脉管复康胶囊治疗2型糖尿病下肢病变的临床效果以及对患者微循环障碍和氧化应激损伤指标水平的影响

Clinical efficacy of vascular rehabilitation capsules in treatment of lower extremity disease in patients with type 2 diabetes and the effect on microcirculatory disorder and oxidative stress injury

目的探讨脉管复康胶囊对2型糖尿病下肢病变的临床效果,并观察其对患者微循环障碍指标内皮素、血栓素和6-酮-前列腺素F-1a(6-Keto-PGF-1a)和氧化应激指标丙二醛、超氧化物歧化酶(SOD)、晚期氧化蛋白产物(AOPP)水平的影响。方法选取2017年10月至2019年3月海南省琼海市中医院收治的74例2型糖尿病下肢病变患者。根据治疗方法不同分为对照组和观察组,各37例。对照组在常规治疗基础上给予甲钴胺注射液静脉滴注,观察组在常规治疗基础上口服脉管复康胶囊。比较2组治疗前后神经病变主觉症状问卷(TSS)评分、氧化应激和微循环障碍指标水平,同时观察不良反应情况。结果2组治疗后疼痛、灼热感、感觉异常、麻木症状评分及TSS总评分均较治疗前降低,且观察组低于对照组[总评分:(3.9±1.4)分比(6.8±1.5)分],差异均有统计学意义(均P<0.05)。治疗后观察组血清内皮素、血栓素、丙二醛、AOPP水平低于对照组,6-Keto-PGF-1a、SOD水平高于对照组,差异均有统计学意义(均P<0.05)。观察组和对照组患者治疗期间均未出现严重心血管事件,不良反应发生率差异无统计学意义[10.8%(4/37)比13.5%(5/37)](P>0.05)。结论脉管复康胶囊治疗2型糖尿病下肢病变患者具有显著成效,可以有效改善微循环障碍及氧化应激损伤,具有较高的安全性。

Objective To investigate the clinical effect of vascular rehabilitation capsules on type 2 diabetic patients with lower extremity vascular lesions,and to observe the effect on microcirculatory disorder[endothelin,endothelin,6-Keto-prostaglandin-F-1a(6-Keto-PGF-1a)]and oxidative stress[malondialdehyde,superoxide dismutase(SOD),advanced oxidative protein products(AOPP)].Methods A total of 74 type 2 diabetic patients with lower extremity disease admitted to Qionghai Traditional Chinese Medicine Hospital from October 2017 to March 2019 were respectively treated with mecobalamine for intravenous infusion(37 cases)or vascular rehabilitation capsules(37 cases).Neuropathy Total Symptoms Score(TSS),oxidative stress,microcirculation indicators and adverse reactions were analyzed.Results After treatment,scores of pain,burning sensation,abnormal sensation,numbness and TSS were significantly reduced and the scores in the observation group were lower than those in the control group[TSS(3.9±1.4)vs(6.8±1.5)](all P<0.05).After treatment,serum levels of endothelin,thromboxane,malondialdehyde and AOPP in the observation group were significantly lower,6-Keto-PGF-1 a and SOD levels were higher than those in the control group(all P<0.05).No serious cardiovascular event occurred during treatment and there was no significant difference in the incidence of adverse reactions between groups[10.8%(4/37)vs 13.5%(5/37)](P>0.05).Conclusion Vascular rehabilitation capsules treating lower extremity disease of type 2 diabetes can safely and effectively improve microcirculation and reduce oxidative stress injury.