津力达颗粒联合甲钴胺治疗糖尿病周围神经病变的临床效果

Clinical effect of Jinlida granules combined with methylcobalamin on diabetic peripheral neuropathy

目的探讨津力达颗粒联合甲钴胺治疗糖尿病周围神经病变（DPN）的临床效果。方法选取2016年1-12月于哈尔滨市第一医院就诊的2型糖尿病合并DPN患者120例。根据随机数字表法，将患者分为观察组和对照组，各60例。在控制血糖的综合治疗的基础上，对照组给予甲钴胺治疗，观察组在对照组基础上加用津力达颗粒。2组均连续治疗12周。比较2组治疗前后多伦多临床评分系统（TCSS）评分、血清共轭双烯水平及神经传导速度。结果治疗前，2组TCSS评分和血清共轭双烯水平比较，差异均无统计学意义（均P〉0．05）；治疗后，2组TCSS评分和血清共轭双烯水平均低于治疗前[观察组：（8．3±2．1）分比（10．5±1．8）分、（0．73±0．12）pg／L比（1．43±0．14）μg／L；对照组：（9．0±2．0）分比（10．6±2．0）分、（1．02±0．13）μg／L比（1．45±0．11）μg／L]，且观察组明显低于对照组，差异均有统计学意义（均P〈0．05）。治疗前，2组患者腓总神经、胫神经的感觉传导速度（SNCV）和运动传导速度（MNCV）比较，差异均无统计学意义（均P〉0．05）；治疗后，2组腓总神经、胫神经的SNCV和MNCV高于治疗前[观察组腓总神经：（43±6）m／s比（36±5）m／s、（46±4）m／s比（38±3）m／s，观察组胫神经：（43±6）m／s比（35±4）m／s、（44±g）m／s比（38±5）m／s；对照组腓总神经：（39±5）m／s比（36±5）m／s、（41±4）m／s比（37±5）m／s，对照组胫神经：（38±6）m／s比（36±6）m／s、（41±5）m／s比（38±5）m／s]，且观察组明显高于对照组，差异均有统计学意义（均P〈0．05）。结论津力达颗粒联合甲钴胺治疗DPN，可改善患者临床症状、减轻其体内氧化应激状态、提高神经传导速度。

Objective To explore the clinical efficacy of Jinlida granules combined with methylcobalamin in treatment of diabetic peripheral neuropathy（DPN）. Methods Totally 120 type 2 diabetic patients complicated with DPN from January to December 2016 in Harbin the First Hospital were randomly divided into observation group and control group, with 60 cases in each group. Both groups received basic blood sugar controlling; the control group had methylcobalamin; the observation group had Jinlida granules based on control group; both groups were treated for 12 weeks. The score of Toronto Clinical Scoring System, serum level of conjugated dienes and nerve conduction velocity were analyzed. Results The TCSS score and serum conjugated dienes level had no significant differences between groups before treatment（P 〉 0. 05 ）. The TCSS score and serum conjugated dienes level after treatment were significantly lower than those before treatment[ observation group ： （ 8.3 ± 2. 1 ） scores vs （10.5±1.8）scores, （0.73 ±0.12）μg/L vs （1.43 ±0.14）μg/L; control group： （9.0 ±2.0）scores vs （ 10. 6 ± 2. 0 ） scores, （ 1.02 ± 0. 13 ） μg/L vs （ 1.45 ± 0. 11 ） μg/L ] （ P 〈 0. 05 ） ; the TCSS score and serum conjugated dienes level in observation group after treatment were significantly lower than those in control group （ P 〈0. 05 ）. The sensory conduction velocity（SNCV） and motor conduction velocity（MNCV） of common peroneal nerve and tibial nerve had no significant differences between groups before treatment（ P 〉 0. 05 ）. The SNCV and MNCV of common peroneal nerve and tibial nerve after treatment were significantly higher than those before treatment[ SNCV in observation group： （43 ±6）m/s vs （36 ±5）m/s, （43 ±6）m/s vs （35 ±4）m/s, MNCV in observation group： （46 ±4）m/s vs （38 ±3）m/s, （44 ±4）m/s vs （38 ±5）m/s; SNCV in control group： （39 ± 5）m/s vs （36 ±5）m/s, （38 ±6）m/s vs （36 ±6）m/s, MNCV in control group： （41 ±4）m/s vs （37 ±5）m/s, （41 ±5）m/s vs （38 ±5）m/s] ; the SNCV and MNCV of common peroneal nerve and tibial nerve in observation group after treatment were significantly higher than those in control group （ P 〈 0. 05 ）. Conclusion Jinlida granules combined with mecobalamin treating DPN patients can improve clinical symptoms, relieve oxidative stress and increase the nerve conduction velocity.