《中国康复理论与实践》

《中国康复理论与实践》 ›› 2008, Vol. 14 ›› Issue (02): 166-168.

• 临床研究 • 上一篇    下一篇

172例糖尿病周围神经病变患者中医证候特点与神经传导速度的关系

孙连庆; 梁晓春; 姜楠; 栾松; 吴群励; 郭赛珊   

  1. 中国协和医科大学;中国医学科学院; 北京协和医院中医科;北京市 100730
  • 收稿日期:2007-07-16 出版日期:2008-02-01 发布日期:2008-02-01

Clinical Study on Relationship between Syndrome Differentiation of Traditional Chinese Medicine and Nerve Conduction Velocity in 172 Patients with Diabetic Peripheral Neuropathy

SUN Lian-qing, LIANG Xiao-chun,   

  1. JIANG Nan, et al. The Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2007-07-16 Published:2008-02-01 Online:2008-02-01

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摘要： 目的探讨糖尿病周围神经病变(DPN)患者中医证候特点与神经传导速度的关系。方法对172例DPN患者按气虚、阴虚、阳虚、血瘀、痰湿进行中医证候归类,5级记分法量化评分,并进行常规神经传导速度(NCV)检测。结果中医证候出现频率阴虚、血瘀>50%;高龄组阳虚证候比重及积分高于低龄组(P<0.05);血瘀、阳虚证候积分随着病程的延长明显增高(P<0.01)。神经系统症状、体征评分与阴虚、阳虚、血瘀积分呈正相关;空腹血糖(FBG)与气虚积分、脂蛋白a与阴虚积分、同型半胱氨酸(Hcy)与阳虚积分呈正相关;NCV异常组中的阴虚、血瘀证候比例高于各自正常组,而气虚、痰湿证候反之,但无统计学意义(P>0.05);阳虚、血瘀积分越高,NCV异常越明显。病程、FBG、收缩压(SBP)、同时并发糖尿病肾病(DN)和糖尿病视网膜病变(DR)、神经系统体征评分是NCV异常的独立危险因素。结论DPN临床证候以阴虚、血瘀为主,阳虚、血瘀越明显,神经传导速度越慢;病程延长、FBG和SBP升高、合并DN和DR及神经系统体征评分增加是NCV异常的独立危险因素。

关键词: 2型糖尿病, 周围神经病变, 神经传导速度, 神经系统评分, 证候

Abstract: Objective To investigate the relationship between nerve conduction velocity(NCV)and syndrome differentiation of traditional Chinese medicine(TCM)in patients with diabetic peripheral neuropathy(DPN).Methods 172 patients with DPN were scored by 5 grades according to their symptoms which were classified by 5 kinds of patterns such as Qi-deficiency,Yin-deficiency,Yang-deficiency,Blood-stasis,Phlegm-dampness.NCV of the patients were also tested.Results The frequency of Yin-deficiency and Blood-stasis was more than 50%.The proportion and scores were significantly higher in the elder-age group than in the younger-age group(P<0.05).The scores of Blood-stasis and Yang-deficiency increased in the patients with longer-course(P<0.01).The correlation analysis showed that scores of nervous system were correlated positively with scores of Yin-deficiency,Yang-deficiency and Blood-stasis.There were positive correlation between scores of Qi-deficiency and fasting blood glucose(FBG)as well as between scores of Yin-deficiency and a-lipoprotein(LPa),and between scores of Yang-deficiency and homocysteine(Hcy).The proportion of Yin-deficiency and blood stasis in abnormal NCV group were higher than the normal while the results of Qi-deficiency and Phlegm-dampness were contrary.But the consequence had no statistical significance(P>0.05).Abnormality of NCV was aggravated with the high scores of Yang-deficiency and blood stasis.The analysis with logistic stepwise regression showed that diabetic course,levels of FBG and systolic blood pressure(SBP),be complicated by DN and DR,scores of nervous system sign were the independent risk factors for NCV.Conclusion Yin-deficiency and Blood-stasis are the major TCM syndromes in patients with DPN.The degree of Yang-deficiency and Blood-stasis influenced on the parameters of NCV.Abnormality of NCV can be aggravated with long diabetic course,high levels of FBG and SBP,be complicated by DN and DR,high scores of nerve system sign.

Key words: type 2 diabetes mellitus, peripheral neuropathy, nerve conduction velocity, scores of nervous system, syndrome