芪丹通络颗粒联合硫辛酸治疗糖尿病周围神经病变的临床研究

Clinical study on Qidan Tongluo Granules combined with thioctic acid in treatment of diabetic peripheral neuropathy

目的探讨芪丹通络颗粒联合硫辛酸注射液治疗糖尿病周围神经病变的临床疗效。方法选取2015年5月-2018年5月在成都市青白江区人民医院治疗的86例糖尿病周围神经病变患者,根据用药差别分为对照组(43例)和治疗组(43例)。对照组静脉滴注硫辛酸注射液,12 mL加入生理盐水250 mL,2次/d;治疗组在对照组的基础上口服芪丹通络颗粒,8 g/次,3次/d。两组患者均经4周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者MDNS和TCSS评分,神经传导速度,及血清同型半胱氨酸(Hcy)、核因子-κB(NF-κB)、内皮素-1(ET-1)和一氧化氮(NO)水平。结果治疗后,对照组临床有效率为62.79%,显著低于治疗组的86.05%,两组比较差异有统计学意义(P<0.05)。经治疗,两组MDNS评分、TCSS评分均明显降低(P<0.05),且治疗组下降更明显(P<0.05)。经治疗,两组患者正中神经和腓总神经的运动神经传导速(MNCV)、感觉神经传导速度(SNCV)均明显增快(P<0.05),且治疗组传导速度明显快于对照组(P<0.05)。经治疗,两组患者血清Hcy、NF-κB、ET-1水平均明显降低(P<0.05),NO水平明显升高(P<0.05),且治疗组患者血清Hcy、NF-κB、ET-1和NO水平明显好于对照组(P<0.05)。结论芪丹通络颗粒联合硫辛酸注射液治疗糖尿病周围神经病变可有效改善患者症状,促进神经功能恢复,具有一定的临床推广应用价值。

Objective To explore the clinical effect of Qidan Tongluo Granules combined with thioctic acid in treatment of diabetic peripheral neuropathy. Methods Patients(86 cases) with diabetic peripheral neuropathy in Chengdu Qingbaijiang District People’s Hospital from May 2015 to May 2018 were divided into control(43 cases) and treatment(43 cases) groups based on different treatments. Patients in the control group were iv administered with Thioctic Acid Injection, 12 mL added into normal saline 250 mL, twice daily. Patients in the treatment group were po administered with Qidan Tongluo Granules on the basis of the control group, 8 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the MDNS scores, TCSS scores, the nerve conduction velocity, the serum level of Hcy, NF-κB, ET-1, and NO in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 62.79%, which was significantly lower than 86.05% in the treatment group, and there were differences between two groups(P<0.05). After treatment, the MDNS and TCSS scores in two groups were significantly decreased(P<0.05), and the scores in the treatment group were significantly lower than those in the control group(P<0.05). After treatment, the MNCV and SNCV of median nerve and common peroneal nerve in two groups were significantly faster(P<0.05), and the conduction velocity in the treatment group was significantly faster than that in the control group(P<0.05). After treatment, the serum level of Hcy, NF-κB, and ET-1 in two groups was significantly decreased(P<0.05), but NO level was significantly increased(P<0.05), and the level of Hcy, NF-κB, ET-1, and NO in the treatment group was significantly better than those in the control group(P<0.05). Conclusion Qidan Tongluo Granules combined with Thioctic Acid Injection in treatment of diabetic peripheral neuropathy can effectively improve the symptoms, promote the recovery of nerve function, which has a certain clinical application value.