补阳还五汤治疗创伤性周围神经损伤的临床疗效

赵岩　　赵云珍　　何贤标　　薛慧

[关键词] 中药;补阳还五汤;创伤性周围神经损伤;神经传导速度

[中图分类号] R285.2          [文献标识码] B          [文章编号] 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

周圍神经损伤是指周围神经丛、神经干或分支因外力而发生的损伤，主要表现为该神经支配的区域出现运动感觉障碍、自主神经功能障碍及反射异常。具有较高的致残率，不仅严重影响患者的生活质量，还给社会和家庭带来沉重的经济负担。周围神经损伤是由于外伤或相关疾病导致，其中外伤是最主要原因，外伤主要分为牵拉伤、撕裂伤和挤压伤[1]。创伤性的周围神经损伤大多数需要显微外科的修复，手术修复是神经再生的基础，能够使神经断端进行物理连接，但是仅靠手术修复并不能达到理想的恢复效果，往往需要结合其他方法进行综合治疗[2]。中药是具有多种成分的复合物，有些中药富有促神经再生的有益成分，多靶点能够更好的契合神经再生过程需要的多因子、多因素联合起效的生物特点[3]。基于中医辨证施治的理论，近年来，笔者在常规的显微外科手术缝合基础上配合中药补阳还五汤加减治疗创伤性周围神经损伤，取得满意的临床疗效，现报道如下。