论文部分内容阅读
目的探讨丹参多酚酸盐联合甲钴胺治疗糖尿病周围神经病变的疗效及对相关血清指标的影响,为糖尿病周围神经病变临床治疗方案的选择提供参考。方法选择2014年8月至2016年8月于辽宁省葫芦岛市中心医院诊治的90例糖尿病周围神经病变患者作为研究对象,按入组先后顺序分为联合治疗组和对照组,每组45例,对照组首先给予糖尿病教育、运动疗法、饮食控制、门冬胰岛素加甘精胰岛素等降糖药物控制血糖,之后给予甲钴胺注射液,联合治疗组患者在对照组治疗方法的基础之上加用丹参多酚酸盐,两组均治疗28 d。比较两组治疗前后的正中神经、腓总神经的运动神经(MNCV)、感觉神经传导速度(SNCV)、临床疗效和血清中白细胞介素-6(IL-6)、C反应蛋白(hs-CRP)、丙二醛(MDA)和超氧化物歧化酶(SOD)水平。用SPSS 19.0统计学软件进行t检验和χ2检验。结果治疗后,两组患者正中神经、腓总神经的MNCV和SNCV均较治疗前明显升高,且联合治疗组治疗后正中神经和腓总神经的MNCV和SNCV均明显高于对照组治疗后,差异均有统计学意义(P<0.05);联合治疗组总有效率(88.89%)明显高于对照组(66.67%),差异有统计学意义(P<0.05);两组患者血清中IL-6、hs-CRP和MDA水平均较治疗前明显降低,SOD水平均较治疗前明显升高,差异均有统计学意义(P<0.05),其中联合治疗组患者血清中IL-6、hs-CRP、MDA水平明显低于对照组治疗后,SOD水平明显高于对照组治疗后,差异均有统计学意义(P<0.05)。结论丹参多酚酸盐联合甲钴胺治疗糖尿病周围神经病变的临床疗效显著,且其作用机制可能与降低血清炎症因子(IL-6、hs-CRP),调整机体氧化应激状态(SOD、MDA)有关。
Objective To investigate the curative effect of Salviae miltiorrhizae polyphenols and mecobalamin on diabetic peripheral neuropathy and its influence on serum indexes, and to provide reference for clinical treatment of diabetic peripheral neuropathy. Methods Ninety patients with diabetic peripheral neuropathy diagnosed and treated in Huludao Central Hospital from August 2014 to August 2016 were selected as study subjects and divided into treatment group and control group according to the sequence of admission group, 45 cases in each group , The control group was first given diabetes education, exercise therapy, diet control, insulin aspart and insulin glargine and other hypoglycemic agents to control blood sugar, and then given mecobalamin injection, combined treatment group patients in the control group based on the treatment of With salvianolate, two groups were treated for 28 days. The levels of median nerve, motor nerve of common peroneal nerve (MNCV), sensory nerve conduction velocity (SNCV), clinical efficacy and serum levels of interleukin-6 (IL-6) and C-reactive protein ), Malondialdehyde (MDA) and superoxide dismutase (SOD) levels. SPSS 19.0 statistical software t test and χ2 test. Results After treatment, MNCV and SNCV of the median nerve and common peroneal nerve of the two groups were significantly higher than those before treatment, and the MNCV and SNCV of the median nerve and common peroneal nerve in the combined treatment group were significantly higher than those in the control group after treatment, (P <0.05). The total effective rate (88.89%) in the combination therapy group was significantly higher than that in the control group (66.67%), the difference was statistically significant (P <0.05) 6, hs-CRP and MDA levels were significantly lower than before treatment, SOD levels were significantly higher than before treatment, the difference was statistically significant (P <0.05), in which the combination therapy group serum IL-6, hs- CRP, MDA levels were significantly lower than the control group after treatment, the SOD level was significantly higher than the control group after treatment, the difference was statistically significant (P <0.05). Conclusion Salviae miltiorrhizae polyphenols combined with mecobalamin have significant clinical effect on diabetic peripheral neuropathy, and its mechanism may be related to the decrease of serum inflammatory cytokines (IL-6, hs-CRP) and the regulation of oxidative stress (SOD, MDA )related.