【摘要】：目的:探究中醫(yī)中藥于糖尿病周圍神經(jīng)病變(Diabetic peripheral neuropathy,DPN)的認識。通過隨機對照法,進一步考證祛胰抵方對本病的療效并通過檢測患者血同型半胱氨酸(homocysteine,Hcy)含量,探其機理,評價其安全性,為日后運用祛胰抵方醫(yī)治氣陰兩虛兼痰瘀阻絡(luò)型DPN論述新的證據(jù)。方法:募集氣陰兩虛、痰瘀阻絡(luò)型DPN確診患者70例,按照隨機對照原則分為治療組(n=35)和對照組(n=35)。兩組患者基礎(chǔ)治療方案一致。其中治療組服用祛胰抵方300ml日一劑,水煎早晚各150ml溫服,并加服甲鈷胺片,0.5毫克,3次/日;對照組服用甲鈷胺片,0.5毫克,3次/日。兩組連續(xù)治療12周。試驗前后分別察看患者的神經(jīng)傳導(dǎo)速度以及血同型半胱氨酸。結(jié)果:①治療后,兩組受試患者糖化血紅蛋白(HbA1c)值均較入組前明顯下降(P0.05),且治療組患者指標結(jié)果的改善較對照組更加明顯(P0.05)。②治療后,兩組受試患者中醫(yī)證候積分均下降(P0.05),且治療組癥候改善優(yōu)于對照組。治療組及對照組總有效率分別為94.3%,71.4%,說明祛胰抵方療效優(yōu)于西藥治療。③治療后,兩組患者雙側(cè)腓淺神經(jīng)感覺神經(jīng)傳導(dǎo)速度(SCV)、雙側(cè)腓總神經(jīng)運動神經(jīng)傳導(dǎo)速度(MCV)均有提高(P0.05),治療組改善優(yōu)于對照組。④治療后,兩組患者TG、TC、LDL-C均下降,差異具有統(tǒng)計學(xué)意義(P0.05);HDL-C明顯升高,差異明顯,具有統(tǒng)計學(xué)意義(P0.05)且治療組優(yōu)于對照組。⑤治療后,兩組患者血同型半胱氨酸含量均有下降,說明治療組的血同型半胱氨酸的下降優(yōu)于對照組(P0.05)。結(jié)論:①祛胰抵方可改善氣陰兩虛、痰瘀阻絡(luò)型DPN患者的中醫(yī)證候。②祛胰抵方可有效緩解患者肢體麻木、口干口渴、乏力、五心煩熱、氣短懶言、自汗盜汗等癥癥狀。③祛胰抵方可有效改善患者雙側(cè)腓總神經(jīng)MCV運動神經(jīng)傳導(dǎo)速度、腓淺神經(jīng)SCV感覺神經(jīng)傳導(dǎo)速度;④ 祛胰抵方降低患者TG、TC、LDL-C,升高HDL-C水平、降低血糖水平。⑤祛胰抵方能夠降低DPN患者血同型半胱氨酸含量,其治療DPN的機制可能是通過減少血同型半胱氨酸而成。
[Abstract]:Objective: to explore the knowledge of (Diabetic peripheral neuropathy in diabetic peripheral neuropathy. By means of randomized controlled method, the curative effect of QYJI recipe on this disease was further studied, and its mechanism was investigated by detecting the content of homocysteine (Hcy) in blood of the patients, and its safety was evaluated. In order to treat Qi and Yin deficiency and phlegm stasis collaterals type DPN, the new evidence is discussed. Methods: 70 DPN patients with deficiency of qi and yin and phlegm and blood stasis were recruited and divided into two groups according to the principle of random control: the treatment group (n = 35) and the control group (n = 35). The two groups had the same basic treatment plan. The treatment group took one dose of Quyi decoction 300ml, the morning and evening of decoction of 150ml were taken warm, and the control group took mecobalamin tablet 0.5 mg / d, and the control group took mecobalamin tablet 0.5 mg / d. The control group was treated with mekobalamin tablet 0.5 mg / d, and the control group was given Mecobalamin tablet (0.5 mg / d). The two groups were treated continuously for 12 weeks. Nerve conduction velocity and homocysteine were examined before and after the trial. Results the glycosylated hemoglobin (HbA1c) values of the two groups were significantly lower than those of the control group (P0.05), and the improvement of the index of the patients in the treatment group was more obvious than that in the control group (P0.05). The scores of TCM syndromes in both groups were decreased (P0.05), and the improvement of symptoms in the treatment group was better than that in the control group. The total effective rates of the treatment group and the control group were 94.3 and 71.4, respectively. The sensory nerve conduction velocity (SCV),) of bilateral superficial peroneal nerve (SCV),) and the motor nerve conduction velocity (MCV) of bilateral common peroneal nerve were increased in both groups (P0.05). The improvement in treatment group was better than that in control group (P < 0.05). The difference was statistically significant (P0.05), HDL-C was significantly increased, there was significant difference (P0.05) and the treatment group was better than the control group after 5 treatment, the two groups of patients' blood homocysteine content decreased, The decrease of homocysteine in the treatment group was better than that in the control group (P0.05). Conclusion the TCM syndrome of Qi-Yin deficiency and deficiency of Qi and Yin, phlegm and stasis obstructing collaterals in patients with DPN can be effectively alleviated by "1: 1" Quyi decoction, which can effectively relieve the numbness of limbs, dry mouth thirst, fatigue, five upset and heat, and short and lazy talk of qi. Self-sweating and night sweating symptom 3.Quyi decoction can effectively improve the motor nerve conduction velocity of bilateral common peroneal nerve (MCV) and the sensory nerve conduction velocity of superficial peroneal nerve (SCV) Quyi decoction can reduce the level of TGG TCLDL-C and increase the level of HDL-C. Lowering blood glucose level of 5. 5 Quyi decoction can reduce the content of homocysteine in patients with DPN. The mechanism of treatment of DPN may be by reducing the level of blood homocysteine.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)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 周昊玲;顏燦群;;糖尿病周圍神經(jīng)病變的研究進展[J];西南軍醫(yī);2017年01期

2 尚金燕;李桂榮;邵明輝;田真;;西洋參的藥理作用研究進展[J];人參研究;2016年06期

3 張寧;李自輝;于卉;劉冠璋;趙洪偉;董婉茹;劉樹民;;玄參及其各組分的降血糖作用[J];中藥藥理與臨床;2016年05期

4 王政;李哲;余俊先;王群;;小牛血清去蛋白提取物在神經(jīng)系統(tǒng)疾病應(yīng)用研究進展[J];人民軍醫(yī);2016年06期

5 于希忠;尚文斌;趙娟;郭超;徐傳，

本文編號：2180046