《芪黄汤加减内服外熏联合艾灸治疗2型糖尿病周围神经病变疗效及对血清MDA、ET-1水平的影响.docx》由会员分享,可在线阅读,更多相关《芪黄汤加减内服外熏联合艾灸治疗2型糖尿病周围神经病变疗效及对血清MDA、ET-1水平的影响.docx(10页珍藏版)》请在优知文库上搜索。
1、黄黄汤加减内服外熏联合艾灸治疗2型糖尿病周围神经病变疗效及对血清MDA、ET7水平的影响张彦芬,王可可,郭浩楠,吴红群,徐彦娜商洛市中心医院中西医结合科,陕西商洛726000基金项目:陕西省科技攻关项目(编号:2010K21393)第一作者:张彦芬(1985-12),女,本科,主治医师,研究方向:中西医结合治疗糖尿病神经病变通讯作者:徐彦娜(1989-11),女,硕士,主治医师,研究方向:中西医结合,E-mail:【摘要】目的探讨芭黄汤加减内服外熏联合艾灸治疗2型糖尿病周围神经病变(DPN)的疗效及对血清丙二醛(MDA)、内皮素-I(ET-I)水平的影响。方法选择2021年2月至2022年12
2、月商洛市中心医院接诊的160例DPN患者进行治疗,按照随机数表法分为观察组和对照组,各80例,对照组给予常规处理及甲钻胺片治疗,观察组在对照组基础上,联合黄黄汤加减内服外熏、艾灸治疗,两组患者均持续治疗4周。比较两组患者治疗4周后的临床疗效,以及治疗前、治疗4周后正中神经、腓总神经的运动神经传导速度(MNCV)、运动神经传导速度(MNCV),及多伦多临床评分系统(TCSS)评分、血清MDA、ET-I水平的变化,以及治疗期间不良反应发生情况。结果治疗后,观察组患者的临床疗效总有效率为91.25%,明显高于对照组的76.25%,差异有统计学意义(P(48.124.69)m/s、(44.293.46
3、)ms,均明显高于对照组的(46.034.13)m/s、(43.193.84)ms(45.284.37)m/s、(41.734.11)ms,差异有统计学意义(PV0.05);观察组患者的TCSS评分、血清MDA、ET-I水平分别为(6.161.15)分、(4.180.62)nmolmL(65.127.63)mgL,均明显低于对照组的(7.381.34)分、(5.090.78)nmol/mL、(78.119.04)mgL,有统计学意义(PV0.05);两组治疗期间均无严重不良反应情况出现。结论芭黄汤加减内服外熏联合艾灸治疗DPN患者的疗效显著,可明显改善患者神经传导速度,且能降低血清MDA、ET
4、-I水平的表达,促进病情恢复,值得临床应用。【关键词】2型糖尿病;糖尿病周围神经病变;黄黄汤;艾灸;神经传导速度;丙二醛;内皮素-1EffectofQiHuangdecoctionplusorminusfororalandexternalfumigationcombinedwithMoxibustionontype2diabeticperipheralneuropathyanditseffectonserumMDAandET-1levelsZHANGYan-fen,WANGKe-kefGUOHao-nan,WUHong-qun,XUYan-naDepartmentofIntegratedTra
5、ditionalChineseandWesternMedicine,TheCentralhospitalofShangluoCity,Shangluo726000,Shaanxi,CHINAAbstractObjectiveTostudytheeffectofQihuangdecoctionplusorminusfororalandexternalfumigationcombinedwithMoxibustionontype2diabeticperipheralneuropathy(DPN)anditseffectonserumMaIondialdehyde(MDA)andEndothelin
6、-I(ET-I)levels.Methods160patientswithDPNtreatedinourhospitalfromFebrUary2021toDecember2022wereselectedfortreatment,accordingtotherandomnumbertablemethod,theyweredividedintoobservationgroupandcontrolgroup,with80casesineachgroup.ThecontrolgrouppatientswastreatedwithroutinetreatmentandMecobalamintablet
7、s,onthebasisofthecontrolgroup,theobservationgrouppatientswascombinedwithQihuangdecoctionplusorminusfororalandexternalfumigation,moxibustion,thepatientsinbothgroupsweretreatedfor4weeks.Theclinicalefficacyatafter4treatmenweeks,thechangesofmotornerveconductionvelocity(MNCV)andmotornerveconductionveloci
8、ty(MNCV)ofmediannerveandcommonperonealnerve,theTorontoclinicalscoringsystem(TCSS)scores,theserumMDAandET-Ilevelsatbeforetreatmentandafter4treatmenweeks,andtheoccurrenceofadversereactionsduringtreatmentintwogrouppatientswerecompared.ResultsAftertreatment,thetotaleffectiverateintheobservationgroupwas9
9、1.25%,whichwassignificantlyhigherthan76.25%ofthecontrolgroup,thedifferencewasstatisticallysignificant(P0,05);aftertreatment,theMNCVofmediannerveandcommonperonealnerveandSNCVofmediannerveandcommonperonealnerveinobservationgrouppatientswere(49.225.17)ms,(45.274.03)ms,(48.124.69)ms,(44.293.46)ms,whichw
10、eresignificantlyhigherthanthecontrolgroup(46.034.13)ms,(43.193.84)ms,(45.284.37)ms,(41.734.11)ms,thedifferenceswerestatisticallysignificant(P0.05),见表I0所有患者均签署研究知情同意书,且研究已通过我院伦理委员会批准。表1两组一般资料比较由s,11(%)JTable1Comparisonofgeneraldatabetweenthetwogroupss,n(%)J组别例数性别年龄(岁)2型糖尿病病DPN病程男女程(年)(年)观察组8047(58.75)33(41.25)64.577.10I2.262.484.53l.26对照组8050(62.50)30(37.50)63.987.6912.152.604.581.15值0.2360.5040.2740.262P值0.6270.6150.7850.7941.2 方法对照组给予常规处理,包括积极控制血糖、指导运动、合理饮食等,并给予甲钻胺片(规格0.5mg,厂家:扬子江药业集团南京海陵药业有限公司,国药准字H)口服治疗,0.5mg次,3次/d。观察组在对照组基础上,联合茶黄汤加减内服外熏、艾灸治疗;及黄汤加减药方组成:黄芭、玄参、生地、桂枝、赤芍、丹参、地龙各15g,鸡血藤30