本文關(guān)鍵詞：益氣通絡(luò)湯治療糖尿病周圍神經(jīng)病變氣虛血瘀證的臨床觀察　出處：《南京中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 糖尿病周圍神經(jīng)病變 氣虛血瘀證 益氣通絡(luò)湯 臨床研究

【摘要】：目的:采用臨床隨機對照研究方法,運用中醫(yī)學理論和現(xiàn)代檢查檢驗技術(shù),通過觀察益氣通絡(luò)湯治療糖尿病周圍神經(jīng)病變氣虛血瘀證患者的臨床療效,為治療糖尿病周圍神經(jīng)病變氣虛血瘀證提供有效方藥。方法:本研究將60例符合DPN的氣虛血瘀證分型的患者,隨機分為治療組和對照組,各30例。在控制血壓、血糖等一般治療基礎(chǔ)上,對照組給予甲鈷銨片500ug,口服,每日三次;在對照組的治療基礎(chǔ)上,治療組加用益氣通絡(luò)湯口服,每日早餐后及午餐后各一次。療程12周。對比兩組治療前后中醫(yī)證候積分、神經(jīng)電生理、血流變、血脂等指標差異,進行療效分析和安全性評估。結(jié)果:糖尿病周圍神經(jīng)病變氣虛血瘀證患者60例,隨機分為2組。治療組與對照組各30例,治療前兩組在性別、年齡等方面無顯著差異,具有均衡可比性。治療后:①證候療效比較:治療組總有效率為76.60%,對照組為50.00%,經(jīng)卡方檢驗P0.05,說明治療組優(yōu)于對照組;②臨床癥狀及積分比較:治療組組內(nèi)比較P0.05,對照組組內(nèi)比較P0.05,治療后組間比較P0.05,治療組療效優(yōu)于對照組。③神經(jīng)傳導速度比較:左、右腓總神經(jīng)及左、右脛神經(jīng)的運動傳導速度,治療組組內(nèi)比較P0.05,對照組組內(nèi)比較P0.05,治療后組間比較P0.05,治療組療效優(yōu)于對照組。左、右腓淺神經(jīng)的感覺傳導速度,治療組組內(nèi)比較P0.05,對照組組內(nèi)比較P0.05,治療后組間比較P0.05,說明在改善神經(jīng)感覺傳導速度方面兩組療效相近。④血液流變學比較:全血低切還原黏度、全血高切還原黏度、血漿黏度,治療組組內(nèi)比較P0.05,對照組組內(nèi)比較P0.05,治療后組間比較P0.05,治療組療效優(yōu)于對照組。紅細胞聚集指數(shù)和紅細胞變形指數(shù),治療組組內(nèi)比較P0.05,對照組組內(nèi)比較P0.05,治療后組間比較P0.05,說明在改善紅細胞聚集指數(shù)、紅細胞變形指數(shù)方面兩組療效相近。⑤血脂比較:膽固醇和低密度脂蛋白,治療組內(nèi)比較P0.05,對照組組內(nèi)比較P0.05,治療后組間比較P0.05,治療組療效優(yōu)于對照組。高密度脂蛋白、甘油三酯:治療組組內(nèi)比較P0.05,對照組組內(nèi)比較P0.05,治療后組間比較P0.05,說明在改善高密度脂蛋白及甘油三酯方面兩組療效相近。⑥安全性比較:所有病例在治療過程中均未發(fā)現(xiàn)不良反應(yīng)事件。一般體格檢查、血尿糞常規(guī)、心電圖、肝腎功能檢查均未見異常。結(jié)論:從本次研究結(jié)果分析,益氣活血通絡(luò)湯合用甲鈷銨治療糖尿病周圍神經(jīng)病變氣虛血瘀證,可明顯改善患者的臨床證候療效、癥狀及積分;在西醫(yī)學檢測指標方面,益氣通絡(luò)湯能夠改善神經(jīng)運動傳導速度、血液流變學、血脂等。其應(yīng)用前景廣泛且安全有效,值得進一步深入研究。
[Abstract]:Objective: a randomized controlled clinical research methods, theory and modern inspection technology used by Chinese medicine, to observe the clinical effect of Yiqi Tongluo Decoction in the treatment of diabetic peripheral neuropathy patients with Qi deficiency and blood stasis, provide effective prescriptions for the treatment of diabetic peripheral neuropathy with Qi deficiency and blood stasis syndrome. Methods: this study will be divided into type DPN 60 cases with Qi deficiency blood stasis syndrome patients were randomly divided into treatment group and control group, 30 cases in each group. In the control of blood pressure, blood sugar and so on the basis of general treatment, the control group was given Mecobalamin tablets 500ug, oral, three times a day; treatment based on the control group, the treatment group was treated with Yiqi Tongluo Decoction, daily after breakfast and after lunch each time. The course of treatment was 12 weeks. Two groups were compared before and after treatment of TCM syndrome integral, neural electrophysiology, blood rheology, difference of lipids and other indicators, analysis of efficacy and safety evaluation. Results: diabetic peripheral neuropathy 60 cases of patients with Qi deficiency and blood stasis, were randomly divided into 2 groups. The treatment group and the control group with 30 cases in each group, the two groups before treatment, no significant differences in gender, age and so on, have balanced comparability after treatment: comparison of syndrome curative effect: the total effective rate of treatment group was 76.60%, control group was 50%. The chi square test P0.05, shows that the treatment group than the control group; the clinical symptoms and score: the treatment group compared P0.05, control group P0.05 after treatment group P0.05, treatment group than the control group. The comparison of the nerve conduction velocity of left and right common peroneal nerve and left movement the right tibial nerve conduction velocity, the treatment group P0.05, control group P0.05 after treatment group P0.05, treatment group than the control group. The left and right peroneal nerve sensory conduction velocity, the treatment group compared P0.05 group than in control group, compared with the P0.05 group after treatment comparison between P0.0 5, that improve the nerve conduction velocity of two groups were similar. The effect of blood rheology comparison: whole blood reduction viscosity, high shear reduced viscosity, plasma viscosity, the treatment group P0.05, control group P0.05 after treatment group P0.05, treatment group than the control group. Erythrocyte aggregation index and erythrocyte deformation index, the treatment group P0.05, control group P0.05 after treatment, comparison between groups P0.05, indicating improvement in erythrocyte aggregation index, erythrocyte deformation index of the two groups. Compare the curative effect close blood fat, cholesterol and low density lipoprotein in the treatment group. Comparison of P0.05 and control group P0.05 after treatment group P0.05, treatment group than the control group. High density lipoprotein, triglyceride: treatment group P0.05, control group P0.05 after treatment between two groups of P0.05, said The improvement in HDL and triglycerides on the efficacy of the two groups were similar. Compared the safety of all patients during treatment were not found adverse events. The general physical examination, urine stool, ECG, liver and kidney function tests were normal. Conclusion: from the results of this study analysis, combination of Yiqi Huoxue Tongluo Decoction with Mecobalamin in treating diabetic peripheral neuropathy with Qi deficiency and blood stasis syndrome clinical curative effect, can significantly improve the patient's symptoms, and integral; in western medicine detection index, Yiqi Tongluo Decoction can improve nerve conduction velocity, hemorheology, blood lipid and so on. Its wide application prospect is safe and effective, which is worthy of further research.

【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

【參考文獻】

相關(guān)期刊論文 前10條

1 孫政華;邵晶;郭玫;;黨參化學成分及藥理作用研究進展[J];安徽農(nóng)業(yè)科學;2015年33期

2 陸小華;馬驍;王建;朱云;周宗元;陳哲;趙艷玲;王伽伯;;赤芍的化學成分和藥理作用研究進展[J];中草藥;2015年04期

3 趙云平;;丹紅注射液聯(lián)合西藥對糖尿病周圍神經(jīng)病變神經(jīng)傳導速度及神經(jīng)生長相關(guān)因子的影響觀察[J];世界中醫(yī)藥;2013年07期

4 扈曉佳;殷莎;袁婷婷;王玉玨;黃珍茹;陸陽;;紅花的化學成分及其藥理活性研究進展[J];藥學實踐雜志;2013年03期

5 謝寶強;周青美;;甲鈷胺與法舒地爾聯(lián)合治療糖尿病周圍神經(jīng)病變的療效[J];中國老年學雜志;2012年05期

6 鄭彩云;;茯苓多糖抗糖尿病作用的實驗研究[J];中國醫(yī)療前沿;2010年14期

7 王佳;劉銅華;;糖痹康對糖尿病大鼠血清神經(jīng)性因子及坐骨神經(jīng)神經(jīng)性因子基因表達的影響[J];中國實驗方劑學雜志;2010年06期

8 趙南南;;不同疾病狀態(tài)下各項血液流變學指標的異常變化[J];中國實用醫(yī)藥;2009年24期

9 王欽芳;劉雄;李兵;易珂;王默思;鄒巍;;中老年體檢者血液流變學檢測結(jié)果分析[J];西南國防醫(yī)藥;2009年03期

10 滿永;丁莉;國漢邦;王蕾;王抒;黎健;;丹參紅花提取物保護內(nèi)皮細胞免受氧化損傷的體外實驗[J];中國臨床康復;2006年39期

，

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