黄芪桂枝五物汤加减治疗糖尿病周围神经病变疗效观察

目的:评价黄芪桂枝五物汤加减治疗糖尿病周围神经病变的(DPN)临床疗效。方法:将符合纳入标准的160例DPN患者以随机数字表法分为观察组和对照组各80例,两组均给予常规治疗,对照组在常规治疗基础上给予依帕司他片+贝前列素钠片,观察组在常规治疗基础上给予黄芪桂枝五物汤加减,两组均治疗6个月;观察比较治疗前后两组中医症状评分、多伦多临床评分系统(TCSS)评分、血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、神经生长因子水平及神经传导速度。结果:两组治疗后中医症状评分均低于治疗前(P0.05),且观察组低于对照组(P0.05);治疗后两组TCSS评分及血清IL-6、TNF-α水平均较治疗前降低(P0.05),且观察组低于对照组(P0.05);在神经生长因子水平上,治疗后两组血管内皮生长因子(VEGF)、人脑源性神经营养因子(BDNF)高于治疗前(P0.05),人磷髓脂碱性蛋白(MBP)低于治疗前(P0.05),且观察组表现均优于对照组(P0.05);在神经传导速度方面,治疗后两组运动神经传导速度(MCV)、感觉神经传导速度(SCV)均高于治疗前(P0.05),且观察组高于对照组(P0.05)。结论:黄芪桂枝五物汤加减能够明显改善DPN临床症状,降低血清IL-6、TNF-α水平,提高神经传导速度及神经相关生长因子水平。

Therapeutic Effects of Huangqi Guizhi Wuwu Decoction in Treating Diabetic Peripheral Neuropathy

Objective:To evaluate the clinical therapeutic effects of Huangqi Guizhi Wuwu Decoction in treating diabetic peripheral neuropathy(DPN).Methods:Total 160 patients with DPN according with the inclusion criteria were selected and divided into the observation group and the control group according to random number table,with 80 cases in each group. Both groups were treated with conventional western medicine,the control group was given ipastat tablets and beprost sodium tablets on the basis of conventional treatment while the observation group was given Huangqi Guizhi Wuwu Decoction on the basis of conventional treatment. Both groups received a course of treatment for 6 months. The TCM symptoms,TCSS score,serum IL-6,TNF-α level,nerve conduction velocity and nerve growth factor level of patients in the two groups after one course of treatment were observed and compared. Results:After treatment,the TCM symptom evaluation of patients in both groups was lower than that before treatment(P< 0.05),the observation group was lower than the control group(P< 0.05). TCSS scores,serum IL-6 and TNF-α levels in the two groups were lower than those before treatment(P< 0.05),and the observation group was lower than the control group(P< 0.05). At the nerve growth factor levels,VEGF and BDNF were higher in the two groups af ter treatment than those before treatment(P< 0.05),MBP was lower than that before treatment(P< 0.05),the observation group was lower than the control group(P< 0.05). After treatment,the motor nerve conduction velocity(MCV) and sensory nerve conduction velocity(SCV) of the two groups were higher than those before treatment(P< 0.05),the observation group was higher than the control group(P< 0.05). Conclusions:Huangqi Guizhi Wuwu Decoction can significantly improve the clinical symptoms of DPN,increase nerve conduction speed and nerve related growth factor,reduce serum IL-6 and TNF-α levels.