桂枝茯苓丸加减结合西医常规疗法治疗2型糖尿病周围神经病变临床研究

目的：评价桂枝茯苓丸加减结合西医常规疗法治疗T2DM合并DPN患者的疗效。方法将78例DPN患者按随机数字表法分为治疗组40例，对照组38例。对照组在常规治疗基础上口服甲钴胺片，治疗组在对照组基础上服用桂枝茯苓丸加减。2组均治疗2周。检测患者治疗前后血清同型半胱氨酸水平(homocysteine, Hcy)及运动神经传导速度(motor nerve conduction velocity, MNCV)和感觉神经传导速度(sensory nerve conduction velocity, SNCV)，采用多伦多神经病变评分(Toronto clinical scoring system, TCSS)评价疗效。结果治疗组总有效率为95.0%(38/40)、对照组为76.3%(29/38)，2组比较差异有统计学意义(χ2＝5.616，P＝0.018)。治疗后，治疗组MNCV中腓总神经(46.1±6.3)m/s比(42.5±5.5)m/s，t＝2.734]、正中神经(49.8±5.2)m/s 比(46.3±5.9)m/s ， t＝2.607]，以及 SNCV 中腓总神经(38.5±4.6)m/s 比(35.4±4.3)m/s，t＝3.105]、正中神经(45.3±5.2)m/s 比(42.3±4.8)m/s，t＝2.627]的传导速度均快于对照组(P＜0.05)；治疗组TCSS评分(5.3±3.1)分比(7.2±2.9)分，t＝2.823]及血清Hcy水平(13.3±3.2)μmol/L比(17.1±3.4)μmol/L，t＝5.178]低于对照组(P＜0.05)。结论桂枝茯苓丸加减结合西医常规疗法可提高DPN患者神经传导速度，降低Hcy水平，提高临床疗效。

Guizhi-Fuling Pill combined with conventional western medicine therapy for diabetic peripheral neuropathy

Objective To evaluate the therapeutic effect ofGuizhi-Fuling Pill combined with conventional western medicine therapy for diabetic peripheral neuropathy (DPN).Methods A total of 78 patients with DNP were randomly divided into treatment group (40 patients) and control group (38 patients).The patients in the control group were administrated with mecobalamin on the basis of conventional treatment. In addition to the therapy of control group,patients in treatment group were givenGuizhi-Fuling Pill. The patients in both groups were treated for 2 weeks.The level of homocysteine (Hcy) and sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) in both groups were measured. Toronto clinical scoring system (TCSS) was used to evaluate the curative effect.Results The total effect rate in the treatment group was significantly higher than that in the control group (95.0%vs. 76.3%;χ2=5.616,P=0.018). After treatment, the MNCV of common peroneal nerve (46.1 ± 6.3 m/svs.42.5 ± 5.5 m/s;t=2.734,P<0.01 ), MNCV of median nerve (49.8 ± 5.2 m/svs.46.3 ± 5.9 m/s;t=2.607,P<0.05 ), SNCV of common peroneal nerve (38.5 ± 4.6 m/s vs. 35.4 ± 4.3 m/s;t=3.105,P<0.05 ), SNCV of median nerve (45.3 ± 5.2 m/svs. 42.3 ± 4.8 m/s;t=2.627, P<0.05 ) in the treatment group were significantly increased than those in the control group. The integral of TCSS (5.3 ± 3.1vs. 7.2 ± 2.9;t=2.823,P<0.01) and the level of Hcy (13.3 ± 3.2 μmol/Lvs. 17.1 ± 3.4 μmol/L;t=5.178, P<0.05) were significantly lower in treatment group than those in control group (P<0.05).Conclusions The Guizhi-Fuling Pill combined with conventional western medicine therapy could improve MNCV and SNCV and reduce the level of Hcy and improve the clinical effect.