目的 探讨阳和汤联合血栓通注射液治疗阳虚寒凝证糖尿病周围神经病变 (DPN) 患者的临床疗效及对炎性因子的影响.方法 将72例阳虚寒凝证DPN患者随机分成血栓通组和联合组, 每组36例.血栓通组在常规降糖、营养神经治疗基础上给予血栓通注射液静滴, 联合组在血栓通组基础上给予阳和汤口服.分别于治疗前及治疗2周后检测2组患者腓总神经、胫前神经运动神经传导速度 (MNCV) 和感觉神经传导速度 (SNCV) , 进行多伦多临床神经病变评分 (TCSS) , 取血检测血清白细胞介素-6 (IL-6) 、核转录因子-κB (NF-κB) 水平.治疗2周后评估2组临床疗效.结果 治疗2周后, 血栓通组仅胫前神经和腓总神经SNCV明显加快 (P均＜0. 05) , 而联合组胫前神经和腓总神经MNCV、SNCV均明显加快 (P均＜0. 05) , 且均明显快于血栓通组 (P均＜0. 05) .治疗2周后, 2组TCSS评分及血清IL-6、NF-κB水平均明显降低 (P均＜0. 05) , 且联合组均明显低于血栓通组 (P均＜0. 05) .血栓通组和联合组的总有效率分别为61. 11％和88. 89％, 联合组总有效率明显高于血栓通组 (P ＜0. 05) .结论 阳和汤联合血栓通治疗阳虚寒凝证糖尿病周围神经病变, 可提高患者神经传导速度, 减轻临床症状, 降低炎性因子水平, 减轻患者神经炎症反应, 疗效更好.%Objective It is to investigate the clinical efficacy of Yanghe Decoction combined with Xueshuantong injection on diabetic peripheral neuropathy (DPN) of syndrome of Yang deficiency and cold congealing and its effect on inflammatory factors in the patients. Methods 72 patients with DPN of syndrome of Yang deficiency and cold congealing were randomly divided into Xueshuantong group and combined group, 36 cases in each group. The Xueshuantong group was given Xueshuangtong injection by intravenous injection on the basis of conventional hypoglycemic and nutritional neurotherapy.The combined group was given Yanghe Decoction orally on the basis of the Xueshuantong group. The motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of common peroneal nerve and anterior tibial nerve were detected, the Toronto clinical neuropathy score (TCSS) was assessed, and the levels of interleukin-6 (IL-6) , nuclear transcription factor-κB (NF-κB) were determined before treatment and after treatment for 2 weeks in the two groups. The clinical efficacy of the two groups was evaluated after 2 weeks of treatment. Results After 2 weeks of treatment, only the SNCV of the anterior tibial nerve and the common peroneal nerve was significantly accelerated in the Xueshuantong group (P ＜ 0. 05) , while the MNCV and SNCV of the anterior tibial nerve and the common peroneal nerve were significantly accelerated in the combined group (P ＜ 0. 05) , they were significantly faster than that in the Xueshuantong group (P ＜0. 05). After 2 weeks of treatment, the TCSS scores and the levels of serum IL-6 and NF-κB in the two groups were significantly decreased (P ＜ 0. 05) , and the indexes above in combination group were significantly lower than those in Xueshutong group (P ＜ 0. 05). The total effective rates of Xueshuantong group and combined group were 61. 11％ and 88. 89％, respectively, the total effective rate of combined group was significantly higher than that of Xueshutong group (P ＜ 0. 05).Conclusion Yanghe Decoction combined with Xueshuantong can improve the nerve conduction velocity, reduce clinical symptoms, reduce the level of inflammatory factors, and reduce the neuroinflammatory response in patients in the treatment of DPN of syndrome of Yang deficiency and cold congealing, its curative is better.
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