西格列汀联合腺苷钴胺治疗糖尿病周围神经病变的临床疗效

Clinical effect of sigliptin combined with cobamamide in the treatment of diabetes peripheral neuropathy

目的观察西格列汀联合腺苷钴胺治疗糖尿病周围神经病变(DPN)的临床疗效。方法选取2019年5月—2020年5月北京市昌平区中西医结合医院收治的82例DPN患者,根据治疗方法不同分为腺苷钴胺组和联合用药组,各41例。患者入院后均接受常规治疗及干预,在此基础上,腺苷钴胺组予以腺苷钴胺,联合用药组在腺苷钴胺组基础上予以西格列汀,2组均治疗1个月。比较2组临床疗效,治疗前及治疗1个月后空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA_(1c)),腓总神经、正中神经的运动神经传导速度(MCV)和感觉神经传导速度(SCV),多伦多临床评分系统(TCSS)评分及不良反应发生率。结果联合用药组总有效率为78.05%,高于腺苷钴胺组的56.10%(χ^(2)=4.473,P=0.034)。治疗1个月后,2组FBG、2 hPG水平、HbA_(1c)及神经症状、神经反射、感觉功能评分低于治疗前,且联合用药组低于腺苷钴胺组(P<0.01);2组腓总神经和正中神经的MCV、SCV均高于治疗前,且联合用药组高于腺苷钴胺组(P<0.01)。联合用药组不良反应总发生率为7.32%,与腺苷钴胺组的12.20%比较,差异无统计学意义(χ^(2)=0.139,P=0.710)。结论DPN患者在临床治疗中应用西格列汀联合腺苷钴胺可增强疗效,可更有效地降低患者血糖水平,减轻神经损伤,促进神经功能恢复,且安全性较高。

Objective To explore the clinical effect of sigliptin combined with cobamamide in the treatment of diabetes peripheral neuropathy(DPN).Methods A total of 82 cases of patients with DPN admitted in Beijing Changping District Hospital of Integrated Traditional Chinese and Western Medicine from May 2019 to May 2020 were included,and they were divided into the cobamamide group and the combined medication group according to treatment method,41 cases in each group.All patients were given routine treatment and intervention after admission,on the basis of this,patients in the cobamamide group were treated with cobamamide,and patients in the combined medication group were treated with sigliptin on the basis of cobamamide group,both groups were treated for 1 month.Clinical effect,FBG,2 hPG,HbA_(1c),and MCV,SCV of common peroneal nerve and median nerve,TCSS score before and after 1 month of treatment,incidence of adverse reactions of the two groups were compared.Results Total effective rate of the combined medication group was 78.05%,which was higher than 56.10%of the cobamamide group(χ^(2)=4.473,P=0.034).After 1 month of treatment,FBG level,2 hPG level,HbA_(1c) and scores of nerve symptoms,nerve reflex,sensory function of the two groups were lower than those before treatment,and the indexes of the combined medication group were lower than those of the cobamamide group(P<0.01);MCV,SCV of common peroneal nerve and median nerve of the two groups were higher than those before treatment,and the indexes of the combined medication group were higher than those of the cobamamide group(P<0.01).There was no significant difference of the incidence of adverse reactions between the combined medication group(7.32%)and the cobamamide group(12.20%)(χ^(2)=0.139,P=0.710).Conclusion Sigliptin combined with cobamamide can enhance curative effect in the treatment of DPN patients,which can effectively reduce the blood glucose levels of patients,alleviate nerve injury,promote nerve function recovery,and with high safety.