依帕司他联合葛根素治疗糖尿病周围神经病变的效果

Effect of epalrestat combined with puerarin in the treatment of diabetic peripheral neuropathy

目的分析依帕司他联合葛根素治疗糖尿病周围神经病变(DPN)的临床效果。方法选取2017年1月至2019年1月收治的91例DPN患者为研究对象。根据不同治疗方式将患者分为对照组(46例)和研究组(45例)。所有患者均接受对症基础治疗。在此基础上,对照组患者采用依帕司他片治疗,研究组患者采用依帕司他片+葛根素治疗。比较两组患者的临床疗效,治疗前、后腓总神经、正中神经的运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)及多伦多临床评分系统(TCSS)评分。观察治疗期间两组不良反应情况。结果研究组患者的治疗总有效率为84.44%,明显高于对照组的60.87%,差异具有统计学意义(P<0.05)。治疗前,两组患者腓总神经、正中神经的MNCV、SNCV和TCSS评分比较,差异无统计学意义(P>0.05);治疗后,两组患者腓总神经、正中神经的MNCV、SNCV均显著高于治疗前,且研究组高于对照组,差异具有统计学意义(P<0.05);治疗后,研究组患者的TCSS评分显著低于治疗前和对照组,差异具有统计学意义(P<0.05)。治疗期间,研究组和对照组分别出现1例恶心、发热患者,且未经药物干预,自行缓解,不影响继续治疗。结论依帕司他联合葛根素治疗DPN患者的效果满意,可提高患者周围神经传导速度,改善临床症状,安全性高,值得临床推广。

Objective To analyze the clinical effect of epalrestat combined with puerarin in the treatment of diabetic peripheral neuropathy(DPN). Methods Ninety-one DPN patients admitted from January 2017 to January 2019 were selected as the study objects, and the patients were divided into control group(46 cases) and study group(45 cases)according to different treatment methods. All the patients received symptomatic basic treatment. On this basis, the patients in the control group were treated with epalrestat tablets, while those in the study group were treated with epalrestat tablets +puerarin. The clinical effect, motor nerve conduction velocity(MNCV) and sensory nerve conduction velocity(SNCV) of common peroneal nerve and median nerve and Toronto clinical scoring system(TCSS) scores before and after treatment were compared between the two groups. The adverse reactions of the two groups were observed during the treatment. Results The total effective rate of treatment in the study group was 84.44%, which was significantly higher than 60.87% in the control group, the difference was statistically significant(P <0.05). Before treatment, there were no significant differences in MNCV, SNCV of common peroneal nerve and median nerve and TCSS score between the two groups(P>0.05). After treatment, the MNCV and SNCV in common peroneal nerve and median nerve in the two groups were significantly higher than those before treatment, and those in the study group were higher than the control group, the differences were statistically significant(P <0.05). After treatment, the TCSS score in the study group was significantly lower than that before treatment and in the control group, the differences were statistically significant(P<0.05). During the treatment, 1 case of nausea and fever occurred in the study group and the control group respectively, which were relieved without drug intervention and did not affect the continuous treatment. Conclusion Epalrestat combined with puerarin in the treatment of DPN patients can get satisfactory effects, and improve peripheral nerve conduction velocity and clinical symptoms, with high safety, which is worthy of clinical promotion.