改良升降散治疗糖尿病周围神经病变络热血瘀证的临床研究

发布时间：2018-10-30 20:28

【摘要】：目的：观察改良升降散对糖尿病周围神经病变(DPN)络热血瘀证患者的临床疗效,探讨中药改良升降散的作用机制。方法：根据随机对照原则将有效病例65例,随机分为2组,即治疗组33例和对照组32例,分别予改良升降散联合甲钴胺片、甲钴胺片单独治疗,每4周为1个疗程,持续观察3个月,观察治疗前后患者中医证候积分的改善情况；检测治疗前后患者的空腹血糖(FBG)、餐后血糖(PBG)及糖化血糖蛋白(HBA1c).甘油三酯(TG)、总胆固醇(TC)、神经元特异性烯醇化酶(NSE)、血清胱抑素C (Cys-C)、C反应蛋白(CRP)、神经传导速度水平。结果：(1)总体疗效：治疗组总有效率为81.82%,对照组为62.50%。两组组间比较有统计学差异(P0.05)；(2)中医证候积分：治疗后两组中医证候积分均显著下降(P0.01),治疗组下降比对照组更明显,差异有统计学意义(P0.05)；(3)Toronto积分：治疗后两组Toronto积分均显著下降(P0.01),治疗组下降比对照组更明显,差异有统计学意义(P0.05)；(4)糖代谢相关指标：治疗后两组FBG、PBG、HbA1c均较治疗前明显改善,有统计学差异(P0.05)；组间比较,治疗组优于对照组,有统计学意义(P0.05)；(5)脂代谢相关指标：治疗后两组TG、TC无统计学差异(P0.05);组间比较也无统计学差异(P0.05)；(6)NSE、Cys-C、CRP指标：治疗后Cys-C、CRP指标较前改善(P0.05),治疗组NSE指标较前改善明显(P0.01)；组间比较,治疗组均优于对照组(P0.05)；(7)神经传导速度：治疗组与对照组的神经传导速度均显著提高(P0.01),治疗组提高比对照组更明显,差异有统计学意义(P0.05)。结论：中药改良升降散治疗糖尿病周围神经病变络热血瘀型患者有一定疗效,可缓解患者临床症状和体征,调节糖代谢,降低NSE、Cys-C、CRP水平,提高神经传导速度。治疗期间未见不良反应,值得进一步研究。
[Abstract]:Objective: to observe the clinical effect of modified Shengsheng Powder on patients with (DPN) syndrome of collateral heat and blood stasis in diabetic peripheral neuropathy and to explore the mechanism of modified Shengshang Powder. Methods: according to the principle of randomized control, 65 effective cases were randomly divided into two groups: treatment group (n = 33) and control group (n = 32). Observe continuously for 3 months, observe the improvement of TCM syndrome integral before and after treatment; Fasting blood glucose (FBG), postprandial blood glucose (PBG) and glycosylated glucose protein (HBA1c) were measured before and after treatment. Triglyceride (TG), total cholesterol (TC), neuron specific enolase (NSE), serum cystatin C (Cys-C), C reactive protein (CRP),) nerve conduction velocity level. Results: (1) the total effective rate was 81.82 in the treatment group and 62.50 in the control group. There was statistical difference between the two groups (P0.05); (2) TCM syndrome score: after treatment, the TCM syndromes score of the two groups were significantly decreased (P0.01), the treatment group was more obvious than the control group, the difference was statistically significant (P0.05); (3) Toronto integral: after treatment, the Toronto score of the two groups decreased significantly (P0.01), the decrease of the treatment group was more obvious than that of the control group, the difference was statistically significant (P0.05); (4) related indexes of glucose metabolism: after treatment, FBG,PBG,HbA1c in the two groups were significantly improved compared with those before treatment (P0.05), and the treatment group was better than the control group (P0.05). (5) related indexes of lipid metabolism: there was no significant difference in TG,TC between the two groups after treatment (P0.05), and there was no statistical difference between the two groups (P0.05). (6) NSE,Cys-C,CRP: the Cys-C,CRP index was improved after treatment (P0.05), the NSE index of the treatment group was improved obviously (P0.01), the treatment group was superior to the control group (P0.05). (7) nerve conduction velocity: the nerve conduction velocity of the treatment group and the control group were significantly increased (P0.01), the improvement of the treatment group was more obvious than that of the control group, the difference was statistically significant (P0.05). Conclusion: modified Shengshang Powder has a certain curative effect on patients with diabetic peripheral neuropathy with collateral heat and blood stasis. It can relieve clinical symptoms and signs, regulate glucose metabolism, reduce NSE,Cys-C,CRP level and increase nerve conduction velocity. There was no adverse reaction during treatment, and it is worth further study.
【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】：2016
【分类号】：R259

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