脑心通及弥可保干预对不同中医证型糖尿病周围神经病变电生理的影响

Electrophysiological Changes in Diabetic Peripheral Neuropathy Patients of Different Chinese Medicine Syndrome Types Intervened by Naoxintong and Mecobalamin

免费下载全文查看/发表评论下载PDF阅读器

DOI：

中文关键词: 糖尿病周围神经病变中医辨证神经电生理脑心通弥可保

英文关键词:diabetic peripheral neuropathy Chinese medicine syndrome differentiation neuroelectrophysiology Naoxintong mecobalamin

基金项目:

作者	单位
王燕萍	福建医科大学附属协和医院内分泌科
潘晓东	福建医科大学附属协和医院神经内科
毛小红	福建医科大学附属协和医院中医科
刘礼斌	福建医科大学附属协和医院内分泌科
黄培基	福建医科大学附属协和医院内分泌科
黄华品	福建医科大学附属协和医院神经内科
陈瑶	福建医科大学附属协和医院内分泌科

摘要点击次数: 1661

全文下载次数: 4

中文摘要:

目的通过对糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的中医辨证分型,探讨脑心通及弥可保(甲钴胺)对其干预效果。方法 180例DPN患者,中医辨证分为5型,应用脑心通(脑心通组)、弥可保(弥可保组)及脑心通联合弥可保组(联合组)干预,均4周为1个疗程,共3个疗程,通过临床评分、神经电生理和血管内径超声检查评估其疗效。结果 (1)肝肾亏虚型运动神经传导速度较其他证型明显减慢(P<0.01),肝肾亏虚型及阳虚血瘀型F-波潜伏期较其他证型明显延长(P<0.01),气虚血瘀型及痰瘀阻络型皮肤交感反射潜伏期较其他证型明显延长(P<0.01)。(2)3组干预在气虚血瘀型(χ2=7.112,P<0.05)和肝肾亏虚型(χ2=6.667,P<0.05)的疗效比较中差异有统计学意义;其中脑心通组对气虚血瘀型的总有效率达87.5%,显效率达43.8%(P<0.05);弥可保组对肝肾亏虚型总有效率达100.0%、显效率达50%(P<0.05);联合组治疗在气虚血瘀型、阴虚血瘀型、痰瘀阻络型、阳虚血瘀型、肝肾亏虚型疗效的总有效率分别为92.9%、83.3%、81.8%、81.8%和75.0%。(3)脑心通与弥可保对各中医证型的运动和感觉传导有改善作用(P<0.05);弥可保对皮肤交感反射改善作用明显(P<0.05);联合组对各证型神经电生理指标均有改善作用(P<0.05),对胫前动脉内径也有改善(P<0.05)。结论结合中医辨证分型,脑心通对气虚血瘀型的DPN疗效较好,脑心通联合弥可保干预有助于改善各证型的DPN。

英文摘要:

Objective To investigate the intervention of Naoxintong and mecobalamin on electrophysiological changes in diabetic peripheral neuropathy (DPN) of different Chinese medicine (CM) syndrome types.Methods According to syndrome differentiation,180 patients with DPN were classified as five syndrome types.And they were treated with Naoxintong (Group A),mecobalamin (Group B),and Naoxintong+mecobalamin (Group C).Four weeks was taken as one therapeutic course,and totally three courses.Their efficacies were assessed using clinical scoring,electrophysiological examinations,and ultrasonic examinations of the blood vessel inner diameter.Results (1) The motor nerve conduction velocity was obviously slowed down in the Gan-Shen deficiency syndrome (P<0.01).F-wave latency was obviously prolonged in the Gan-Shen deficiency syndrome and yang deficiency blood stasis syndrome (P<0.01).The skin sympathetic reflex latency was obviously prolonged in the qi deficiency blood stasis syndrome and phlegm stagnation collateral obstruction syndrome (P<0.01).(2) Statistical difference existed in the three groups of qi deficiency blood stasis syndrome (χ2=7.112,P<0.05) and Gan-Shen deficiency syndrome (χ2=6.667,P<0.05).Of them,the total effective rate of qi deficiency blood stasis syndrome was 87.5% and the markedly effective rate 43.8% in Group A (P<0.05).The total effective rate of Gan-Shen deficiency syndrome was 100.0% and the markedly effective rate 50.0% in Group B (P<0.05).The total effective rate of qi deficiency blood stasis syndrome,yin deficiency blood stasis syndrome,phlegm stagnation collateral obstruction syndrome,yang deficiency blood stasis syndrome,and Gan-Shen deficiency syndrome was respectively 92.9%,83.3%,81.8%,81.8%,and 75.0% in Group C.(3) Naoxintong and mecobalamin had some improvement of motor and sensory conduction of each CM syndrome type (P<0.05).Mecobalamin showed obvious effect on the skin sympathetic reflection (P<0.05).The nerve electrophysiological index of each syndrome types as well as the diameter of arteriae tibialis anterior could be improved in Group C (P<0.05).Conclusions Naoxintong gained better effect in treatment of DPN patients of qi deficiency blood stasis syndrome by syndrome typing.Naoxintong combined with mecobalamin could be helpful for ameliorating DPN patients of each syndrome.

关闭