丹红注射液、维生素B_(12)、依帕司他片联合治疗糖尿病周围神经病变疗效观察

Effect of Danhong injection combined with vitamin B_(12) and epalrestat in the treatment of diabetic peripheral neuropathy

目的探讨丹红注射液联合维生素B_(12)、依帕司他片治疗糖尿病周围神经病变(DPN)的临床疗效。方法采用随机抽签方式将120例DPN患者均分为对照组与观察组。对照组在常规控制血糖、运动饮食干预基础上服用维生素B_(12)和依帕司他片;观察组在对照组基础上静脉滴注丹红注射液。对比2组治疗前后神经神经功能受损情况,正中神经、腓总神经、尺神经、胫神经的感觉神经传导速度(SCV)、运动神经传导速度(MCV)以及血清人神经生长因子(NGF)、血管内皮生长因子(VEGF)含量变化;观察2组临床效果。结果与治疗前相比,2组DPN患者治疗后的感觉功能、神经反射及神经症状3个维度及多伦多临床评分系统(TCSS)总评分均显著下降(P <0. 05),正中神经、腓神经、尺神经及胫神经的SCV、MCV显著加快(P <0. 05),血清神经营养因子NGF、VEGF含量显著增加(P <0. 05);与对照组比较,观察组TCSS 3个维度评分、TCSS总评分,正中神经、腓神经、尺神经、胫神经的SCV、MCV,以及血清NGF、VEGF含量的变化更显著(P <0. 05)。观察组治疗后的临床总有效率显著高于对照组(P <0. 05)。结论丹红注射液联合维生素B_(12)和依帕司他治疗DPN具有较好的临床效果,可促进神经组织释放神经营养因子,显著促进患者受损神经功能修复,加快神经传导速度。

Objective To explore the clinical efficacy of Danhong injection combined with vitamin B12and epalrestat in the treatment of diabetic peripheral neuropathy(DPN).Methods A total of120patients with DPN were randomly divided into control group and observation group.The control group treated with vitamin B12and epalrestat tablets on the basis of routinely controlled blood sugar and exercise diet intervention.The observation group was treated with Danhong injection on the basis of the control group.The changes of neurological impairment,sensory nerve conduction velocity(SCV)and motor nerve conduction velocity(MCV)of median nerve,common peroneal nerve,ulnar nerve and radial nerve,and the content of serum human nerve growth factor(NGF)and vascular endothelial growth factor(VEGF)were compared between two groups.The clinical effects of the two groups were observed.Results Compared with the treatment before,the scores of sensory function,nerve reflex and neurological symptoms and total scores of Toronto clinical scoring system(TCSS)decreased significantly after treatment in two groups(P<0.05).The SCV and MCV of median nerve,phrenic nerve,ulnar nerve and radial nerve were significantly increased(P<0.05).Serum neurotrophic factor NGF and VEGF levels increased significantly(P<0.05).Compared with the control group,the3dimension scores of TCSS and the TCSS,content of SCV and MCV median,phrenic nerve,ulnar nerve and radial nerve,levels of serum NGF and VEGF in the observation group had prominent changes(P<0.05).The total clinical effective rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion Danhong injection combined with vitamin B12as well as epalrestat for the treatment of DPN both have good clinical effect,which can promote the release of neurotrophic factors in nerve tissue,significantly promote the repair of damaged nerve function and accelerate the nerve conduction velocity in patients with DPN.