CAJ | 학술논문

目的：探讨周围神经松解术配合中医辨证治疗糖尿病周围神经病（DPN）的临床疗效。方法将343例下肢 DPN 患者随机分为三组。研究组114例，应用补阳还五汤或四妙勇安汤配合周围神经松解术治疗；对照组115例，单纯进行周围神经松解术治疗；常规组114例，只给予应用补阳还五汤或四妙勇安汤等中药活血化瘀、利湿、止痛、换药及对症治疗。观察比较三组治疗后麻木症状、胫腓神经传导速度、VAS 评分改善情况。结果研究组94.7％的患者的疼痛缓解、97.4％的患者感觉恢复，胫腓神经传导速度为（45±4）m/ s，（49±4）m/ s，VAS 评分由术前7.6±1.6降至1.8±0.8，疗效明显。对照组93％的患者的疼痛缓解、78.9％的患者感觉恢复，神经传导速度为（41±4）m/ s，（43±4）m/ s， VAS 评分由术前7.5±1.5降至术后2.1±0.9，疗效好。常规组只有18.45％的患者的疼痛缓解、22.85％的患者感觉恢复，神经传导速度为（33.2±4）m/ s，（36±4）m/ s，VAS 评分由术前7.3±1.5降至7.1±0.9，疗效差，症状无明显缓解。结论周围神经松解术配合补阳还五汤或四妙勇安汤可以明显改善 DPN 下肢麻木、下肢疼痛症状，提高神经传导速度。
목적：탐토주위신경송해술배합중의변증치료당뇨병주위신경병（DPN）적림상료효。방법장343례하지 DPN 환자수궤분위삼조。연구조114례，응용보양환오탕혹사묘용안탕배합주위신경송해술치료；대조조115례，단순진행주위신경송해술치료；상규조114례，지급여응용보양환오탕혹사묘용안탕등중약활혈화어、리습、지통、환약급대증치료。관찰비교삼조치료후마목증상、경비신경전도속도、VAS 평분개선정황。결과연구조94.7％적환자적동통완해、97.4％적환자감각회복，경비신경전도속도위（45±4）m/ s，（49±4）m/ s，VAS 평분유술전7.6±1.6강지1.8±0.8，료효명현。대조조93％적환자적동통완해、78.9％적환자감각회복，신경전도속도위（41±4）m/ s，（43±4）m/ s， VAS 평분유술전7.5±1.5강지술후2.1±0.9，료효호。상규조지유18.45％적환자적동통완해、22.85％적환자감각회복，신경전도속도위（33.2±4）m/ s，（36±4）m/ s，VAS 평분유술전7.3±1.5강지7.1±0.9，료효차，증상무명현완해。결론주위신경송해술배합보양환오탕혹사묘용안탕가이명현개선 DPN 하지마목、하지동통증상，제고신경전도속도。
Objective To explore the therapeutic effect of surgical decompression of peripheral nerves in combination with traditional Chi-nese medicine in treatment of diabetic peripheral neuropathy. Methods A total of 343 patients with diabetic peripheral neuropathy in lower ex-tremities were randomly divided into 3 groups. 114 cases in trial group were treated by surgical decompression of peripheral nerves combined with BuYang HuanWu Decoction( BYHWD or SiMiao YunAn Decoction( SMYAD)in order to cure their diabetic peripheral neuropathy,recover the function of their feet and relieve the symptoms of numbness and paresthesia. B)115 cases in control group were only treated with surgical decom-pression of peripheral nerves. 114 cases in routine treatment group were only treated with BYHWD or SiMiao YunAn Decoction in order to restore their sensation,relieve pain and prevent ulceration and amputation in diabetes mellitus patients with DPN. The curative effects of these 3 groups were compared and statistically analyzed by using SPSS 12. 0 software. Results The surgical decompression of peripheral nerves combined with BYHWD or SMYAD could relieve the symptom of pain in 94. 7% of patients and restore the function of sensation in lower extremities in 97. 4% of patients. Conclusion Surgical decompression of peripheral nerves combined with BYHWD or SMYAD may significantly improve the therapeutic effect,hence it had been proved its efficacy in treatment of diabetic patients with DPN. Long - term follow - up showed that the course of disease can be changed by combination of surgical decompression of peripheral nerves and traditional Chinese medicine,and the result of treatment is per-fect.