的FBG、2h PG、空腹C肽、餐后2h C肽、血脂四项、肱动脉收缩压、双侧胫后动脉及足背动脉收缩压、ABI、VPT、TCSS评分及临床症状积分,并对研究数据进行统计学分析。结果1、化验检查:(1)血糖、C肽:治疗后两组患者的FBG、2h PG、空腹C肽及餐后2h C肽与治疗前比较均无显著差异(P0.05)。(2)血脂四项:未服用降脂药的患者血脂四项在对照组中于治疗前后无显著差异(P0.05),治疗组中TC和LDL-L较治疗前明显下降,差异具统计学意义(P0.05);服用降脂药的患者对照组中TC及LDL-L较治疗前明显下降(P0.05),治疗组的血脂四项均较治疗前明显下降,差异具统计学意义(P0.05)。2、临床检查:(1)血压:两组患者的肱动脉收缩压、足背动脉收缩压及胫后动脉收缩压经治疗后均较治疗前明显下降,差异显著(P0.05),但治疗组下降程度明显优于对照组。(2)ABI:对照组治疗前后无明显变化(P0.05),而治疗组则下降明显,治疗前后差异显著(P0.05),且治疗组较多的患者ABI值恢复到正常。(3)VPT:对照组治疗前后无明显变化(P0.05),而治疗组治疗后较治疗前明显改善,有统计学意义(P0.01)。3、临床疗效分析:(1)DPN临床等级分布:对照组治疗前后其临床等级分布无明显变化(P0.05),而治疗组变化明显(P0.05),且治疗组较多患者向较轻的等级转变。(2)TCSS评分及临床症状总积分:治疗后两组患者的TCSS评分及临床症状总积分均较治疗前明显下降,差异显著(P0.01),但对照组的下降度不及治疗组明显。(3)主要单项症状:治疗后两组患者在四肢疼痛、麻木、发凉、肢软无力、感觉减退方面均有明显改善,治疗后症状积分明显下降,具统计学意义(P0.05),但治疗组有效率均明显高出对照组。(4)总体临床疗效:对照组与治疗组的临床总有效率分别为70.0%、92.5%,两组疗效比较差异显著(P0.05)。4、两组患者在治疗过程中均未见明显不良反应。结论1、硫辛酸联合中药足浴治疗能够改善血瘀型DPN患者的血脂(TC、LDL-L)、血压及ABI等,明显改善肢体血循环。2、硫辛酸联合中药足浴治疗能够明显改善血瘀型DPN患者的临床症状及体征,提高临床疗效,明显改善患者的生活质量。3、中药足浴简便、安全、经济、有效,联合西药治疗能显著提高治疗效果,且没有不良反应。
[Abstract]:Objective to observe the clinical effect of lipoic acid combined with traditional Chinese medicine foot bath in the treatment of blood stasis type DPN. Methods 80 cases of DPN with blood stasis were selected and collected from March 1st 2014 to August 2015 in the Department of traditional Chinese Medicine and Endocrinology Department of Wuhan third Hospital. They were randomly divided into two groups (control group, treatment group). The two groups were treated with general treatment. The control group received 600mg lipoic acid, combined with 0.9 Cl250m L intravenous drip once a day, and the treatment group was treated with traditional Chinese medicine foot bath once a day on the basis of the control group. The two groups were treated for 2 weeks. Before and after treatment, the FBGG 2h PGG, fasting C-peptide, postprandial C-peptide, four items of blood lipids, systolic blood pressure of brachial artery, systolic blood pressure of bilateral posterior tibial artery and dorsum pedis artery, TCSS score and clinical symptom score were recorded. The data of the study were analyzed statistically. Results 1. Blood glucose C peptide: FBG 2 h, fasting C peptide and postprandial 2 h C peptide in the two groups were not significantly different from those before treatment. In the control group, there was no significant difference in blood lipids before and after treatment. TC and LDL-L in the treatment group were significantly lower than those before treatment. The difference was statistically significant (P 0.05), TC and LDL-L in the control group were significantly lower than those before treatment, and the four items of blood lipids in the treatment group were significantly lower than those before treatment. Blood pressure: the systolic blood pressure of brachial artery, dorsalis pedis artery and posterior tibial artery were significantly decreased after treatment. The difference was significant (P 0.05), but the degree of decrease in the treatment group was significantly better than that in the control group. There was no significant change in the control group before and after treatment, but the decrease in the treatment group was significant. The difference was significant before and after treatment, and the ABI value of more patients in the treatment group returned to normal. There was no significant change in the control group before and after treatment, while in the treatment group, it was significantly improved after treatment. Clinical grade distribution: there was no significant change in clinical grade distribution before and after treatment in the control group, while in the treatment group, the change was significant (P 0.05), and more patients in the treatment group changed to a lighter grade. Total score of clinical symptoms: after treatment, the TCSS score and the total score of clinical symptoms of the two groups were significantly lower than those before treatment. The difference was significant (P 0.01), but the degree of decrease in the control group was not as obvious as that in the treatment group. The main single symptom was: after treatment, the patients in the two groups had obvious improvement in limb pain, numbness, cooling, weakness in limbs, weakness in limbs, and decrease in symptom score after treatment. The effective rate of the treatment group was significantly higher than that of the control group. The total clinical efficacy of the control group and the treatment group was 70.05 and 92.5, respectively. The difference between the two groups was significant (P0.05. 4) during the course of treatment, the total effective rate of the two groups was all significantly higher than that of the control group (P < 0.05), but the total effective rate of the treatment group was significantly higher than that of the control group (P < 0.05). Conclusion 1. Lipoic acid combined with traditional Chinese medicine foot bath therapy can improve the blood lipids, blood pressure and ABI in patients with blood stasis type DPN. The treatment with lipoic acid combined with traditional Chinese medicine foot bath can obviously improve the clinical symptoms and signs of DPN patients with blood stasis, improve the clinical efficacy, improve the quality of life of the patients, and improve the quality of life of the patients. The traditional Chinese medicine foot bath is simple, safe, economical and effective. Combination of western medicine can significantly improve the therapeutic effect, and there is no adverse reaction.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R587.2

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