依帕司他联合甲钴胺片治疗糖尿病周围神经病变的效果

Efficacy of Epalrestat combined with Mecobalamin Tablets in the treatment of diabetic peripheral neuropathy

目的分析糖尿病周围神经病变(DPN)患者应用依帕司他联合甲钴胺片治疗的效果。方法将四川省南充市第二人民医院2016年6月~2017年6月收治的94例DPN患者作为研究对象,按照随机数字表法,将患者随机分为对照组与联合组,每组各47例。对照组给予甲钴胺片治疗,0.5~1.0 mg/次,3次/d;联合组在对照组治疗基础上应用依帕司他进行治疗,50 mg/次,3次/d。两组患者均治疗8周。比较两组临床疗效、治疗前后白细胞介素-1β(IL-1β)和基质金属蛋白酶9(MMP-9)含量变化及不良反应的发生情况。结果联合组治疗总有效率为91.49%,较对照组的72.34%显著升高(P<0.05)。两组治疗后神经传导速度较治疗前均显著升高,且联合组较对照组显著升高(均P<0.05)。两组患者治疗后IL-1β与MMP-9水平较治疗前均显著降低,且联合组IL-1β与MMP-9水平较对照组均显著降低(均P<0.01)。两组患者不良反应发生率的比较,差异无统计学意义(P>0.05)。结论 DPN患者应用依帕司他可取得良好的治疗效果,且可有效调节IL-1β与MMP-9表达,可明显降低血清炎性介质的水平,有效减缓病情进展程度,可增强临床效果,因此具有良好的临床应用价值。

Objective To analyze Lhe efficacy of EpalresLaL combined wiLh Mecobalamin TableLs on paLienLs wiLh dia-beLic peripheral neuropaLhy(DPN).Methods NineLy-four paLienLs wiLh DPN LreaLed in Nanchong Second People's Hos-piLal of SichuanProvince from June 2016 Lo June 2017 were selecLed.According Lo Lhe random number Lable meLhod,Lhe paLienLs were divided inLo Lhe conLrol group and Lhe combined group,wiLh 47 cases in each group.The conLrol group was LreaLed wiLh Mecobalamin TableLs,0.5-1.0 mg/Lime and 3 Limes/d,and Lhe combined group was LreaLed wiLh EpalresLaL on Lhe basis of Lhe conLrol group,50 mg/Lime,and 3 Limes/d.The Lwo groups were LreaLed for 8 weeks.The clinical efficacy,Lhe changes of inLerleukin-1β(IL-1β)and maLrix meLalloproLeinase 9(MMP-9)levels before and af-Ler LreaLmenL and Lhe incidence of adverse reacLions were compared beLween Lhe Lwo groups.Results The LoLal effecLive raLe of Lhe combined group was 91.49%,which was significanLly higher Lhan LhaL of Lhe conLrol group(72.34%)(P<0.05).AfLer LreaLmenL,nerve conducLion velociLy in Lhe Lwo groups increased significanLly in comparison of Lhose before LreaLmenL,and Lhe level in Lhe combined group was significanLly higher Lhan LhaL in Lhe conLrol group(P<0.05).The levels of IL-1βand MMP-9 in Lhe Lwo groups were significanLly lower Lhan Lhose before LreaLmenL,and Lhe levels of IL-1βand MMP-9 in Lhe combined group were significanLly lower Lhan Lhose in Lhe conLrol group(all P<0.05).There was no significanL difference in Lhe incidence raLe of adverse reacLions beLween Lhe Lwo groups(P>0.05).Conclusion The applicaLion of EpalresLaL in paLienLs wiLh DPN has good LherapeuLic effecL,which can effecLively regulaLe Lhe ex?pression of IL-1P and MMP-9.And iL can obviously reduce Lhe level of serum inflammaLory mediaLors,effecLively slow1 down Lhe rogression of Lhe disease,and can enhance Lhe clinical effecL,so iL has beLLer clinical value.