木丹颗粒联合不同药物治疗糖尿病周围神经病变疗效

Curative Effects of Mudan Granules(木丹颗粒)Plus Different Drug Therapies in Diabetic Peripheral Neuropathy

目的探讨木丹颗粒联合不同药物治疗糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的疗效。方法随机将该院2019年1月—2020年10月收治的90例DPN患者分为3组,分别以A、B、C 3组命名,其中A组给予木丹颗粒联合甲钴胺治疗,B组采用木丹颗粒联合依帕司他治疗,C组则采用木丹颗粒联合胞磷胆碱钠治疗,比较各组治疗4周后临床效果,并比较各组患者治疗前后的正中神经、腓总神经和胫神经传导速度及血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)水平和神经病变自觉症状问卷(TSS)评分;统计各组不良反应情况。结果3组治疗有效率比较差异无统计学意义(P>0.05),各组治疗前神经功能传导速度对比差异无统计学意义(P>0.05);治疗后,3组患者正中神经、腓总神经及胫神经传导速度均较治疗前有所改善,与B、C两组相比,A组的下肢腓总神经运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)及正中神经、胫神经SNCV改善明显,对比差异有统计学意义(P<0.05);各组治疗前TSS评分差异无统计学意义(P>0.05);治疗后,各组评分均有所减少,但3组治疗后评分差异无统计学意义(P>0.05),3组治疗前血清Hcy、hs-CRP水平对比差异无统计学意义(P>0.05);治疗后,3组Hcy、hs-CRP水平均有所下降,其中A组Hcy、hs-CRP较低于B、C两组,对比差异有统计学意义(P<0.05),3组不良反应发生率对比差异无统计学意义(P>0.05)。结论木丹颗粒联合不同西药治疗DPN均可取得满意效果,其中可选择的药物有甲钴胺、依帕司他、胞磷胆碱钠,但木丹颗粒联合甲钴胺对腓总神经运动神经传导速度的改善效果更显著。

Objective To discuss the curative effects of Mudan Granules(木丹颗粒)plus different drug therapies in diabetic peripheral neuropathy(DPN).Methods 90 patients with DPN treated from January 2019 to October 2020 in our hospital were randomly assigned to group A,group B and group C.Group A took Mudan Granules and mecobalamine;group B took Mudan Granules and epalrestat;group C took Mudan Granules and citicoline sodium.Curative effects after 4 weeks of treatment,left peroneal nerve,and the median nerve,common peroneal nerve and tibial nerve,serum homocysteine(Hcy)and hypersensitive C-reactive protein(hs-CRP),neurological symptom questionnaire(TSS)scores were compared;to count the adverse reactions in each group.Results There was no statistically significant difference in the effectiveness of the three treatment groups(P>0.05),and there was no significant difference in the nerve function conduction velocity before treatment among the groups(P>0.05);After treatment,the conduction velocities of the median nerve,common peroneal nerve,and tibial nerve in the three groups of patients improved compared to before treatment.Compared with groups B and C,the motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of the common peroneal nerve in the lower limbs in group A were significantly improved,as well as the median nerve and tibial nerve SNCV,with significant differences(P<0.05);There was no significant difference in TSS scores among the groups before treatment(P>0.05);After treatment,the scores of each group decreased,but there was no significant difference in scores among the three groups after treatment(P>0.05).There was no significant difference in serum Hcy and hs-CRP levels among the three groups before treatment(P>0.05);After treatment,the levels of Hcy and hs-CRP in all three groups decreased.Among them,the Hcy and hs-CRP in group A were significantly lower than those in group B and groupC(P<0.05),and there was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Mudan Granules combined with different Western medicines like mecobalamine,epalrestat and citicoline sodium have fair effects on treatment of DPN;however,Mudan Granules combined with mecobalamine can better improve the common peroneal nerve conduction velocity in clinical treatment.