摘要
目的探讨降糖祛瘀汤联合α-硫辛酸治疗颅脑创伤合并糖尿病周围神经病(diabetic peripheral neuropathy,DPN)的疗效及对血清同型半胱氨酸(Homocysteine,Hcy)和脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平影响。方法选取2020年11月—2022年6月收治的颅脑创伤合并DPN患者128例,随机分为对照组(n=66)和观察组(n=62),两组入院后给予脱水、脑保护等常规治疗,对照组静脉滴注硫辛酸注射液,观察组在此基础上口服降糖祛瘀汤,对比两组临床疗效、多伦多临床神经病变评分量表(toronto clinical scoring system,TCSS)评分和密歇根糖尿病神经病变评分(Michigan Diabetic Neuropathy Score,MDNS)、中医证候评分、腓神经和正中神经的运动神经传导速度(motor nerve conduction velocity,MNCV)和感觉神经传导速度(sensory nerve conduction velocity,SNCV)值、血清同型半胱氨酸(Homocysteine,Hcy)和脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平及血流动力学指标变化。结果治疗后观察组治疗有效率明显较高(P<0.05);治疗后两组TCSS评分和MDNS评分、主症、次症及中医证候总评分、血清MNCV和SNCV;治疗前后采用全自动血液流变仪测定血浆黏度(Plasma viscosity,PV)、全血黏度(Blood viscocity,BV)、纤维蛋白原(Fibrinogen reagent,FIB)和红细胞比容(Hematocrit,HCT)水平明显降低(P<0.05);且观察组降低较多(P<0.05);治疗后两组血清Hcy和BDNF水平明显改善(P<0.05);且观察组改善较明显(P<0.05);治疗后两组腓神经和正中神经的SNCV和MNCV值明显升高(P<0.05);且观察组升高较多(P<0.05)。结论颅脑创伤合并DPN采用降糖祛瘀汤联合α-硫辛酸治疗具有较好的疗效。
Objective To investigate the efficacy of Jiangtang Quyu Decoction(降糖祛瘀汤)combined withα-lipoic acid in the treatment of traumatic brain injury complicated with diabetic peripheral neuropathy(DPN)and its effect on serum Homocys-teine(Hcy)and brain-derived neurotrophic factor(BDNF).Methods A total of 128 patients with craniocerebral trauma compli-cated with DPN admitted to the hospital from November 2020 to June 2022 were selected and randomly divided into control group(66 cases)and observation group(62 cases).After admission,the two groups were given routine treatment such as dehydration and brain protection.The clinical efficacy,Toronto clinical scoring system(TCSS)score and Michigan diabetic neuropathy score(MDNS),TCM syndrome scores,motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of per-oneal nerve and median nerve velocity,serum levels of Hcy and BDNF and hemodynamic parameters were compared between the two groups.Results After treatment,the effective rate in the observation group was significantly higher(P<0.05).TCSS scores and MDNS scores,total scores of main symptoms,secondary symptoms and TCM symptoms,values of MNCV and SNCV,the levels of plasma viscosity(PV),blood viscosity(BV),fibrinogen(FIB)and hematocrit(HCT)were significantly decreased(P<0.05).The decrease in the observation group was significant(P<0.05).After treatment,the levels of serum Hcy and BDNF in both groups were significantly improved(P<0.05)and the levels of the observation group were improved significantly(P<0.05).After treatment,the values of SNCV and MNCV of the peroneal and median nerves in the two groups were increased significantly(P<0.05)and the increase in the observation group was significant(P<0.05).Conclusion Jiangtang Quyu Decoction com-bined withα-lipoic acid has a good therapeutic effect in the treatment of head trauma complicated with DPN.
作者
付永奇
赵庚水
周玲
王宏业
FU Yongqi;ZHAO Gengshui;ZHOU Ling;WANG Hongye(Harrison International Peace Hospital,Hengshui 053099,Hebei,China)
出处
《中华中医药学刊》
CAS
北大核心
2023年第9期239-242,共4页
Chinese Archives of Traditional Chinese Medicine
基金
河北省医学科学研究课题计划项目(20200184)
衡水市科技计划自筹经费项目(2021014098Z)。
