丹参多酚酸盐联合前列地尔治疗痛性糖尿病神经病变的疗效观察

Clinical observation of alprostadil combined with salvianolate in treatment of painful diabetic neuropathy

目的观察丹参多酚酸盐联合前列地尔治疗糖尿病痛性神经病变的临床疗效。方法选取2014年5月—2016年5月在广西民族医院治疗的痛性糖尿病周围神经病变患者126例,随机分为对照组和治疗组,每组各63例,对照组静脉注射前列地尔注射液,10μg加入生理盐水或5%葡萄糖溶液10 m L,1次/d;治疗组在对照组的基础上静脉滴注注射用丹参多酚酸盐,200 mg加入生理盐水或5%葡萄糖溶液250~500 m L,1次/d,两组患者均连续治疗2周。治疗后,观察两组临床疗效,同时比较两组患者治疗前后神经传导速度、视觉模拟评分(VAS)和匹茨堡睡眠质量指数量表(PSQI)评分。结果治疗后,对照组和治疗组的总有效率分别为80.9%和93.6%,两组总有效率比较差异有统计学意义(P<0.05)。两组患者的正中神经、胫神经和腓总神经的运动神经传导速度和感觉神经传导速度均高于治疗前,同组比较差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者VAS和PSQI评分均较治疗前降低,同组比较差异具有统计学意义(P<0.05);且治疗组VAS和PSQI评分均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。结论丹参多酚酸盐联合前列地尔治疗痛性糖尿病神经病变疗效显著,明显改善患者自觉症状和睡眠质量,显著提高周围神经传导速度,具有一定的临床应用价值。

Objective To observe the curative effect of alprostadil combined with salvianolate in treatment of painful diabetic neuropathy.Methods Patients （126 cases） with painful diabetic neuropathy in Guangxi Minzu Hospital from May 2014 to May 2016 were randomly divided into control and treatment groups, and each group had 63 cases. Patients in the control group were iv administered with Alprostadil Injection, 10μg added into normal saline or 5% glucose injection 10 mL, once daily. Patients in the treatment group were ivadministered with Salvianolate for injection on the basis of the control group, 200 mg added into normal saline or 5% glucose injection 250 — 500 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the efficacy was evaluated, and the nerve conduction velocity, scores of VAS and PSQI scores were compared.Results After treatment, the clinical efficacy in the control and treatment groups were 80.9% and 93.6%, respectively, and there were differences between two groups （P 〈 0.05）. After treatment, the motor nerve conduction velocity and sensory nerve conduction velocity of median nerve, tibial nerve, and common peroneal nerve in two groups were significantly higher than those before treatment, and there were differences between two groups （P 〈 0.05）. These indicators in the treatment group were increased more significantly than those in the control group （P 〈 0.05）.After treatment, the scores of VAS and PSQI in two groups were significantly decreased （P 〈 0.05）. And these clinical symptom scores in treatment group were decreased more significantly than those in the control group （P 〈 0.05）.Conclusion Alprostadil combined with salvianolate has a significant clinical efficacy in treatment of painful diabetic neuropathy, can improve subjective symptom and sleep quality, and enhance nerve conduction velocity, which has a certain clinical application value.