双通法治疗糖尿病周围神经病变对氧化应激、炎性因子的影响

Effects of bi-pass method on diabetic peripheral neuropathy,oxidative stress and inflammatory factors

目的观察内外同治联合西医常规治疗糖尿病周围神经病变的疗效观察。方法选择2018年1月至2020年9月收治的糖尿病周围神经病变患者100例,按照随机数字表法分为对照组和治疗组,每组50例。对照组给予甲钴胺联合中药阳和汤治疗;治疗组在对照组治疗基础上加用趾尖放血治疗。2组均3个月为1个疗程,1个疗程后比较临床疗效,并观察2组治疗前后临床症状改善情况、超氧化物(SOD)、丙儿醛(MDA)、同型半胱氨醛(Hcy)、C-反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、脂蛋白相关磷脂酶A2(Lp-PLA2),以及症状缓解时间及症状持续改善时间。结果治疗前2组神经病变自觉症状积分差异无统计学意义(P>0.05);治疗后2组神经病变自觉症状积分均降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后2组炎性因子水平较治疗前均降低(P<0.05);2组治疗后SOD较治疗前升高,MDA、Hcy水平较治疗前降低(P<0.05)。治疗后治疗组炎性因子水平均低于对照组(P<0.05);治疗后治疗组SOD水平高于对照组、MDA、Hcy水平低于对照组(P<0.05)。治疗组症状缓解时间早于对照组,症状持续改善时间长于对照组(P<0.05)。结论双通法治疗糖尿病周围神经病变疗效确切,并具有显著改善氧化应激及降低炎性反应作用,且疗效持久。

Objective To observe the effects of bi-pass method on diabetic peripheral neuropathy(DPN),oxidative stress and inflammatory factors.Methods A total of 100 patients with diabetic peripheral neuropathy were randomly divided into control group(n=50)and observation group(n=50).The patients in control group were treated by mecobalamin combined with Yanghe Soup while those in treatment group were treated with bloodletting of toe tip on the basis of the control group.Three month later,the clinical efficacy,the improvement of clinical symptom,SOD,MDA,Hcy,CRP,IL-6,TNF-α,Lp-PLA2,symptom relief time and continuous improvement time of symptoms before and after treatment were observed and compared between the two groups.Results Before treatment there were no significant differences in peripheral neuropathy symptoms scores between the two groups(P>0.05).After treatment,the peripheral neuropathy symptoms scores in both groups were significantly decreased(P<0.05),moreover,which in observation group were significantly lower than those in control group(P<0.05).Moreover,the levels of inflammatory factors and MDA as well as Hcy were significantly decreased(P<0.05),which in observation group were significantly lower than those in control group(P<0.05).The SOD in both groups was increased,which in observation group was significantly higher than that in control group,while the levels of MDA and Hcy were significantly lower than those in control group(P<0.05).In addition,the symptom relief time and the continuous improvement time of symptoms in observation group were significantly earlier and longer than those in control group,respectively(P<0.05).Conclusion The bi-pass method can significantly improve the oxidative stress and reduce inflammatory reaction in treating DPN,with definite therapeutic effect and sustained efficacy.