针刺与自拟方联合西药治疗糖尿病周围神经病变随机平行对照研究

[目的]观察针刺与自拟方联合西药治疗糖尿病周围神经病变疗效。[方法]使用随机平行对照方法,将76例门诊患者按就诊顺序编号法简单随机分为两组。对照组34例西医常规治疗,口服降糖药、饮食调理、胰岛素注射和合理运动等,将血糖控制在正常范围内后予以神经营养支持,口服维生素B1、维生素B12和地巴唑,药量根据患者病情决定。治疗组42例自拟方(山药10g,熟地黄、茯苓、黄芪各30g,天花粉20g,当归15g,葛根10g,川芎15g,泽泻、丹皮各12g,白芍15g,丹参20g、赤芍15g,木香10g;盗汗、烦热、失眠加黄柏10g,知母12g;畏寒恶冷、四肢欠温加淡附子3g,肉桂6g;肢体明显疼痛加乳香、没药各9g,延胡索炒15g;烦渴的加栀子、知母各2g),水煎200m L,早晚温服;西医常规治疗同对照组。连续治疗10d为1疗程。观测临床症状、空腹血糖、餐后2h血糖和糖化血红蛋白、正中神经和腓总神经传导速度、不良反应。连续治疗6疗程,判定疗效。[结果]治疗组显效25例,有效15例,无效2例,总有效率为95.24%。对照组显效15例,有效13例,无效6例,总有效率为82.35%。治疗组疗效优于对照组(P0.05)。两组血糖控制疗效均有改善(P0.05),治疗组优于对照组(P0.05)。两组正中神经和腓总神经传导速度均有改善(P0.05),治疗组优于对照组(P0.05)。[结论]针刺与自拟方联合西药治疗糖尿病周围神经病变,疗效满意,无严重不良反应,值得推广。

Acupuncture and Self-developed TCM Decoction combined with Western Medicine in Treating Diabetic Peripheral Neuropathy Randomized Parallel Controlled Study

[Objective] To observe the effects of acupuncture and Self-developed TCM decoction combined with western medicine curative effect in the treatment of diabetic peripheral neuropathy. [Method] Us ing random parallel control method, 76 outpatients according to visit order numbering method of simple random divided into two groups. Routine treatment group 34 cases in western medicine, oral hypoglycemic drugs, diet, insulin injection and reasonable exercise, blood glucose control to neural nutrition support in the normal range, oral administration of vitamin B1, vitamin B12 and Dibazol, charge according to patients condition decision. The treatment group of 42 cases Self-developed TCM decoction（yam 10 g,prepared rehmannia root, Poria, Radix Astragali Radix trichosanthis each 30 g, 20 g, 15 g of angelica, Pueraria 10 g,Chuanxiong 15 g, Oriental waterplantain rhizome, Moutan each 12 g, Radix Paeoniae Alba, Radix Paeoniae Rubra 15 g 20g 15 g, radix salviae miltiorrhizae, Radix Aucklandiae 10g; sweating, insomnia Fanre, plus 10 g Huangbai,Anemarrhena 12g; cold evil cold, limbs owe vinga light monkshood 3G, cinnamon 6G; limb pain plus frankincense,myrrh was the 9g, corydalis speculation 15g; polydipsia Ka Ko, each 2G）, Rhizoma Anemarrhenae Decoction 200 m L,morning and evening clothes; conventional treatment of Western medicine with the control group. Continuous treatment with 10 d for 1 courses. The clinical symptoms, blood biochemical indexes of observation（fasting blood glucose, 2h postprandial blood glucose and glycosylated hemoglobin）, median nerve and common peroneal nerve conduction velocity, adverse reaction. Continuous treatment of 6 courses of treatment, curative effect. 25 cases of the treatment group produce. [Results] Effective 15 cases, invalid 2 cases, the total effective rate was 95.24%. The control group of 15 cases markedly effective, effective 13 cases, invalid 6 cases, the total effective rate was 82.35%.The efficacy of the treatment group was better than that of the control group（P 〈 0.05）