糖尿病周围神经病变中医辨证与电生理所见的关系

作者	单位
高长玉	河北医科大学第二医院石家庄050000
段伟松	河北医科大学第二医院石家庄050000
潘栓珍	河北医科大学第二医院石家庄050000
王淑英	河北医科大学第二医院石家庄050000
常庚	河北医科大学第二医院石家庄050000
张艳景	河北医科大学第二医院石家庄050000
杨东宁	河北医科大学第二医院石家庄050000

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中文摘要:

目的探讨糖尿病周围神经病变中医证候与电生理的关系。方法选择87例糖尿病周围神经病变患者,按中医辨证标准进行中医辨证,应用丹麦产DANTEC CANTATA型肌电图仪,采用表面电极测定腓总神经运动传导速度(MCV)和腓肠神经感觉传导速度(SCV)。结果阳虚证患者腓总神经MCV最慢,明显低于气虚证、热证、血瘀证和湿证(P<0.05);复合肌肉动作电位波幅(CMAP)最低,明显低于气虚证、热证和湿证(P<0.05)。阳虚证患者腓肠神经SCV亦最慢,感觉神经动作电位波幅(SNAP)亦最低,均明显低于气虚证、热证、阴虚证、血瘀证和湿证(P<0.05)。结论糖尿病周围神经病变患者中医辨证阳虚证的运动感觉传导速度异常最明显。神经传导速度异常可以作为糖尿病周围神经病变阳虚证的参考指标。

英文摘要:

Objective To study the relationship between TCM syndrome type and electrophysiological changes of nerves in patients with peripheral diabetic neuropathy (PDN). Methods TCM syndrome differentiation of 87 patients with PDN were performed, and the sensory nerve conduction velocity (SCV) of common peroneal nerve and the motor nerve conduction velocity (MCV) of sural nerve were measured as well using surface electrodes. Results Patients of yang-deficiency type showed the slowest MCV and SCV as well as the lowest compound muscular action potential (CMAP) and sensory nerve action potential (SNAP), with significant difference as compared with those in patients of qi-insufficiency type, heat type, and dampness type, respectively; also significant slower MCV and SCV and lower SNAP than those in patients with blood stasis type. Besides, the SCV and SNAP level in patients with yang-deficiency type were lower as compared with those in patients with yin-deficiency type (all P<0.05). Conclusion Obvious changes of MCV and SCV could be found in PDN patients of TCM yang-deficiency syndrome, so the abnormal velocity of nerve conduction could be taken as a referential index for diagnosis of patients belonging to that type.

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