胰岛素泵强化治疗2型糖尿病周围神经病变的临床疗效观察

Observation of clinical effect of insulin pump intensive therapy on type 2 diabetic peripheral neuropathy

目的观察胰岛素泵强化治疗2型糖尿病周围神经病变的临床疗效。方法选择2型糖尿病周围神经病变患者112例,随机分为治疗组与对照组,每组56例,对照组予饮食控制、调脂、扩管、营养神经等综合治疗,治疗组在对照组治疗基础上予胰岛素泵强化治疗将血糖控制在理想范围(空腹≤6.0 mmol/L,餐后2 h≤8.0 mmol/L),2周后观察比较两组的治疗效果。结果治疗后两组的多伦多评分系统(TCSS)评分以及足部麻木、疼痛的视觉模拟评分法(VAS)评分均明显下降,但治疗组下降幅度更加明显,差异有统计学意义(P<0.01);治疗后两组患者正中神经、腓总神经的MNCV和SNCV均明显提高(P<0.01),且治疗组的提高幅度大于对照组(P<0.01);治疗后两组总有效率分别为92.9%、73.2%,治疗组疗效明显优于对照组,差异差异有统计学意义(P<0.01)。结论胰岛素泵强化治疗能明显改善2型糖尿病并周围神经病变患者的临床症状。

Objective To observe clinical effect of insulin pumps intensive therapy on type 2 diabetic peripheral neuropathy. Methods 112 cases of type 2 diabetic peripheral neuropathy were selected,and they were randomly divided into treatment group and control group with 56 cases in each group. The control group were given comprehensive treatment which included diet control,lipid regulation and blood expanding,etc,and based on which the treatment group were added insulin pumps intensive therapy to control blood sugar in an ideal limit（ FBG ≤6. 0 mmol / L,2 h PBG ≤8. 0 mmol / L）. Clinical effects after two weeks＇ of treatment were observed and compared between the two groups. Results After treatment,Toronto clinical scoring system（ TCSS） scores,foot numb and pain＇s VAS scores in both the treatment group and the control group significantly declined,and those of the treatment group declined more significantly than those of the control group,so the difference was statistically significant（ P 〈0. 01）. MNCV and SNCV of both median nerve and nervus peroneus communis of the two groups after treatment obviously increased（ P 〈0. 01）,and those of the treatment group increased more significantly than the control group（ P 〈0. 01）. Total effective rate of the treatment group and the control group was 92. 9% and 73. 2%respectively after treatment,which showed that the total effective rate of the treatment group was obviously higher than that of the control group,so the difference was statistically significant（ P 〈0. 01）. Conclusion Insulin pumps intensive therapy can significantly improve clinical symptoms of patients with type 2 diabetic peripheral neuropathy.