陈芳 赵璐 郭鑫鑫

【摘 要】 目的：观察西药联合黄芪注射液穴位注射治疗糖尿病周围神经病变（DPN）的临床疗效。方法：将88例DPN患者采用随机数字表法分为对照组与研究组各44例。对照组给予甲钴胺片治疗，研究组在对照组治疗方法的基础上给予黄芪注射液穴位注射治疗。两组均连续治疗12周后比较两组治疗前后的中医证候总积分、多伦多临床评分系统（TCSS）评分、神经传导速度及两组的临床疗效。结果：两组治疗后的中医证候总积分、TCSS均明显低于治疗前，正中神经、胫神经和腓总神经的运动神经传导速度（MNCV）与感觉神经传导速度（SNCV）较治疗前均有明显提高（P<0.05），且研究组各项指标改善程度明显优于对照组（P<0.05）;研究组总有效率为93.18%，明显优于对照组的75%（P<0.05）。结论：西药联合黄芪注射液穴位注射治疗DPN效果显著，可明显改善患者的临床症状，加快神经传导功能，提高神经传导速度，延缓病情进展，提高患者日常生活质量，无不良反应。

【关键词】 糖尿病周围神经病变;黄芪注射液;甲钴胺片;穴位注射

【中图分类号】R587.2   【文献标志码】 A    【文章编号】1007-8517（2020）12-0108-05

Abstract：Objective To observe the clinical curative effect of mecobalamine combined with Radix Astragali acupoint injection in the treatment of diabetic peripheral neuropathy（DPN）. Methods 88 patients enrolled were divided into the clinical group and blank control group by completely randomized digital table. Mecobalamine was used as the conventional therapy in the control group，while patients in the clinical group underwent acupoint injection with Radix Astragali injection besides Mecobalamine. Symptom scores of Traditional Chinese Medicine，Toronto clinical scoring system（TCSS）and nerve conductive velocity were applied to evaluate the curative effects of different groups after 12 weeks. Results Symptom scores of Traditional Chinese Medicine，TCSS and nerve conductive velocity were improved in both groups compared to baseline after 12 weeks treatment（P<0.05）;a more significant difference could be observed in the clinical group than the control group，with the total efficiency of 93.18%（P<0.05）. Conclusion Combination treatment of mecobalamine and Radix Astragali acupoint injection had a credible efficacy in the treatment of DPN. Not only to improve the function of nervous，quicken the nervous conduction velocity，check the progress of disease，no bad reaction.

Keywords：Diabetic Peripheral Neuropathy; Radix Astragali Injection; Mecobalamine; Acupoint Injection

糖尿病周圍神经病变（Diabetic peripheral neuropathy，DPN）是糖尿病患者较为常见的慢性并发症之一，主要表现为四肢末端麻木、疼痛、感觉异常等，甚至出现肌肉萎缩[1]。若患者不及时进行有效治疗，进一步发展可演变为糖尿病足，诱发感染、溃疡及坏疽。因此，早期发现、诊断和治疗尤为重要。目前西医尚缺乏特异性的治疗措施，常规治疗单用药物疗法效果欠佳。近年来穴位注射在治疗DPN取得了较大进展，有研究表明[2]，穴位注射治疗DPN疗效较好，可有效调和气血、协调脏腑阴阳，改善患者的临床症状及其预后情况，优于单纯西医治疗。笔者采用西药联合黄芪注射液穴位注射足三里治疗DPN患者44例，取得良好疗效，现总结报道如下。

1 资料与方法