木丹颗粒联合甲钴胺治疗糖尿病周围神经病变的临床研究

Clinical study of Mudan granule combined with Mecobalamin in treatment of diabetic peripheral neuropathy

目的探讨木丹颗粒联合甲钴胺治疗糖尿病周围神经病变的临床疗效。方法采用随机数字法将98例2015年6月—2016年2月间武警浙江省消防总队医院收治的糖尿病周围神经病变(DPN)患者随机分为2组,每组49例。对照组给予甲钴胺,观察组在对照组的基础上加用木丹颗粒。治疗前后,检测患者血液生化指标[血清总胆固醇(TC)、甘油三酯(TG)、全血高切粘度(HBV)、全血低切粘度(LBV)]、临床症状积分(肢体麻木和刺痛感、肢端温度感觉障碍、肢端反射灵敏度和肢体无力感)、神经传导速度[正中神经、腓总神经和胫前神经的运动传导速度(MNCV)和感觉传导速度(SNCV)],并统计2组的临床治疗效果。结果治疗后2组TC、TG、HBV及LBV水平均明显降低(P<0.05),且观察组TC、TG、HBV及LBV水平明显低于对照组(P<0.05)。治疗后,2组肢体麻木和刺痛感、肢端温度感觉障碍、肢端反射灵敏度、肢体无力感水平均明显降低(P<0.05),且观察组肢体麻木和刺痛感、肢端温度感觉障碍、肢端反射灵敏度、肢体无力感水平明显低于对照组(P<0.05)。治疗后,2组正中神经、腓总神经、胫前神经的MNCV和SNCV水平均较前明显加快(P<0.05),且观察组正中神经、腓总神经、胫前神经的MNCV和SNCV水平明显快于对照组(P<0.05)。观察组治疗总有效率为89.8%,显著高于对照组的73.5%(P<0.05)。结论木丹颗粒联合甲钴胺治疗糖尿病周围神经病变,可以显著改善患者的临床症状,治疗效果满意。

Objective To investigate the clinical effect of Mudan granule combined Mecobalamin on diabetic peripheral neuropathy. Methods Ninety-eight cases of diabetic peripheral neuropathy patients were randomly divided into 2 groups （49 cases in each group）. The control group was given mecobalamin, and observation group was given Mudan granule based on control group. Before and after treatment, serum biochemical parameters[ serum total cholesterol（TC） ,triglycer- ide（TG）, whole blood high shear viscosity （HBV）, whole blood low shear viscosity （LBV）], clinical symptom score （Limb numbness and tingling sensation, acral temperature sensory disturbance, acral reflex sensitivity and limb weak- ness）, nerve conduction velocity [ motor nerve conduction velocity （MNCV） and sensory conduction velocity （SNCV） of median nerve, common peroneal nerve and anterior tibial nerve ] of two groups were detected, and the clinical effect of two groups were accounted. Results After treatment, the TC, TG, HBV and LBV levels of two groups were significantly reduced （ P 〈 0.05 ） ; and TC, TG, HBV and LBV levels of observation group were significantly lower than control group （ P 〈 0.05 ）. After treatment, limb numbness and tingling sensation, acral temperature sensory disturbance, acral reflex sensitivity and limb weakness of two groups were significantly reduced （ P 〈 0.05 ） ; and limb numbness and tingling sensation, ac- ral temperature sensory disturbance, acral reflex sensitivity and limb weakness of observation group were significantly lower than control group（ P 〈 0.05 ）. After treatment, median nerve, common peroneal nerve and anterior tibial nerve MNCV and SNCV of two groups were significantly increased（ P 〈 0.05 ） ;and median nerve, common peroneal nerve and anterior tibial nerve MNCV and SNCV of observation group were significantly higher than control group （ P 〈 0.05 ）. The total effective rate of the observation group was 89.8%, which was significantly higher than control group （73.5 %, P 〈 0.05 ）. Conclu- sion Mudan granule combined Mecobalamin could significantly improve the clinical symptoms of diabetic peripheral neuropathy with satisfactory effect.