当归四逆汤对糖尿病周围神经病变神经传导速度及AEGs、Cys-C、Hcy 水平的影响

目的：探讨当归四逆汤对糖尿病周围神经病变（Diabetic Peripheral Neuropathy，DPN）神经传导速度（Nerve Conduction Velocity，NVC）及晚期糖基化终末产物（Advanced Glycationend Products，AGEs）、胱抑素C（Cystatin C，Cys-C）及同型半胱氨酸（Homocysteine，Hcy）水平的影响。方法：选取我院2015年3月-2017年1月收治的78例DPN患者，采用随机数字表法均分为两组。两组均采取相同的基础治疗措施，对照组在此基础上予以甲钴胺片治疗，观察组在对照组基础上给予当归四逆汤治疗。记录比较两组中医证候疗效、治疗前后多伦多临床评分系统（Toronto Clinical Scoring System，TCSS）评分、血清氧化-抗氧化水平变化神经传导速度及血清AEGs、Cys-C、Hcy水平变化情况，并评价两组用药安全性。结果：治疗4周后，观察组总有效率为89.7%明显高于对照组的71.8%（χ2 = 4.044，P < 0.05）。与本组治疗前对比，两组治疗4周后腓总神经与正中神经的感觉神经传导速度（Sensory Nerve Conduction Velocity，SNCV）与运动神经传导速度（Motor Nerve Conduction Velocity，MNCV）值均显著提高（t = 11.475、11.162、11.032、8.008，P < 0.01）；且观察组治疗4周后神经传导速度的改善效果均显著优于对照组同期（t = 5.582、5.837、6.918、3.635，P < 0.01）。两组治疗4周后TCSS评分及血清AEGs、Cys-C、Hcy水平均显著低于治疗前（t = 11.831、32.106、15.972，P < 0.01）；且与对照组同期相比，观察组治疗4周后TCSS评分及血清AEGs、Cys-C、Hcy水平的改善效果均更为显著（t = 6.473、21.999、7.973，P < 0.01）。两组均未出现明显不良反应。结论：DPN患者应用当归四逆汤治疗更能有效缓解临床症状与体征，提高神经传导速度，降低AEGs水平，改善微循环，疗效显著且安全性高。

Effects of Angelica Four Decoction on Nerve Conduction Velocity and AEGs, Cys-C and Hcy Levels in Patients with Diabetic Peripheral Neuropathy

To investigate the influence of Angelica Four Inverse Decoction on diabetic peripheral neuropathy (DPN)nerve conduction velocity and advanced glycation end products (AEGs), Cystatin C (Cys-C) and homocysteine (Hcy)levels, 78 cases of DPN patients admitted in our hospital from March 2015 to January 2017 were selected and dividedinto two groups by random number table method. The two groups adopted the same basic treatment, on the basis of which,the control group was added mecobalamin tablets treatment, while the observation group was given Angelica Four InverseDecoction. The curative effect of Chinese medicine syndrome, the scores of toronto clinical scoring system (TCSS), nerveconduction velocity and the change of serum AEGs, Cys-C and Hcy levels before and after treatment were recorded andcompared between the two groups and then the safety of medicine were evaluated between the two groups. 4 weeks afterthe treatment, the total effective rate of the observation group was 89.7%, significantly higher than 71.8% of the controlgroup (P < 0.05). Compared with those before receiving treatment, the SNCV and MNCV values of the common peronealnerve and median nerve both significantly increased in the two groups 4 weeks after the treatment (P < 0.01); theimprovement of nerve conduction velocity of the observation group was significantly better than that of the control group(P < 0.01). 4 weeks after the treatment, TCSS score and serum AEGs, Cys-C, Hcy levels were all significantly lower thanthose before receiving the treatment in the two groups (P < 0.01); compared with that of the control group in the sametime period, the improvement effect of TCSS score and serum AEGs, Cys-C, Hcy levels were more significant in theobservation group 4 weeks after the treatment (P < 0.01). There were no obvious adverse reactions in the two groups. As aresult, Angelica Four Inverse Decoction applied to DPN patients can more effectively relieve clinical symptoms andsigns, improve nerve conduction velocity, reduce the level of AEGs, and improve microcirculation with remarkablecurative effect and high safety.