健脾益气通络法联合穴位注射治疗糖尿病周围神经病变临床研究
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R587.2

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中国民族医药学会科研项目(2022Z1126-1090301)


Clinical Study on Jianpi Yiqi Tongluo Method Combined with Point Injection for Diabetic Peripheral Neuropathy
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    摘要:

    目的:观察健脾益气通络法联合穴位注射治疗糖尿病周围神经病变的临床疗效。方法:选择糖尿 病周围神经病变患者200 例,按随机数字表法分为对照组和观察组各100 例。对照组给予丹参注射液穴位注射 治疗,观察组在对照组基础上给予健脾益气通络法治疗。评价2 组临床疗效,比较2 组治疗前后血清相关因子 水平、神经传导速度、临床症状评分和生活质量评分。结果:观察组总有效率为98.00%,高于对照组 91.00%(P<0.05)。治疗后,2 组γ-谷氨酰转肽酶(γ-GGT)、晚期糖基化终产物(AGEs)、血清高迁移率族 蛋白B1 (HMGB1)、血友病因子(vWF)、内皮细胞特异性分子-1 (ESM-1) 含量较治疗前降低(P<0.05); 且观察组γ-GGT、AGEs、HMGB1、vWF、ESM-1 含量低于对照组(P<0.05)。治疗后, 2 组脂氧素 A4(LXA4)、超氧化物歧化酶(SOD)、γ-氨基丁酸(γ-GABA)、神经生长因子(NGF)、血小板衍化内皮细 胞生长因子(PD-ECGF) 含量较治疗前升高(P<0.05);且观察组LXA4、SOD、γ-GABA、NGF、PD-ECGF 含量高于对照组(P<0.05)。治疗后,2 组正中神经以及腓总神经运动神经传导速度(MCV)、感觉神经传导 速度(SCV) 较治疗前升高(P<0.05);且观察组正中神经以及腓总神经MCV、SCV 高于对照组(P<0.05)。 治疗后,2 组多伦多临床评分系统(TCSS) 评分较治疗前降低(P<0.05),观察组TCSS 评分低于对照 组(P<0.05);2 组生活质量综合评定问卷(GQOLI-74) 评分较治疗前升高(P<0.05),观察组GQOLI-74 评 分高于对照组(P<0.05)。结论:健脾益气通络法联合穴位注射治疗糖尿病周围神经病变可降低AGEs、 HMGB1 水平,减少炎症及氧化应激损伤,促进神经修复,改善内皮细胞相关因子水平,减少血管内皮细胞损 伤,改善神经传导速度,缓解临床症状,提升患者生活质量。

    Abstract:

    Abstract:Objective:To observe the clinical effect of Jianpi Yiqi Tongluo method combined with point injection for diabetic peripheral neuropathy. Methods: A total of 200 cases of patients with diabetic peripheral neuropathy were selected and divided into the control group and the observation group according to the random number table method, with 100 cases in each group. The control group was given point injection with Danshen Injection, and the observation group was additionally treated with Jianpi Yiqi Tongluo method based on the treatment of the control group. The clinical effects in the two groups were evaluated. Before and after treatment, the levels of serum related factors, nerve conduction velocity, clinical symptom scores and quality of life scores were compared between the two groups. Results:The total effective rate was 98.00% in the observation group, higher than that of 91.00% in the control group (P<0.05). After treatment,the contents of γ-glutamyl transpeptidase (γ-GGT),advanced glycation end products (AGEs),high mobility group protein B1 (HMGB1) in serum,von willebrand factor (vWF),and endothelial cell specific molecule-1 (ESM-1) in the two groups were decreased when compared with those before treatment (P<0.05);the contents of γ-GGT,AGEs,HMGB1,vWF and ESM-1 in the observation group were lower than those in the control group (P < 0.05). After treatment , the contents of lipoxin A4 (LXA4),superoxide dismutase (SOD),γ-aminobutyric acid (γ-Gaba),nerve growth factor (NGF),and platelet derived endothelial cell growth factor (PD-ECGF) in the two groups were increased when compared with those before treatment (P<0.05);the contents of LXA4,SOD,γ-Gaba,NGF and PD-ECGF in the observation group were higher than those in the control group (P<0.05). After treatment, motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) of median nerve and common peroneal nerve in the two groups were increased when compared with those before treatment (P<0.05); the MCV and SCV of median nerve and common peroneal nerve in the observation group were higher than those in the control group (P<0.05). After treatment,Toronto Clinical Scoring System (TCSS) scores in the two groups were decreased when compared with those before treatment (P<0.05),and TCSS score in the observation group was lower than that in the control group (P<0.05);the Generic Quality of Life Inventory- 74 (GQOLI-74) scores in the two groups were increased when compared with those before treatment (P< 0.05), and the GQOLI- 74 score in the observation group was higher than that in the control group (P< 0.05). Conclusion: Jianpi Yiqi Tongluo method combined with point injection for diabetic peripheral neuropathy can reduce the levels of AGEs and HMGB1,inflammation,oxidative stress injury and vascular endothelial cell injury,promote nerve repair,improve the levels of endothelial cell related factors and nerve conduction velocity,relieve clinical symptoms,and enhance the quality of life of patients.

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杨维,宋燕燕,张文婧,赵春雷.健脾益气通络法联合穴位注射治疗糖尿病周围神经病变临床研究[J].新中医,2023,55(11):123-128

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  • 在线发布日期: 2023-06-16
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