【作者】 余晓琳；

【导师】 冯维斌；

【作者基本信息】 广州中医药大学 ， 中医内科学， 2005， 硕士

【摘要】 糖尿病周围神经病变是糖尿病常见并发症之一,不仅严重危害健康,有很高的病死率和致残率,而且与其他慢性并发症的发生发展有密切的联系,它的存在造成了多器官的调节障碍。目前,针对不同发病机制的治疗对糖尿病周围神经病变有部分改善作用,但疗效尚不确切。因此,除严格控制血糖外,还要积极的从其他致病机制入手,寻找DPN的有效治疗方案,从中医药中开发和客观评价有效而副作用小的药物是现在和今后发展的方向。 糖尿病周围神经病变主要是继发于糖尿病微血管病变的并发症,近来研究表明在气阴两虚的基础上瘀血阻络是其重要的病理基础之一。活血化瘀通络是贯穿糖尿病周围神经病变治疗始终的基本方法。 目的:本课题侧重于益气养阴活血通络法对糖尿病周围神经病变疗效的研究,通过临床观察探讨糖痹胶囊对气虚血瘀型糖尿病周围神经病变的影响及其可能的作用机制。 方法:在本研究中,将受试者随机分为糖痹胶囊(A)组40例,弥可保+阿司匹林(B)组20例,糖痹胶囊+弥可保+阿司匹林(C)组20例,观察治疗前后DPN患者症状、体征的改善情况及血液流变学、神经传导速度的变化。 结果:三组在年龄、性别、体重指数、HbAlc及使用胰岛素比例等基线资料上无显著性差异。对肢体麻木、无力及口干等症状的改善,A组要优于B组(P<0.05);对血液流变性、神经传导速度的影响,三组治疗前后均有不同程度的改善(P<0.01),C组明显优于A组和B组;对腓总、正中运动神经传导速度的改善,A组优于B组(P<0.01或P<0.05)。C组治疗DPN的总有效率为80%,优于A组(65%)与B组(60%)。 结论:糖痹胶囊能够减轻DPN患者的临床症状,改善血液流变性和神经传导速度,是治疗DPN安全有效的药物。与弥可保、阿司匹林联用,能增加疗效。更多还原

【Abstract】 Diabitic peripheral Neuropathy(DPN) is one of the common complications of DM. It is not only a particularly debilitating complication of diabetes and accounts for significant morbidity by predisposing the foot to ulceration and lower extremity amputation, but also has closely relationship to the other complications and causes the abnormities in multi-organs. At present,the treatment to aim directly at different pathogenesis may have some amelioration , but not certain. Besides excellent glycemic control, we should study other pathogenesis positively and develop more effective methods for DPN. It is the direction to develop now and in the future that developing and evaluating objectively effective and safe drugs from the Chinese medicine.DPN is a continuous microvascular complication. Recent evidence indicate that the retention of blood stasis in channels on the basis of weakness of Qi and Yin was involved in its etiology. Other reports also present evidence that significant amelioration can be provided by treatment with drugs of promoting blood circulation and dreging the channels. The experiment aimed at the important principle in the treatment of DPN. By means of two-month clinical observation, the report tried to evaluate the protective effect and mechanism of Tang Bi capsule on DPN patients.Objective: to investigate the effect of Tang Bi capsule on DPN patients. Methods: Three matched groups were studied:40 patients were given Tang Bi capsule (A group), 20 patients given Aspirin and Methylcobalamin(B group), 20 patients were given Tang Bi capsule,Aspirin and Methylcobalamin(C group). All patients were observed on symptoms, signs, hemorheology and nerve conduction velocity .Results:The basal line of three groups is coincident , and with comparability, including age、 gender、 body mass index、 HbAlc and the radio更多还原