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目的观察自拟化湿活血汤、甲钴胺、前列地尔联合治疗2型糖尿病下肢周围神经病变(DPN)临床疗效。方法选择汕头市潮阳区大峰医院2014年1月—2015年12月收治的86例2型糖尿病下肢周围神经病变患者作为研究对象,随机分为研究组(43例)和对照组(43例),对照组采用甲钴胺、前列地尔联合治疗,研究组在对照组的基础上再口服自拟化湿活血汤,两组均治疗2周,观察两组患者治疗前后症状体征改善情况,进行血液流变学及血脂指标检测,采用丹麦DISA1500型肌电图仪测定运动传导速度(MNCV)和感觉传导速度(SNCV)。采用SPSS19.0统计软件进行统计分析,计量资料用均数±标准差(xˉ±s)表示,采用t检验,计数资料用率(%)表示,采用χ2检验,P<0.05为差异有统计学意义。结果研究组的麻木、疼痛、感觉障碍、腱反射异常改善效果均明显优于对照组(P<0.05)。与本组治疗前比较,两组治疗后全血黏度、血浆黏度、总胆固醇、甘油三酯均明显下降(P<0.05);与对照组比较,研究组治疗后全血黏度、血浆黏度、总胆固醇、甘油三酯明显低于对照组(P<0.05)。与本组治疗前比较,两组治疗后正中神经、腓总神经的MNCV和正中神经、腓总神经的SNCV均显著升高(P<0.05);与对照组比较,研究组治疗后正中神经、腓总神经的MNCV和正中神经、腓总神经的SNCV均明显高于对照组(P<0.05)。结论自拟化湿活血汤、甲钴胺、前列地尔联合疗法是治疗2型糖尿病下肢周围神经病变的安全有效方法,能有效改善症状体征,提高神经传导速度,作用机制可能与其改善脂代谢及血液循环有关。
Objective To observe the curative effect of self-made Huashi Huoxue Decoction, mecobalamin and alprostadil in the treatment of type 2 diabetes mellitus (DPN) with peripheral neuropathy. Methods 86 patients with peripheral neuropathy of type 2 diabetes mellitus who were admitted to Dafeng Hospital, Chaoyang District, Shantou from January 2014 to December 2015 were randomly divided into study group (43 cases) and control group (43 cases) The control group was treated with mecobalamin and alprostadil. The study group was orally administered with Huashi Huoxue Decoction orally on the basis of the control group. Both groups were treated for 2 weeks. The improvement of the symptoms and signs before and after treatment in both groups were observed, Rheology and lipids were measured. The Danish DISA1500 electromyography was used to measure the motor conduction velocity (MNCV) and sensory conduction velocity (SNCV). Using SPSS19.0 statistical software for statistical analysis, measurement data with mean ± standard deviation (x ˉ ± s), using t test, the count data (%) that the use of χ2 test, P <0.05 was statistically significant significance. Results The numbness, pain, sensory disturbances and tendon reflexes in the study group were significantly better than those in the control group (P <0.05). Compared with the control group before treatment, the whole blood viscosity, plasma viscosity, total cholesterol and triglyceride were significantly decreased after treatment (P <0.05). Compared with the control group, the whole blood viscosity, plasma viscosity, total plasma Cholesterol, triglyceride was significantly lower than the control group (P <0.05). Compared with the group before treatment, the median nerve, peroneal nerve MNCV and median nerve, common peroneal nerve SNCV were significantly increased in both groups after treatment (P <0.05); compared with the control group, the study group after treatment, median nerve, The peroneal nerve of MNCV and median nerve, common peroneal nerve SNCV were significantly higher than the control group (P <0.05). Conclusion Combination of Huashi Huoxue Decoction, mecobalamin and alprostadil is a safe and effective method for the treatment of peripheral neuropathy of lower extremity in type 2 diabetes mellitus, which can effectively improve the symptoms and signs and improve the nerve conduction velocity. The mechanism may be related to the improvement of lipid metabolism and Blood circulation related.