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目的:观察自拟黄芪通络化痰汤治疗2型糖尿病性周围神经病变的临床疗效。方法:160例2型糖尿病性周围神经病变患者,随机分为两组,黄芪通络化痰汤治疗组80例,弥可保对照组80例,两组共治疗8周。观察临床症状、体征、血液流变学、神经传导速度等改变,并在2个月后评价疗效。结果:黄芪通络化痰汤治疗组总有效率87.50%,明显优于对照组62.50%,比较有统计学意义(P<0.01);治疗组中医证候改善积分减分率优于对照组,比较均有统计学意义(P<0.05或P<0.01);治疗组血液流变学各项指标与治疗前相比及治疗后与对照组比较改善明显,比较有统计学意义(P<0.01);治疗组神经传导速度治疗后与对照组比较,MCV中正中神经、腓神经和SCV中尺神经、腓神经比较有所改善(P<0.05),SCV中正中神经比较具有显著性差异(P<0.01),MCV中尺神经比较无明显差异(P>0.05)。结论:黄芪通络化痰汤治疗2型糖尿病性周围神经病变有确切疗效,且能显著改善临床症状、血液粘滞度及神经传导速度。
Objective: To observe the clinical efficacy of self-made Astragalus Tongluo Huatan Decoction in the treatment of type 2 diabetic peripheral neuropathy. Methods: One hundred and sixty patients with type 2 diabetic peripheral neuropathy were randomly divided into two groups. 80 cases were treated with Astragalus Tongluo Huatan Decoction and 80 cases were treated with miconconazole. The two groups were treated for 8 weeks. Observation of clinical symptoms, signs, hemorheology, nerve conduction velocity and other changes, and in 2 months after the evaluation of efficacy. Results: The total effective rate of the treatment group was 87.50%, which was significantly better than that of the control group (62.50%) (P <0.01). The improvement rate of TCM syndromes in the treatment group was better than that of the control group (P <0.05 or P <0.01). The indices of hemorheology in treatment group were significantly improved compared with those before treatment and after treatment, and were statistically significant (P <0.01) Compared with control group, median nerve, peroneal nerve and SCV midrib nerve and peroneal nerve in MCV group were improved (P <0.05) and median nerve in SCV was significantly different after treatment (P < 0.01). There was no significant difference in MCV midbrain nerve (P> 0.05). Conclusion: Astragalus Tongluo Huatan Decoction has the exact curative effect on type 2 diabetic peripheral neuropathy and can significantly improve the clinical symptoms, blood viscosity and nerve conduction velocity.