消渴丸对2型糖尿病神经病变的临床疗效及对血糖和血浆纤维蛋白原的影响

Evaluation of Xiaoke Pill on Michigan Screening Scale for Type 2 Diabetic Neuropathy and Its Effect on FIB

目的:观察消渴丸对2型糖尿病神经病变的疗效及其对血浆纤维蛋白原(FIB)水平的影响。方法:选取2016年1月至2017年1月德州市中医院2型糖尿病神经病变患者60例,随机分为对照组和观察组,每组30例。2组患者均接受降糖、营养神经等常规处理,观察组在基础治疗方案上加用消渴丸,5丸/次,3次/d。2组患者均以14 d为1个疗程,连续治疗2个疗程,疗程中间间隔2 d。治疗结束后比较糖化血红蛋白(Hb Alc)、餐后2 h血糖(2 h BG)、空腹血糖(FBG)、纤维蛋白原(FIB)、密歇根筛查量表(MNSI)、后正中神经(MN)和腓总神经(CPN)的肌电以及汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分的变化。结果:2组治疗后Hb Alc、2 h BG、FBG、FIB水平均有所下降,观察组下降的幅度明显于对照组,差异有统计学意义(P<0.05);2组治疗后MNSI评分均较治疗前下降,其中观察组下降的趋势更明显,差异有统计学意义(P<0.05);2组受试者MN和CPN的MNCV、SNCV水平均较治疗前有明显提升,其中观察组明显优于对照组,差异有统计学意义(P<0.05);2组治疗前HAMA、HAMD评分数值相似,差异无统计学意义(P>0.05),治疗后观察组HAMA、HAMD评分均明显低于对照组,差异有统计学意义(P<0.05)。相关性分析显示MNSI评分与FIB存在正相关关系(r=0.189,P<0.05)。结论:消渴丸可明显改善2型糖尿病神经病变的神经传导速度,可明显改善预后。

Objective： To observe the curative effect of Xiaoke Pill on type 2 diabetic neuropathy and its effect on plasma fibrinogen（ FIB） level. Methods： From January 2016 to January 2017,60 patients with type 2 diabetic neuropathy were enrolled in the study. They were randomly divided into control group and observation group,with 30 cases in each group. Patients in both groups received routine treatment such as hypoglycemic and neurotrophic nerves. The observation group was treated with Xiaoke Pill,5 pills/time and 3 times/day on the basis of the treatment regimen. A course of treatment was 14 d,and for two courses of continuous treatment with treatment interval 2 d. After the treatment,the levels of Hb Alc,postprandial blood glucose 2 H（ 2 h BG）,fasting（ FBG）,FIB,Michigan Screening Scale（ MNSI）,posterior median nerve（ MN） and common peroneal nerve（ CPN）,as well as the Hamilton Anamiety Scale HAMA score and the Hamilton Depression HAMD scale score were compared after treatment. Results： The levels of Hb Alc,2 h BG,FBG and FIB in both groups decreased after treatment,and the decrease in the observation group was significantly lower than that in the control group（ P 〈0. 05）. The MNSI scores of both groups decreased after treatment（ P 〈0. 05）. The levels of MNCV and SNCV in MN and CPN of both groups were significantly higher than those before treatment（ P 〈0. 05）,and the observation group was significantly better than the control group（ P 〈0. 05）; The HAMA and HAMD scores of two groups before treatment were similar（ P 〈0. 05）,and the scores of HAMA and HAMD in the observation group were significantly lower than those in the control group after treatment（ P 〈0. 05）. The correlation analysis showed that there was a positive correlation between MNSI score and FIB relationship（ r = 0. 189,P 〈0. 05）. Conclusion： Xiaoke pills can significantly improve the nerve conduction velocity of type 2 diabetic neuropathy,which can obviously improve the prognosis.