Effect of cinepazide combined with mecobalamine on nerve conduction velocity, vibration perception threshold and serum indexes in patients with diabetic peripheral neuropathy

Objective:To analyze the effect of cinepazide combined with mecobalamine on nerve conduction velocity, vibration perception threshold and serum indexes in patients with diabetic peripheral neuropathy. Methods:90 patients with diabetic peripheral neuropathy treated in our hospital between March 2013 and March 2016 were selected and divided into observation group and control group (n=45) according to random number table, control group received mecobalamine treatment alone and observation group accepted the cinepazide combined with mecobalamine therapy. Differences in nerve conduction velocity, vibration perception threshold as well as serum oxidative stress indexes and nerve injury marker molecules were compared between two groups of patients 2 weeks after treatment. Results:2 weeks after treatment, median nerve, ulnar nerve and peroneal nerve sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) levels of observation group were higher than those of control group (P<0.05) while both lower extremities vibration perception threshold (VPT) levels were lower than those of control group (P<0.05). Serum homocysteine (HCY), advanced glycosylation end products (AGEs), malondialdehyde (MDA), neuron-specific enolase (NSE), high mobility group B1 (HMGB1) and S100βcontent of observation group were lower than those of control group (P<0.05) while reduced glutathione (GSH), superoxide dismutase (SOD), myelin basic protein (MBP) and brain-derived neurotrophic factor (BDNF) content were higher than those of control group (P<0.05). Conclusions:Cinepazide combined with mecobalamine can reduce the nerve injury degree, improve nerve conduction and vibration perception and alleviate the oxidative stress degree in patients with diabetic peripheral neuropathy.

Effects of pestle needle on nerve conduction velocity and inflammatory injury in patients with diabetic peripheral neuropathy

Background:Diabetic peripheral neuropathy(DPN)is one of the most common complications of diabetes mellitus.Impaired neurological function is one of the main characteristics of DPN and is strongly associated with the inflammatory response.Our previous studies have confirmed that pestle needle can improve the nerve function of patients with DPN.But the mechanism of pestle needle treatment of DPN is still unclear.Methods:A total of 70 DPN patients who met the inclusion criteria were randomly divided into two groups.Control group(CG)(n=35)received DPN conventional treatment and the pestle needle group(PNG)(n=35)received pestle needle therapy at Zhiyang(DU09)eight array,Mingmen(DU04)eight array and Heche Road(from Mingmen(DU04)to Changqiang(DU01)),Zusanli(ST36),Sanyinjiao(SP06),Taixi(KI03)and Yongquan(KI01).Patients in the PNG group were required to take this treatment for 4 weeks,5 times a week.Examination indexes were collected before and after treatment,respectively.Nerve function was examined using the Toronto clinical scoring system and nerve conduction velocity detection.Serum inflammatory factors were measured by enzyme linked immunosorbent assay.Results:The Toronto clinical scoring system was significantly reduced in the PNG compared with the CG after treatment.The sensory nerve conduction velocity and motor nerve conduction velocity of the right peroneal and median nerves were significantly faster in the PNG than those in the CG(P<0.05).After treatment,serum interleukin-1 beta,interleukin-6 and tumor necrosis factor-alpha levels decreased in both groups,and the improvement of PNG was better than CG(P<0.05).Conclusion:The pestle needle can significantly improve the symptoms and nerve conduction velocity of DPN,and its mechanism may be related to the reduction of inflammatory factors.

Abnormality of peripheral nerve conduction velocity associated with illness course, symptoms and fasting blood glucose in patients with type 2 diabetes mellitus

BACKGROUND: It has shown that abnormality of peripheral nerve conduction velocity during onset of diabetes mellitus is not related to age and sex, but to symptoms, illness course and level of fasting blood glucose. OBJECTIVE: To measure correlation of abnormality of peripheral nerve conduction velocity with various illness courses, symptoms and levels of fasting blood glucose of patients with type 2 diabetes mellitus. DESIGN: Case analysis. SETTING: Department of Neurology, Central People's Hospital of Huizhou. PARTICIPANTS: A total of 128 patients who were diagnosed as type 2 diabetes mellitus were selected from Central People's Hospital of Huizhou from September 2001 to October 2005. There were 75 males and 53 females aged 32-83 years and the illness course ranged from 1 month to 20 years. METHODS: All 128 patients with type 2 diabetes mellitus received neuro-electrophysiological study and their clinical data were retrospectively analyzed to measure peripheral nerve conduction velocity and fasting blood glucose so as to investigate the correlation of peripheral nerve conduction velocity with clinical symptoms, illness course and levels of fasting blood glucose. MAIN OUTCOME MEASURES: Correlation of peripheral nerve conduction velocity with clinical symptoms, illness course and levels of fasting blood glucose. RESULTS: All 128 patients with type 2 diabetes mellitus were involved in the final analysis. ① Among 128 patients, 114 patients had abnormality of peripheral nerve conduction velocity; 110 patients had clinical symptoms, including 102 patients having abnormality of peripheral nerve conduction velocity; 18 patients did not have clinical symptoms, including 12 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=8.275, P =0.04). ② Among 128 patients, illness course of 75 patients was equal to or less than 5 years, including 27 patients having abnormality of peripheral nerve conduction velocity; illness course of 53 patients was more than 5 years, including 35 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=11.469, P =0.003). ③ Among 128 patients, levels of fasting blood glucose of 75 patients was equal to or lower than 11 mmol/L, including 41 patients having abnormality of peripheral nerve conduction velocity; levels of fasting blood glucose of 53 patients was higher than 11 mmol/L, including 38 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=4.023, P =0.134). CONCLUSION: ① Abnormality of peripheral nerve conduction velocity of patients with type 2 diabetes mellitus is related to illness courses and clinical symptoms. The longer the illness course is, the severer the abnormality of peripheral nerve conduction velocity is. Abnormality of peripheral nerve conduction velocity always occurs on patients who have clinical symptoms. ② Abnormality of peripheral nerve conduction velocity is not related to levels of fasting blood glucose.

Effect of electroacupuncture on conduction velocity of the sciatic nerve in experimental diabetic rats and its mechanisms

Objective To investigate the mechanisms of acupuncture in accelerating regeneration of injured sciatic nerve, the effect of electroacupuncture （EA） at ＂Huantiao （环跳 GB 30）＂ and ＂Zusanli （足三里 ST 36）＂ on conduction velocity and mRNA expression of receptors of advanced glycation end products （RAGE） of the sciatic nerve were observed in experimental diabetic rats. Methods Streptozotocin was injected into the left abdomen in 30 male rats to establish diabetes mellitus （DM） models with hyperglycemia （〉16.7 mmol/L）. Thirty rats with DM were divided into a diabetes model group （group DM）, a Methycobal group （group MET） and an EA group （group EA）. Another 8 rats comparable in body weight and age were used as a normal control group （group NC）. General situation and blood sugar levels of all the rats were recorded, and the conduction velocities of the sciatic nerves were measured. RAGE mRNA expression of the sciatic nerve was detected by means of reverse transcription polymerase chain reaction（RT-PCR）16 weeks after treatment. Results After 16 weeks, the conduction velocities of the sciatic nerves were lowered in group DM, compared with those in group NC, indicating lesion of peripheral nerves. Compared with group DM, the conduction velocities of the sciatic nerves were significantly elevated in both group EA and group MET （P〈0.01 ）, and there was a significant difference between the two groups, showing superiority of EA to Methycobal （P〈0.01）. The RAGE mRNA levels of the sciatic nerves in group DM were significantly higher than those in group NC （P〈0.01）. The RAGE mRNA levels of the sciatic nerves in both group EA and group MET were remarkably lowered than those in group DM （P〈0.01）, and the decrease in group EA was more obviously than that in group MET （P〈0.01）. Conclusion EA may exert its therapeutic effects on diabetic perineuropathy （DPN） by way of regulating abnormal expression of RAGE mRNA in the sciatic nerve and alleviating its injury caused by advanced glycation end products （AGEs） accumulation and diminishing oxidative stress to enhance its conduction velocity.

探讨F波联合SSR和NCV在糖尿病周围神经病早期的诊断价值

目的探讨F波联合皮肤交感反应(SSR)和常规神经传导检测(NCV)对糖尿病周围神经病(DPN)早期的诊断价值。方法对324例2型糖尿病患者,根据有无周围神经症状分为无症状组(103例)、有症状组(221例)及同期对照组(100例),均行正中神经和胫神经F波,四肢感觉、运动神经传导检测(NCV)和SSR检查。分析比较组间F波、NCV和SSR指标的临床特点。结果糖尿病患者下肢运动、感觉神经损害程度重于上肢,且四肢感觉神经异常比例高于运动神经(P<0.05);对糖尿病有症状组、无症状组进行SSR和NCV联合检测,总异常率为90.1%,明显高于单独应用NCV异常率,差异有统计学意义(P<0.05)。与对照组比较,糖尿病(DM)有症状组上肢正中神经F波出现率减少,F波传导速度减慢,下肢胫神经F波出现率减少,F波潜伏期延长。无症状组仅上肢正中神经F波出现率减少。与DM无症状组比较,有症状组上肢正中神经F波传导速度减慢,下肢F波出现率减少,F波潜伏期延长(P<0.05),而上肢F波出现率差异无统计学意义(P>0.05)。对糖尿病组进行NCV、SSR和F波联合检测异常率为93.2%,明显高于单纯NCV检测(P<0.05)。结论糖尿病在早期无症状时即存在周围神经损害,以小纤维受累为主,F波、SSR联合NCV检测能有效弥补NCV不能反映自主神经小纤维和运动神经近端功能的不足,提高对DPN的早期诊断。

Efficacy and safety of nerve growth factor for the treatment of neurological diseases:a meta-analysis of 64 randomized controlled trials involving 6,297 patients

OBJECTIVE： China is the only country where nerve growth factor is approved for large-scale use as a clinical medicine. More than 10 years ago, in 2003, nerve growth factor injection was listed as a national drug. The goal of this article is to evaluate comprehensively the efficacy and safety of nerve growth factor for the treatment of neurological diseases. DATA RETRIEVAL： A computer-based retrieval was performed from six databases, including the Cochrane Library, PubMed, EMBASE, Sino Med, CNKI, and the VIP database, searching from the clinical establishment of nerve growth factor for treatment until December 31, 2013. The key words for the searches were ＂nerve growth factor, randomized controlled trials＂ in Chinese and in English. DATA SELECTION： Inclusion criteria： any study published in English or Chinese referring to randomized controlled trials of nerve growth factor; patients with neurological diseases such as peripheral nerve injury, central nerve injury, cranial neuropathy, and nervous system infections; patients older than 7 years; similar research methods and outcomes assessing symptoms; and measurement of nerve conduction velocities. The meta-analysis was conducted using Review Manager 5.2.3 software. MAIN OUTCOME MEASURES： The total effective rate, the incidence of adverse effects, and the nerve conduction velocity were recorded for each study. RESULTS： Sixty-four studies involving 6,297 patients with neurological diseases were included. The total effective rate in the group treated with nerve growth factor was significantly higher than that in the control group （P 〈 0.0001, RR： 1.35, 95%CI： 1.30-1.40）. The average nerve conduction velocity in the nerve growth factor group was significantly higher than that in the control group （P 〈 0.00001, MD. 4.59 m/s, 95%CI： 4.12-5.06）. The incidence of pain or sclero- ma at the injection site in the nerve growth factor group was also higher than that in the control group （P 〈 0.00001, RR： 6.30, 95%CI： 3.53-11.27）, but such adverse effects were mild. CONCLUSION： Nerve growth factor can significantly improve nerve function in patients with nervous system disease and is safe and effective.

Qian-Zheng-San promotes regeneration after sciatic nerve crush injury in rats

Qian-Zheng-San, a traditional Chinese prescription consisting of Typhonii Rhizoma, Bombyx Batryticatus, Scorpio, has been found to play an active therapeutic role in central nervous system diseases. However, it is unclear whether Qian-Zheng-San has therapeutic value for peripheral nerve injury. Therefore, we used Sprague-Dawley rats to investigate this. A sciatic nerve crush injury model was induced by clamping the right sciatic nerve. Subsequently, rats in the treatment group were administered 2 mL Qian-Zheng-San(1.75 g/mL) daily as systemic therapy for 1, 2, 4, or 8 weeks. Rats in the control group were not administered Qian-Zheng-San. Rats in sham group did not undergo surgery and systemic therapy. Footprint analysis was used to assess nerve motor function. Electrophysiological experiments were used to detect nerve conduction function. Immunofluorescence staining was used to assess axon counts and morphological analysis. Immunohistochemical staining was used to observe myelin regeneration of the sciatic nerve and the number of motoneurons in the anterior horn of the spinal cord. At 2 and 4 weeks postoperatively, the sciatic nerve function index, nerve conduction velocity, the number of distant regenerated axons and the axon diameter of the sciatic nerve increased in the Qian-Zheng-San treatment group compared with the control group. At 2 weeks postoperatively, nerve fiber diameter, myelin thickness, and the number of motor neurons in the lumbar spinal cord anterior horn increased in the Qian-Zheng-San treatment group compared with the control group. These results indicate that QianZheng-San has a positive effect on peripheral nerve regeneration.

Transdermal delivery of 4-aminopyridine accelerates motor functional recovery and improves nerve morphology following sciatic nerve crush injury in mice

Oral 4-aminopyridine(4-AP)is clinically used for symptomatic relief in multiple sclerosis and we recently demonstrated that systemic 4-AP had previously unknown clinically-relevant effects after traumatic peripheral nerve injury including the promotion of re-myelination,improvement of nerve conductivity,and acceleration of functional recovery.We hypothesized that,instead of oral or injection administration,transdermal 4-AP(TD-4-AP)could also improve functional recovery after traumatic peripheral nerve injury.Mice with surgical traumatic peripheral nerve injury received TD-4AP or vehicle alone and were examined for skin permeability,pharmacokinetics,functional,electrophysiological,and nerve morphological properties.4-AP showed linear pharmacokinetics and the maximum plasma 4-AP concentrations were proportional to TD-4-AP dose.While a single dose of TD-4-AP administration demonstrated rapid transient improvement in motor function,chronic TD-4-AP treatment significantly improved motor function and nerve conduction and these effects were associated with fewer degenerating axons and thicker myelin sheaths than those from vehicle controls.These findings provide direct evidence for the potential transdermal applicability of 4-AP and demonstrate that 4-AP delivered through the skin can enhance in-vivo functional recovery and nerve conduction while decreasing axonal degeneration.The animal experiments were approved by the University Committee on Animal Research(UCAR)at the University of Rochester(UCAR-2009-019)on March 31,2017.

Intraoperative single administration of neutrophil peptide 1 accelerates the early functional recovery of peripheral nerves after crush injury

Neutrophil peptide 1 belongs to a family of peptides involved in innate immunity. Continuous intramuscular injection of neutrophil peptide 1 can promote the regeneration of peripheral nerves, but clinical application in this manner is not convenient. To this end, the effects of a single intraoperative administration of neutrophil peptide 1 on peripheral nerve regeneration were experimentally observed. A rat model of sciatic nerve crush injury was established using the clamp method. After model establishment, a normal saline group and a neutrophil peptide 1 group were injected with a single dose of normal saline or 10 μg/mL neutrophil peptide 1, respectively. A sham group, without sciatic nerve crush was also prepared as a control. Sciatic nerve function tests, neuroelectrophysiological tests, and hematoxylin-eosin staining showed that the nerve conduction velocity, sciatic functional index, and tibialis anterior muscle fiber cross-sectional area were better in the neutrophil peptide 1 group than in the normal saline group at 4 weeks after surgery. At 4 and 8 weeks after surgery, there were no differences in the wet weight of the tibialis anterior muscle between the neutrophil peptide 1 and saline groups. Histological staining of the sciatic nerve showed no significant differences in the number of myelinated nerve fibers or the axon cross-sectional area between the neutrophil peptide 1 and normal saline groups. The above data confirmed that a single dose of neutrophil peptide 1 during surgery can promote the recovery of neurological function 4 weeks after sciatic nerve injury. All the experiments were approved by the Medical Ethics Committee of Peking University People's Hospital, China(approval No. 2015-50) on December 9, 2015.

Saikosaponin a increases interleukin-10 expression and inhibits scar formation after sciatic nerve injury

Nerve scarring after peripheral nerve injury can severely hamper nerve regeneration and functional recovery.Further,the anti-inflammatory cytokine,interleukin-10,can inhibit nerve scar formation.Saikosaponin a（SSa） is a monomer molecule extracted from the Chinese medicine,Bupleurum.SSa can exert anti-inflammatory effects in spinal cord injury and traumatic brain injury.However,it has not been shown whether SSa can play a role in peripheral nerve injury.In this study,rats were randomly assigned to three groups.In the sham group,the left sciatic nerve was directly sutured after exposure.In the sciatic nerve injury（SNI） ＋ SSa and SNI groups,the left sciatic nerve was sutured and continuously injected daily with SSa（10 mg/kg） or an equivalent volume of saline for 7 days.Enzyme linked immunosorbent assay results demonstrated that at 7 days after injury,interleukin-10 level was considerably higher in the SNI ＋ SSa group than in the SNI group.Masson staining and western blot assay demonstrated that at 8 weeks after injury,type I and III collagen content was lower and nerve scar formation was visibly less in the SNI ＋ SSa group compared with the SNI group.Simultaneously,sciatic functional index and nerve conduction velocity were improved in the SNI ＋ SSa group compared with the SNI group.These results confirm that SSa can increase the expression of the anti-inflammatory factor,interleukin-10,and reduce nerve scar formation to promote functional recovery of injured sciatic nerve.

A novel chronic nerve compression model in the rat

Current animal models of chronic peripheral nerve compression are mainly silicone tube models. However, the cross section of the rat sciatic nerve is not a perfect circle, and there are differences in the diameter of the sciatic nerve due to individual differences. The use of a silicone tube with a uniform internal diameter may not provide a reliable and consistent model. We have established a chronic sciatic nerve compression model that can induce demyelination of the sciatic nerve and lead to atrophy of skeletal muscle. In 3-week-old pups and adult rats, the sciatic nerve of the right hind limb was exposed, and a piece of surgical latex glove was gently placed under the nerve. N-butyl-cyanoacrylate was then placed over the nerve, and after it had set, another piece of glove latex was placed on top of the target area and allowed to adhere to the first piece to form a sandwich-like complex. Thus, a chronic sciatic nerve compression model was produced. Control pups with latex or N-butyl-cyanoacrylate were also prepared. Functional changes to nerves were assessed using the hot plate test and electromyography. Immunofluorescence and electron microscopy analyses of the nerves were performed to quantify the degree of neuropathological change. Masson staining was conducted to assess the degree of fibrosis in the gastrocnemius and intrinsic paw muscles. The pup group rats subjected to nerve compression displayed thermal hypoesthesia and a gradual decrease in nerve conduction velocity at 2 weeks after surgery. Neuropathological studies demonstrated that the model caused nerve demyelination and axonal irregularities and triggered collagen deposition in the epineurium and perineurium of the affected nerve at 8 weeks after surgery. The degree of fibrosis in the gastrocnemius and intrinsic paw muscles was significantly increased at 20 weeks after surgery. In conclusion, our novel model can reproduce the functional and histological changes of chronic nerve compression injury that occurs in humans and it will be a useful new tool for investigating the mechanisms underlying chronic nerve compression.

Boric acid reduces axonal and myelin damage in experimental sciatic nerve injury

The aim of this study was to investigate the effects of boric acid in experimental acute sciatic nerve injury. Twenty-eight adult male rats were randomly divided into four equal groups （n = 7）： control （C）, boric acid （BA）, sciatic nerve injury （I） , and sciatic nerve injury ＋ boric acid treatment （BAI）. Sciatic nerve injury was generated using a Yasargil aneurysm clip in the groups I and BAI. Boric acid was given four times at 100 mg/kg to rats in the groups BA and BAI after injury （by gavage at 0, 24, 48 and 72 hours） but no injury was made in the group BA. In vivo electrophysiological tests were performed at the end of the day 4 and sciatic nerve tissue samples were taken for histopathological examination. The amplitude of compound action potential, the nerve conduction velocity and the number of axons were significantly lower and the myelin structure was found to be broken in group I compared with those in groups C and BA. However, the amplitude of the compound action potential, the nerve conduction velocity and the number of axons were significantly greater in group BAI than in group I. Moreover, myelin injury was significantly milder and the intensity of nuclear factor kappa B immunostaining was significantly weaker in group BAI than in group I. The results of this study show that administration of boric acid at 100 mg/kg after sciatic nerve injury in rats markedly reduces myelin and axonal injury and improves the electrophysiological function of injured sciatic nerve possibly through alleviating oxidative stress reactions.

Anterior subcutaneous transposition of the ulnar nerve improves neurological function in patients with cubital tunnel syndrome

Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients（65 elbows） diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial severity of the disease was evaluated using the Mc Gowan scale as modified by Goldberg： 18 patients（28%） had grade IIA neuropathy, 20（31%） had grade IIB, and 27（42%） had grade III. Postoperatively, according to the Wilson ＆ Krout criteria, treatment outcomes were excellent in 38 patients（58%）, good in 16（25%）, fair in 7（11%）, and poor in 4（6%）, with an excellent and good rate of 83%. A negative correlation was found between the preoperative Mc Gowan grade and the postoperative Wilson ＆ Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.

依帕司他联合丁苯酞软胶囊对痛性糖尿病周围神经病变患者的影响

目的:分析依帕司他联合丁苯酞软胶囊对痛性糖尿病周围神经病变(PDPN)患者的影响。方法:选取2021年2月—2022年2月通城县人民医院收治的80例PDPN患者作为研究对象,根据掷硬币法将患者分为对照组和研究组,各40例。对照组给予依帕司他,研究组在对照组基础上给予丁苯酞软胶囊,比较两组临床疗效、不良反应、疼痛程度[视觉模拟评分法(VAS)]、正中神经、腓总神经、尺神经的感觉神经传导速度(SNCV)、运动神经传导速度(MNCV)及氧化应激指标[超氧化物歧化酶(SOD),丙二醛(MDA)]水平。结果:研究组临床总有效率高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);治疗1个月后,两组VAS评分低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗1个月后,两组正中神经、腓总神经、尺神经的SNCV和MNCV较治疗前提高,且研究组高于对照组,差异有统计学意义(P<0.05);治疗1个月后,两组SOD和MDA水平较治疗前改善,且研究组SOD水平高于对照组,MDA水平低于对照组,差异有统计学意义(P<0.05)。结论:依帕司他与丁苯酞软胶囊联合治疗PNDN,临床疗效好,不良反应发生率较低,能显著降低疼痛程度,提高正中神经、腓总神经、尺神经SNCV和MNCV,改善SOD和MDA水平。

小切口原位松解术对腕管综合征病人手术指征、神经传导速度及上肢功能的影响

目的 探讨小切口原位松解术对腕管综合征(CTS)病人手术指证、神经传导速度及上肢功能的影响。方法 2018年1月~2022年1月我院收治的CTS病人100例,采用随机数字表法分为两组,对照组50例,采用传统腕管松解术治疗;观察组50例,采用小切口原位松解术治疗。收集CTS病人的临床资料比较两组病人的手术指证、神经传导速度、上肢功能的变化及并发症发生率。结果 观察组的总有效率为98.00%,对照组为84.00%,两组比较,差异有统计学意义(P<0.05)。观察组CTS病人切口长度为(1.65±0.29)cm、开关切口时间为(4.85±1.02)分钟、住院时间为(3.24±0.62)天、术中出血量为(17.88±3.53)ml、术后1天VAS评分为(3.03±0.56)分,对照组分别为(4.02±0.81)cm、(10.06±2.28)分钟、(7.11±1.34)天、(24.37±5.27)ml和(4.04±0.89)分,两组比较差异有统计学意义(P<0.05)。治疗后,研究组CTS病人的拇指-腕感觉传导速度为(46.05±8.39)m/s、中指-腕感觉传导速度为(45.05±8.95)m/s、大鱼际肌-腕运动传导速度为(53.94±11.47)m/s、FIM自理能力评分为(34.38±7.22)分、FMA上肢评分为(34.23±7.25)分,对照组分别为(41.86±8.22)m/s、(40.88±8.28)m/s、(49.05±10.01)m/s、(27.81±6.01)分、(41.05±9.19)分,两组比较差异有统计学意义(P<0.05)。观察组并发症总发生率为4.00%,对照组为20.00%,两组比较差异有统计学意义(P<0.05)。结论 小切口原位松解术治疗CTS病人可改善病人手术指证、神经传导速度,有利于病人上肢功能的恢复,并降低术后并发症的发生率。

甲钴胺联合依帕司他治疗糖尿病周围神经病变的效果及对患者周围神经传导速度的影响

目的探讨甲钴胺联合依帕司他治疗糖尿病周围神经病变(DPN)的效果。方法将78例DPN患者随机分为两组。对照组应用甲钴胺治疗,观察组则在对照组基础上采用依帕司他治疗。比较两组患者的疗效、神经传导速度与不良反应发生率。结果观察组总有效率为97.44%,高于对照组的82.05%(P<0.05)。治疗后,观察组运动神经与感觉神经传导速度均高于对照组(P<0.05)。两组的不良反应发生率比较无统计学差异(P>0.05)。结论甲钴胺联合依帕司他治疗DPN具有较好的效果,可提高神经传导速度,加速患者病症改善,临床价值显著。

高压氧治疗脊髓损伤的临床效果及对神经电生理的影响

目的探讨高压氧治疗脊髓损伤的临床效果及对神经电生理的影响。方法选取2019年10月至2022年6月吉林大学第二医院脊柱外科收治的104例脊髓损伤患者,采用随机数字表法分为对照组和观察组,每组52例。对照组采用常规治疗,观察组在常规治疗的基础上给予高压氧治疗。比较两组治疗前后的美国脊柱损伤协会(ASIA)神经功能分级,正中神经、尺神经、胫神经、腓总神经的运动神经传导速度(MCV)、感觉神经传导速度(SCV),以及血清白介素(IL)-6、IL-10、IL-17、超敏C反应蛋白(hs-CRP)水平。结果治疗前两组ASIA神经功能分级、MCV、SCV及血清IL-6、IL-10、IL-17、hs-CRP水平比较差异均无统计学意义(P>0.05)。与治疗前相比,治疗后两组ASIA神经功能分级均明显改善,且观察组明显优于对照组,正中神经、尺神经、胫神经、腓总神经MCV及SCV均明显增高,且观察组明显高于对照组,血清IL-6、IL-10、IL-17、hs-CRP水平均明显降低,且观察组明显低于对照组,差异有统计学意义(P<0.05)。结论高压氧治疗脊髓损伤可显著改善神经功能,提高运动及感觉神经传导速度,减轻炎症反应。

糖尿病周围神经病变经当归四逆汤治疗后的神经传导速度与疗效观察

目的探讨糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)经当归四逆汤治疗后的神经传导速度与疗效。方法采用随机数字表法将104例于2021年12月—2022年12月在河南省中医院接受治疗的DPN患者分为A组和B组,各52例。B组患者采用常规治疗,A组在B组基础上给予当归四逆汤治疗。以4周为1个周期,两组均维持治疗1个周期。比较两组治疗4周后的临床疗效,治疗前、治疗4周后的中医证候评分、血清学指标、血糖指标、神经传导情况及治疗期间的不良反应发生情况。结果与B组比较,A组治疗4周后的临床总有效率较高,[98.08%(51/52)vs 84.62%(44/52)];相较于治疗前,两组治疗4周后的肌肉萎缩、感觉减退、肢体麻木、四肢疼痛、四肢发凉各项评分、血清餐后2 h血糖(2 h postprandial blood glucose,2 h PBG)、糖化血红蛋白(glycated hemoglobin,HbA1c)、丙二醛(malondialdehyde,MDA)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-23(interleukin-23,IL-23)水平、胰岛素抵抗指数(insulin resistance index,HOMA-IR)值均降低,且相较于B组,A组更低,两组治疗4周后的正中神经感觉神经传导速度(sensory nerve conduction velocity,SNCV)、腓总神经SNCV、正中神经腓总神经运动神经传导速度(motor nerve conduction velocity,MNCV)、腓总神经MNCV、血清总抗氧化能力(T-AOC)水平均升高,且与B组比较,A组较高(P<0.05)。两组均未发生明显不良反应。结论当归四逆汤治疗DPN可有效改善患者临床症状,减轻机体炎症以及氧化应激反应,稳定患者血糖水平,增强神经传导速度,疗效显著,且安全性较高。

艾灸热敏化腧穴结合中药熏蒸治疗腰椎源性下腰痛疗效观察

目的 探讨艾灸热敏化腧穴结合中药熏蒸治疗腰椎源性下腰痛的效果。方法 采用随机平行对照方法将河南中医药大学第一附属医院2020年4月至2023年5月收治的138例腰椎源性下腰痛患者按随机数表法分为对照1组、对照2组和观察组各46例。对照1组采取艾灸热敏化腧穴,对照2组采取中药熏蒸,观察组采取艾灸热敏化腧穴+中药熏蒸。治疗2周后比较三组患者的治疗效果,治疗前、治疗2周后的中医证候积分、视觉模拟评分法(VAS)、改良Qswestry功能障碍指数量表(ODI)、血管活性调节因子[血栓素2 (TXB2)、6-酮-前列腺素(6-keto-PGF1α)]、神经传导速度、等长肌力(IMS)、腰背肌后伸活动度(ROM),同时比较两组患者治疗期间的不良反应发生情况。结果 观察组患者的治疗总有效率为93.48%,明显高于对照1组的76.09%和对照2组的71.74%,差异有统计学意义(P<0.05);治疗2周后,观察组患者的中医证候积分及VAS、ODI评分分别为(1.31±0.30)分、(1.98±0.42)分、(15.24±1.68)分,明显低于对照1组的(1.50±0.33)分、(2.64±0.46)分、(18.78±2.34)分和对照2组的(1.47±0.34)分、(2.70±0.41)分、(19.11±1.29)分,差异均有统计学意义(P<0.05);治疗2周后,观察组患者的血清TXB2水平为(40.42±4.25) ng/mL,明显低于对照1组的(45.56±4.71) ng/mL和对照2组的(44.88±5.03) ng/mL,6-keto-PGF1α水平为(53.53±5.78) ng/mL,明显高于对照1组的(49.95±5.42) ng/mL和对照2组的(50.11±6.64) ng/mL,差异均有统计学意义(P<0.05);治疗2周后,观察组患者的腓总神经、腓浅神经传导速度分别为(42.50±4.43) m/s、(42.63±4.56) m/s,明显快于对照1组的(39.12±3.78) m/s、(39.40±3.87) m/s和对照2组的(38.89±4.05) m/s、(39.11±3.95) m/s,差异均有统计学意义(P<0.05);治疗2周后,观察组患者的ROM、IMS分别为(7.65±1.85)°、(498.68±75.51) N,明显高于对照1组的(6.25±1.36)°、(452.62±70.33) N和对照2组的(6.32±1.44)°、(450.13±72.68) N,差异均有统计学意义(P<0.05);三组患者治疗期间均未出现明显不良反应。结论 艾灸热敏化腧穴结合中药熏蒸能改善腰椎源性下腰痛患者临床症状,调节血管活性因子水平,促进神经传导速度及腰椎功能恢复,疗效显著且安全性高。

硫辛酸胶囊联合甲钴胺片治疗糖尿病周围神经病变的临床疗效

目的 分析硫辛酸胶囊的基础上辅助甲钴胺片治疗糖尿病周围神经病变(DPN)患者的临床效果。方法 本文的研究对象为80例糖尿病周围神经病变患者,根据随机数字法主要分为观察组与对照组。对照组40例患者均以甲钴胺片进行治疗,观察组40例患者均以硫辛酸胶囊联合甲钴胺片治疗。对比两组的临床疗效、运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)、多伦多临床评分系统(TCSS)评分。结果 对比于对照组,观察组患者的总有效率明显较高(P<0.05)。治疗后,与对照组对比,观察组患者MNCV与SNCV升高(P<0.05)。治疗后与对照组对比,观察组患者的TCSS评分较低(P<0.05)。结论 以硫辛酸胶囊辅助甲钴胺片治疗DPN患者可改善运动神经传导速度、感觉神经传导速度,延缓疾病进展,提升治疗效果,值得临床借鉴、推广。