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目的:观察中西医结合治疗糖尿病周围性神经病变气虚血瘀证患者的临床疗效。方法:将88例糖尿病周围性神经病变气虚血瘀证患者随机分为观察组与对照组各44例。对照组采用甲钴胺注射液联合前列地尔注射液静脉滴注治疗,观察组在对照组治疗础上采用中药通脉活血方治疗,2组均以4周为1疗程,共治疗2疗程。观察2组临床疗效、治疗前后检测主侧肢体正中神经、腓总神经的运动传导速度(MNCV)与感觉传导速度(SNCV)值。结果:治疗后,观察组临床总有效率为95.45%,对照组为70.45%,2组总有效率比较,差异有统计学意义(P<0.05)。观察组4项神经传导速度值均高于治疗前(P<0.05,P<0.01),对照组腓总神经MNCV、SNCV值均高于治疗前(P<0.05,P<0.01)。观察组正中神经MNCV与腓神经MNCV、SNCV值均高于对照组(P<0.05)。观察组临床症状评分与Toronto临床评分均低于对照组(P<0.05)。结论:中西医结合治疗糖尿病周围性神经病变的临床效果优于单纯西药治疗,能减轻症状,改善患者神经传导速度,值得临床使用。
Objective: To observe the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of peripheral neuropathy of diabetes mellitus and blood stasis syndrome. Methods: 88 cases of diabetic peripheral neuropathy patients with qi deficiency and blood stasis were randomly divided into observation group and control group, 44 cases each. The control group was treated with mecobalamin injection and alprostadil injection. The observation group was treated with traditional Chinese medicine Tongmai Huoxue Recipe in the control group. Both groups were given 1 course of treatment for 4 weeks, and a total of 2 courses were treated. The clinical curative effect of the two groups were observed. The median nerve and peroneal nerve conduction velocity (MNCV) and sensory conduction velocity (SNCV) were measured before and after treatment. Results: After treatment, the total clinical effective rate was 95.45% in the observation group and 70.45% in the control group. The total effective rate in the two groups was statistically significant (P <0.05). The nerve conduction velocities in the observation group were higher than those before treatment (P <0.05, P <0.01). The MNCV and SNCV in the control group were higher than those before treatment (P <0.05, P <0.01). MNCV and MNCV and SNCV in the median nerve of the observation group were higher than those in the control group (P <0.05). Clinical symptom score and Toronto clinical score in the observation group were lower than those in the control group (P <0.05). Conclusion: The clinical effect of integrated traditional Chinese and western medicine in the treatment of diabetic peripheral neuropathy is better than that of western medicine alone, which can alleviate the symptoms and improve the nerve conduction velocity in patients. It is worth to be used clinically.