補(bǔ)陽還五湯治療創(chuàng)傷性周圍神經(jīng)損傷的臨床療效

趙巖　　趙云珍　　何賢標(biāo)　　薛慧

[關(guān)鍵詞] 中藥;補(bǔ)陽還五湯;創(chuàng)傷性周圍神經(jīng)損傷;神經(jīng)傳導(dǎo)速度

[中圖分類號] R285.2? ? ? ? ? [文獻(xiàn)標(biāo)識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）19-0148-04

Clinical effect of Buyang Huanwu Decoction in the treatment of traumatic peripheral nerve injury

ZHAO Yan? ?ZHAO Yunzhen? ?HE Xianbiao? ?XUE? Hui

Department of Hand and Foot Microscopic Surgery， Jinhua Hospital of TCM in Zhejiang Province， Jinhua? ?321017， China

[Abstract] Objective To explore the clinical effect of combined Buyang Huanwu Decoction in the treatment of traumatic peripheral nerve injury based on conventional epineurium anastomosis. Methods From June 2017 to June 2019，a total of 60 patients with traumatic peripheral nerve injury who were admitted to our hospital were randomLy divided into two groups， a treatment group and a control group. On the basis of conventional epineurium anastomosis， the treatment group was given modified Buyang Huanwu Decoction orally.The control group was given mecobalamin tablets orally. The treatment course was 6 months in both groups. The TCM syndrome scores in both groups before and after treatment， and the motor nerve conduction velocity and sensory nerve conduction velocity at 3 months and 6 months after treatment were observed. The short-term efficacy was statistically analyzed in both groups. Results After treatment， the scores of TCM syndromes including the numbness of hands and feet， tingling， squamous and dry skin， and dark purple tongue or ecchymosis after treatment in both groups were significantly lower than those before treatment （P<0.01）; the motor nerve conduction velocity and sensory nerve conduction velocity in both groups were increased significantly at 6 months after operation， and the treatment group was significantly higher than the control group （P<0.01）; the short-term effective rate in the treatment group was significantly higher than that in the control group（P<0.05）. Conclusion Buyang Huanwu Decoction can relieve the clinical symptoms of patients with traumatic peripheral nerve injury and increase the nerve conduction velocity in the electromyogram.

[Key words] Chinese medicine; Buyang Huanwu Decoction; Traumatic peripheral nerve injury; Nerve conduction velocity

周圍神經(jīng)損傷是指周圍神經(jīng)叢、神經(jīng)干或分支因外力而發(fā)生的損傷，主要表現(xiàn)為該神經(jīng)支配的區(qū)域出現(xiàn)運(yùn)動感覺障礙、自主神經(jīng)功能障礙及反射異常。具有較高的致殘率，不僅嚴(yán)重影響患者的生活質(zhì)量，還給社會和家庭帶來沉重的經(jīng)濟(jì)負(fù)擔(dān)。周圍神經(jīng)損傷是由于外傷或相關(guān)疾病導(dǎo)致，其中外傷是最主要原因，外傷主要分為牽拉傷、撕裂傷和擠壓傷[1]。創(chuàng)傷性的周圍神經(jīng)損傷大多數(shù)需要顯微外科的修復(fù)，手術(shù)修復(fù)是神經(jīng)再生的基礎(chǔ)，能夠使神經(jīng)斷端進(jìn)行物理連接，但是僅靠手術(shù)修復(fù)并不能達(dá)到理想的恢復(fù)效果，往往需要結(jié)合其他方法進(jìn)行綜合治療[2]。中藥是具有多種成分的復(fù)合物，有些中藥富有促神經(jīng)再生的有益成分，多靶點(diǎn)能夠更好的契合神經(jīng)再生過程需要的多因子、多因素聯(lián)合起效的生物特點(diǎn)[3]。基于中醫(yī)辨證施治的理論，近年來，筆者在常規(guī)的顯微外科手術(shù)縫合基礎(chǔ)上配合中藥補(bǔ)陽還五湯加減治療創(chuàng)傷性周圍神經(jīng)損傷，取得滿意的臨床療效，現(xiàn)報道如下。