舒洛地特联合依帕司他治疗2型糖尿病合并糖尿病周围神经病变的临床疗效

Clinical Efficacy of Sulodexide Combined with Epalrestat in the Treatment of Type 2 Diabetes Mellitus Complicated with Diabetic Peripheral Neuropathy

【目的】探讨舒洛地特联合依帕司他治疗2型糖尿病(T2DM)合并糖尿病周围神经病变(DPN)患者的临床疗效。【方法】选取2020年2月至2023年3月在本院诊治的95例T2DM合并DPN患者,根据治疗方法不同分为对照组(接受依帕司他治疗,n=46)与观察组(在对照组治疗的基础上加用舒洛地特治疗,n=49)。比较两组临床疗效、临床评分、神经传导速度、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、血清学指标及不良反应发生率。【结果】观察组总有效率高于对照组(P<0.05)。治疗后,两组疼痛、感觉异常、灼烧感、麻木评分及血清丙二醛(MDA)、内皮素-1(ET-1)水平均低于治疗前(P<0.05),且观察组疼痛、感觉异常、灼烧感、麻木评分及血清MDA、ET-1水平均低于对照组(P<0.05)。治疗后,两组正中神经和腓总神经的感觉传导速度(SNCV)、运动传导速度(MNCV)及血清一氧化氮(NO)水平均高于治疗前(P<0.05),且观察组正中神经和腓总神经的SNCV、MNCV及NO水平均高于对照组(P<0.05)。治疗后,两组HbA1c、FPG均低于治疗前(P<0.05),且观察组HbA1c、FPG均低于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】舒洛地特联合依帕司他治疗T2DM合并DPN患者,疗效显著,可改善患者血糖控制情况、临床症状、氧化应激反应指标、血管内皮功能指标、神经传导速度,且安全可靠。

【Objective】To investigate the clinical efficacy of Sulodexide combined with epalrestat in the treatment of type 2 diabetes mellitus(T2DM)patients with diabetic peripheral neuropathy(DPN).【Methods】A total of 95 T2DM patients with DPN treated in our hospital from February 2020 to March 2023 were selected and divided into control group(receiving epalrestat treatment,n=46)and observation group(receiving Sulodexide treatment on the basis of control group treatment,n=49)according to different treatment methods.The clinical efficacy,clinical score,nerve conduction velocity,glycated hemoglobin(HbA1c),fasting blood glucose(FPG),serological indexes and incidence of adverse reactions were compared between the two groups.【Results】The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the pain,paresthesia,burning sensation,numbness scores and serum malondialdehyde(MDA)and endothelin-1(ET-1)levels in both groups were lower than before treatment(P<0.05),and the pain,paresthesia,burning sensation,numbness scores and serum MDA and ET-1 levels in the observation group were lower than those in the control group(P<0.05).After treatment,the sensory conduction velocity(SNCV),motor conduction velocity(MNCV)and serum nitric oxide(NO)levels of the median nerve and common peroneal nerve in both groups were higher than before treatment(P<0.05),and the levels of SNCV,MNCV and NO in the median nerve and common peroneal nerve in the observation group were higher than those in the control group(P<0.05).After treatment,the HbA1c and FPG of both groups were lower than before treatment(P<0.05),and the HbA1c and FPG of observation group were lower than those of control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).【Conclusion】Sulodexide combined with epalrestat is effective in the treatment of T2DM patients with DPN,and can improve blood glucose control,clinical symptoms,oxidative stress index,vascular endothelial function index,nerve conduction velocity,and is safe and reliable.