摘要
【目的】观察滋阴疏肝活血法中药联合氟哌噻吨美利曲辛片治疗糖尿病周围神经病变(DPN)合并抑郁状态的临床疗效。【方法】将60例阴虚肝郁血瘀证DPN合并抑郁状态患者随机分为治疗组和对照组,每组各30例。2组患者均给予控制血糖和营养神经的DPN西医常规治疗,在此基础上,对照组给予氟哌噻吨美利曲辛片治疗,治疗组在对照组的基础上,给予滋阴疏肝活血法中药治疗,连续治疗2个月。观察2组患者治疗前后多伦多临床评分系统(TCSS)评分、正中神经和胫神经的运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)及汉密尔顿抑郁量表(HAMD)评分的变化情况,并评价2组患者的中医证候疗效及安全性。【结果】(1)治疗2个月后,治疗组的总有效率为93.3%(28/30),对照组为70.0%(21/30),组间比较,治疗组的中医证候疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的TCSS评分均较治疗前明显降低(P<0.05),且治疗组的TCSS评分明显低于对照组(P<0.05)。(3)治疗后,2组患者的正中神经和胫神经MNCV、SNCV水平均较治疗前明显改善(P<0.05),且治疗组对正中神经和胫神经MNCV、SNCV水平的改善作用均明显优于对照组(P<0.05)。(4)治疗后,2组患者的HAMD评分均较治疗前明显降低(P<0.05),且治疗组的HAMD评分明显低于对照组(P<0.05)。(5)治疗后,治疗组的抗抑郁药副反应量表(SERS)评分明显低于对照组,差异有统计学意义(P<0.05)。(6)治疗过程中,2组患者均未发生明显的与治疗相关的不良反应,患者的血、尿、大便常规及肝肾功能等安全性指标也均无明显异常改变。【结论】滋阴疏肝活血法中药联合氟哌噻吨美利曲辛片治疗阴虚肝郁血瘀证DPN合并抑郁状态患者疗效确切,其疗效优于单用氟哌噻吨美利曲辛片治疗。
Objective To observe the clinical efficacy of the therapy of nourishing yin to sooth liver and activating blood combined with flupentixol and melitracen tablets in the treatment of diabetic peripheral neuropathy(DPN)complicated with depressive disorder.Methods Sixty patients of DPN complicated with depressive disorder and differentiated as yin deficiency,liver stagnation and blood stasis syndrome were randomly divided into treatment group and control group,30 cases in each group.Both groups were given DPN conventional western medicine for blood glucose control and neurotrophic treatment.Additionally,the control group was given oral administration of flupentixol and melitracen tablets,and the treatment group was given Chinese medicine for nourishing yin to sooth liver and activating blood together with flupentixol and melitracen tablets.The treatment for the two groups lasted for 2 continuous months.The changes of Toronto clinical scoring system(TCSS)scores,motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of the median nerve and tibial nerve,and Hamilton Depression Scale(HAMD)scores in the two groups were observed before and after treatment.Meanwhile,the traditional Chinese medicine(TCM)syndrome efficacy and clinical safety in the two groups were evaluated.Results(1)After 2 months of treatment,the total effective rate of the treatment group was 93.3%(28/30),and that of the control group was 70.0%(21/30).The intergroup comparison showed that the TCM syndrome efficacy of the treatment group was superior to that of the control group(P<0.05).(2)After treatment,the TCSS scores of the two groups were significantly decreased compared with those before treatment(P<0.05),and the TCSS scores of the treatment group were significantly lower than those of the control group(P<0.05).(3)After treatment,MNCV and SNCV of the median nerve and tibial nerve in the two groups were significantly improved compared with those before treatment(P<0.05),and the improvement of MNCV and SNCV in the treatment grou
作者
杜顺棠
张琪
张思君
林靖
季兵
DU Shun-Tang;ZHANG QI;ZHANG Si-Jun;LIN Jing;JI Bing(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Clifford Hospital,Guangzhou 511495 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2022年第3期527-533,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广东省中医药局科研课题面上项目(编号:20212190)。
关键词
滋阴疏肝活血法
糖尿病周围神经病变(DPN)
抑郁状态
氟哌噻吨美利曲辛片
阴虚肝郁血瘀证
therapy of nourishing yin to sooth liver and activating blood
diabetic peripheral neuropathy(DPN)
depressive disorder
flupentixol and melitracen tablets
syndrome of yin deficiency
liver stagnation and blood stasis
