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目的:观察中西医结合疗法治疗糖尿病患者周围神经病变的疗效。方法:选取本院2011年5月~2013年9月收治的120例符合气虚血瘀型糖尿病周围神经病变的患者,随机分为治疗组和对照组各60例,对照组采用甲钴胺、硫酸锌、法舒地尔方案进行治疗,治疗组在对照组基础上加用中药方剂益气活血通络汤进行治疗。观察2组患者治疗4周后周围神经评分、疗效、患者满意度等指标的差异。结果:治疗前2组神经症状评分、神经缺陷评分比较,差异均无显著性意义(P>0.05);治疗后2组患者的神经症状评分、神经缺陷评分较治疗前均显著好转,差异均有显著性意义(P<0.05),治疗组治疗后的神经症状评分、神经缺陷评分显著优于对照组,差异均有显著性意义(P<0.05)。治疗前2组中医证候积分比较,差异均无显著性意义(P>0.05);治疗后2组患者的中医证候积分较治疗前均显著好转,差异均有显著性意义(P<0.05),治疗组治疗后中医证候积分显著优于对照组,差异均有显著性意义(P<0.05)。治疗前2组胫神经、腓总神经、腓肠神经传导速度比较,差异均无显著性意义(P>0.05);治疗后2组患者的胫神经、腓总神经、腓肠神经传导速度较治疗前均显著好转,差异均有显著性意义(P<0.05),治疗组治疗后的胫神经、腓总神经、腓肠神经传导速度显著优于对照组,差异均有显著性意义(P<0.05)。治疗前2组的满意度3个维度比较,差异均无显著性意义(P>0.05);治疗后2组患者的满意度3个维度较治疗前均显著好转,差异均有显著性意义(P<0.05),治疗组治疗后的满意度3个维度显著优于对照组,差异均有显著性意义(P<0.05)。治疗后,治疗组的疗效分布显著优于对照组,差异有显著性意义(P<0.05)。结论:采用中西医结合疗法治疗糖尿病患者周围神经病变较单用西医疗法具有更显著的临床效果,值得临床应用推广。
Objective: To observe the curative effect of integrated traditional Chinese and western medicine on peripheral neuropathy in diabetic patients. Methods: From January 2011 to September 2013 in our hospital, 120 cases of diabetic peripheral neuropathy with deficiency of Qi and blood stasis were randomly divided into treatment group (60 cases) and control group (60 cases). The control group was treated with methylcobalamin, Zinc, Fasudil solution for treatment, the treatment group on the basis of the control group plus Chinese medicine prescription Yiqi Huoxue Tongluo Decoction for treatment. The differences of peripheral nerve score, curative effect, patient satisfaction and other indexes were observed after 2 weeks of treatment. Results: There was no significant difference in neurological symptom scores and neurological deficit scores between the two groups before treatment (P> 0.05). Neurological symptom scores and neurological deficit scores of two groups were significantly improved after treatment (P <0.05). The score of neurological symptoms and neurological deficit scores of the treatment group after treatment were significantly better than those of the control group (P <0.05). There was no significant difference in the TCM syndrome scores between the two groups before treatment (P> 0.05). After treatment, the scores of TCM syndromes in both groups were significantly improved compared with those before treatment (P <0.05) , The treatment group after treatment TCM syndrome score was significantly better than the control group, the difference was significant (P <0.05). There was no significant difference in the conduction velocity between tibial nerve, common peroneal nerve and sural nerve between the two groups before treatment (P> 0.05). The conduction velocity of tibial nerve, common peroneal nerve and sural nerve in the two groups after treatment was significantly higher than that of treatment (P <0.05). The conduction velocity of the tibial nerve, common peroneal nerve and sural nerve in the treatment group was significantly better than that in the control group (P <0.05), and the difference was significant ). There was no significant difference in the three dimensions of satisfaction between the two groups before treatment (P> 0.05). After treatment, the three dimensions of satisfaction in two groups were significantly improved compared with that before treatment (P <0.05). The three dimensions of satisfaction in the treatment group were significantly better than those in the control group, the differences were significant (P <0.05). After treatment, the curative effect of the treatment group was significantly better than that of the control group, the difference was significant (P <0.05). Conclusion: The combination of TCM and Western medicine treatment of peripheral neuropathy in patients with diabetes than Western medicine alone has more significant clinical effect, it is worth promoting the clinical application.