灯盏花素联合贝前列素治疗糖尿病周围神经病变的临床效果及对血清高迁移率族蛋白B1和缺血修饰白蛋白水平的影响

The clinical efficacy of breviscapine combined with beraprost on the treatment of diabetic peripheral neuropathy and its influence on serum high mobility group protein B1 and ischemia modified albumin levels

目的观察灯盏花素联合贝前列素对糖尿病周围神经病变(DPN)的临床效果及对血清高迁移率族蛋白B1(HMGB1)和缺血修饰白蛋白(IMA)水平的影响。方法选取2018年1月至2020年11月于武汉科技大学附属天佑医院就诊的DPN患者100例,应用随机数字表法分为对照组和观察组,各50例。依据患者的血糖水平适当给予胰岛素等降糖药物,并且进行低强度的运动和低糖食物等常规治疗。对照组在常规治疗基础上给予贝前列素钠片口服治疗;观察组在对照组基础上给予灯盏花素注射液静脉滴注治疗。2组均治疗4周。比较2组临床疗效、运动和感觉神经传导速度及血清HMGB1、脑源性神经营养因子(BDNF)、髓鞘碱性蛋白(MBP)和IMA水平。结果观察组总有效率高于对照组[84.0%(42/50)比58.0%(29/50)],差异有统计学意义(P<0.05)。治疗后,2组患者运动和感觉神经传导速度均高于治疗前,且观察组运动神经传导速度均高于对照组,差异均有统计学意义(均P<0.05)。治疗后,2组HMGB1、MBP和IMA水平均低于治疗前、且观察组均低于对照组[(34±3)μg/L比(48±4)μg/L、(0.42±0.06)μg/L比(0.75±0.07)μg/L、(65±6)kU/L比(74±5)kU/L],BDNF水平高于治疗前,且观察组高于对照组[(10.22±1.31)μg/L比(7.29±1.21)μg/L],差异均有统计学意义(均P<0.05)。结论灯盏花素联合贝前列素对DPN的临床疗效显著,能够有效改善患者的周围神经功能,有效降低患者血清HMGB1和IMA水平。

Objective To observe the clinical efficacy of breviscapine combined with beraprost on diabetic peripheral neuropathy(DPN)and the influence on serum high mobility group protein B1(HMGB1)and ischemia modified albumin(IMA)levels.Methods From January 2018 to November 2020,100 patients with DPN admitted to Tianyou Hospital Affiliated to Wuhan University of Science and Technology were selected.Patients were randomly divided into control group and observation group,with 50 cases in each group.Insulin and other hypoglycemic drugs were given according to the blood glucose level of patients,and low⁃intensity exercise and low sugar diet were performed.The control group was treated with beraprost sodium tablets orally on the basis of conventional treatment;the observation group was given breviscapine injection on the basis of the control group,and the two groups were treated for 4 weeks.The clinical efficacy,motor and sensory nerve conduction velocities,serum HMGB1,brain⁃derived neurotrophic factor(BDNF),myelin basic protein(MBP)and IMA levels were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[84.0%(42/50)vs 58.0%(29/50)](P<0.05).After treatment,the motor and sensory nerve conduction velocities of the two groups were higher than those before treatment,and the motor nerve conduction velocity of the observation group was higher than that of the control group(all P<0.05).After treatment,the levels of HMGB1,MBP and IMA of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group[(34±3)μg/L vs(48±4)μg/L,(0.42±0.06)μg/L vs(0.75±0.07)μg/L,(65±6)kU/L vs(74±5)kU/L];the level of BDNF of the two groups was higher than that before treatment,and that of the observation group was higher than that of the control group[(10.22±1.31)μg/L vs(7.29±1.21)μg/L](all P<0.05).Conclusion Breviscapine combined with beraprost has the significant clinical effect on DPN,which can effectively improve the patients′peripheral nerve function and effectively reduce serum HMGB1 and IMA levels.