中西医结合治疗糖尿病性眼肌麻痹33例研究.docVIP

中西医结合治疗糖尿病性眼肌麻痹33例研究【摘要】目的:探讨采用中西医结合的方法治疗糖尿病性眼肌麻痹的治疗方法与疗效。方法:对33例糖尿病性眼肌麻痹采用“正容汤”加减（胆南星、僵蚕、钩藤、白附子、花粉、茯神、羌活、秦艽、防风、木瓜、石斛、当归、甘草、生姜等水煎服）治疗单纯动眼神经麻痹20例、动眼神经麻痹合并外展神经麻痹2例、动眼神经合并滑车神经麻痹2例。外展神经麻痹5例，滑车神经麻痹4例。结果以20天为一疗程计算，治愈24例72.72%，好转6例18.18%，总有效率为90.91%，无效3例9.09%。结论:中西医结合治疗糖尿病性眼肌麻痹有效，并对其机理进行了探讨。 【关键词】中西医结合;糖尿病性眼肌麻痹 Integrative Medicine treated 33 cases of diabetic ophthalmoplegia Analysis Wang HongfengWang Enrong 【Abstract】 Objective To explore the use of the method of combining Chinese and Western medicine treatment of diabetic ophthalmoplegia and efficacy of treatment. Methods 33 cases of diabetic ophthalmoplegia use of “positive tolerance soup” addition and subtraction (bile Southern Star, silkworm, Uncaria, white tuber, pollen, Fu Shen, Rhizoma, Gentiana, wind, papaya, Dendrobium, angelica, licorice, ginger decoction) in the treatment of oculomotor nerve palsy alone, 20 cases of oculomotor nerve palsy combined abducens nerve palsy in 2 cases, combined oculomotor trochlear nerve palsy in 2 cases. Abducens nerve paralysis in 5 cases, the trochlear nerve palsy in 4 cases. The results of 20 days for a course calculated to cure 24 cases 72.72%, 18.18% improvement in 6 cases, total effective rate was 90.91%, 9.09% 3 cases. Conclusion Integrative Medicine and effective treatment of diabetic ophthalmoplegia, and its mechanism was discussed 【Key words】Combining traditional Chinese and western medicine; Diabetic eye flesh is paralytic: 【中图分类号】R412 【文献标识码】B 【文章编号】1005-0515(2011)07-0363-01 自1998年始，2008年底止，我科用中西医结合治疗糖尿病眼肌麻痹33例，现报告如下： 1 资料和方法 1.1 一般资料：33例中男14例，女19例，年龄最大者76岁，最小21岁，平均年龄56.1岁，既往均有糖尿病史，病程2-18年。采用服降糖药物和控制饮食者18例，注射胰岛素者15例。合并糖尿病视网膜病变者25例，其中Ⅰ期12例，Ⅱ期8例，Ⅲ期5例。体检有高血压者27例，高血脂者29例。4例有末梢神经炎病史。 1.2 临床表现：33例均因突然出现复视就诊，伴有头痛、眼眶痛者21例，恶心10例，呕吐4例，上睑下垂24例，瞳孔散大12例。均为单眼发病，右眼16例，左眼17例。受累的颅神经为：单纯动眼神经麻痹20例，动眼神经麻痹合并外展神经麻痹2例、动眼神经合并滑车神经麻痹2例。外展神经麻痹5例，滑车神经麻痹4例。就诊时间最短2天，最长2个月，平均20.8天。 1.3 辅助检查：33例发病后有29例做了头部CT或核磁共振检查，19例正常，7例有不同程度的多发性腔隙性脑梗阻，3例有不同程度脑萎缩。查33例空腹血糖为6.20mm0