温通活血乳膏联合依帕司他对糖尿病痛性神经病变的影响

Wentonghuoxue cream combined with epalrestat on diabetic painful neuropathy

目的:观察温通活血乳膏联合依帕司他治疗糖尿病痛性神经病变的疗效。方法:温通活血乳膏由川芎、细辛、桂枝、红花等7味中药组成(本院药学部制备,批件号:新药制字:Z20052604)。90名患者按1:1随机分配进入温通活血乳膏联合依帕司他治疗组(45例)和依帕司他对照组(45例),疗程30天。比较两组治疗前后及其组间下肢神经的传导速度、症状、体征、VAS评分及Na+,K+-ATP酶活性的影响。结果:最终进入统计分析为85例患者。1治疗组和对照组治疗前后自身比较,均较前改善,差异具有显著性(P<0.01)。温通活血乳膏(生药1g/kg)治疗组治疗后运动神经传导速度(腓总神经、胫神经)分别为38.4±2.2 m/s、42.9±4.6m/s,感觉神经传导速度(腓总神经、胫神经)分别为39.2±2.4m/s,40.1±3.5m/s,均高于对照组治疗后运动神经传导速度(腓总神经、胫神经)32.1±2.4m/s,35.3±3.8m/s及感觉神经传导速度(腓总神经、胫神经)30.5±2.5m/s,32.7±2.9m/s,差异有统计学意义(P<0.05);2临床疗效:温通活血乳膏(生药1g/kg)治疗组在改善患者临床症状方面效果明显,显效21例,有效14例,无效8例,总有效率为81.4%;对照组显效9例,有效19例,无效14例,总有效率为66.7%,两组总有效率比较差异具有显著性(P<0.01)。3 VAS评分:温通活血乳膏(生药1g/kg)治疗组在改善患者VAS评分1.3±0.5明显低于对照组1.8±0.7,两组评分比较差异具有统计学意义(P<0.05)。4Na+,K+-ATP酶活性:温通活血乳膏(生药1g/kg)治疗组Na+,K+-ATP酶活性48.05±6.36(u/mg)明显高于对照组35.92±13.71(u/mg),差异有统计学意义(P<0.05)。结论:温通活血乳膏联合依帕司他能够有效改善糖尿病痛性神经病变患者的临床症状,延缓糖尿病周围神经病变的进展。

To observe the curative effect of Wentonghuoxue cream combined with epalrestat in treatment of diabetic painful neuropathy. Methods： Wentonghuoxue cream consists of 7 herb chuanxiong, asarum, cassia twig, safflower, pharmacy department of the hospital prepara- tion （ batch number： new word： Z20052604）. 90 patients with 1 ： 1 were divided into the warming and activating blood cream combined with epalrestat treatment group （45 cases） and epalrestat group （45 cases）. The course of treatment was 30 days. Conduction velocity, compared before and after treatment between the two group and the lower limb nerve symptoms, signs, VAS score and Na - , K - -ATP enzyme activity. Results：Display the end into the statistical analysis of 85 cases. The treatment group and the control group before and after treatment in it- self, were improved, the difference was significant （ P 〈 0.01 ）. Wentonghuoxue cream （ 1 g/kg） after treatment, motor nerve conduction ve- locity （ peroneal nerve, tibial nerve） were 38.4 ± 2.2m/s, 42.9 ± 4.6m/s, sensory nerve conduction velocity （ peroneal nerve, tibial nerve） were 39.2 ± 2.4m/s, 40.1 ± 3.5m/s, were higher than the control group after treatment movement nerve conduction velocity （ peroneal nerve, tibial nerve） 32.1 ± 2.4m/s , 35.3 ± 3.8m/s and sensory nerve conduction velocity （peroneal nerve, tibial nerve） 30.5 ± 2.5m/ s, 32.7 ± 2.9m/s, the difference was statistically significant （P 〈 0. 05 ） ; the clinical curative effect： Wentonghuoxue cream （lg/kg） treat- ment group in improving results clinical symptoms significantly, effective in 21 cases, effective 14 eases, invalid 8 eases, the total effective rate was 81.4% ; 9 cases of control group, 19 eases effective, 14 eases ineffective, the total efficiency of 66.7%, the total efficiency of two groups compare the difference was significant （P 〈 0.01 ）. The VAS score： Wentonghuoxue cream （ 1 g/kg） treatment group in improving the VAS of the patients was 1.3 - 0.5 was significantly lower than the control group of 1.8 ± 0.7, with statistical significance difference be- tween the two groups score （P 〈0.05）. The Na＋ , K＋-ATP activity： Wentonghuoxue cream （lg/kg） treatment group Na＋ , K±-ATP en- zyme activity of 48.05 ± 6.36 （u/mg） was higher than that of the control group was 35.92 ± 13.71 （u/mg）, the difference was statisti- cally significant （P 〈 0.05 ）. Conclusion： This test, Wentonghuoxue cream combined with epalrestat can effectively improve the clinical symptoms in patients with painful diabetic neuropathy, slowing the progression of diabetic peripheral neuropathy.