论文部分内容阅读
目的:观察银丹心脑通软胶囊联合α-硫辛酸注射液治疗糖尿病周围神经病变的临床疗效及机制探讨。方法:将98例糖尿病周围神经病变患者随机按数字表法分为治疗组和对照组各49例;两组患者均接受糖尿病的常规治疗。对照组给予α-硫辛酸注射液静脉滴注治疗,600 mg/次,1次/d;治疗组在对照组治疗的基础上口服银丹心脑通软胶囊,4粒/次,3次/d;两组疗程均为4周。触觉用尼龙丝单丝法检测,温度觉采用Tip Thcrm温度浅感觉仪检测;腱反射检测包括踝反射及膝反射检测,采用多伦多临床神经病变(TCSS)进行评分;证候积分参照糖尿病症状分级量化表进行评分;检测两组患者治疗前后正中神经、腓总神经的运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)的变化,检测治疗前后血糖、血脂、血清丙二醛(MDA),一氧化氮(NO),超氧化物歧化酶(SOD)和血管内皮素(ET-1)水平。结果:治疗组临床总有效率为89.8%,对照组为73.47%,治疗组优于对照组(P<0.05);治疗后治疗组的正中神经MNCV和SNCV传导速度明显高于对照组(P<0.05);两组患者治疗后血糖均比治疗前下降(P<0.01),但两组间比较无统计学意义;治疗组治疗后血脂水平较治疗前显著下降(P<0.01);治疗后治疗组患者血清SOD和NO水平均明显高于对照组(P<0.05);治疗后治疗组血清MDA和ET-1水平均低于对照组(P<0.05)。结论:银丹心脑通软胶囊联合α-硫辛酸注射液治疗糖尿病周围神经病变临床疗效显著,其作用机制可能与调节血脂代谢和MDA,SOD,NO及ET-1水平有关。
Objective: To observe the clinical efficacy and mechanism of Yin Dan Xin Nao Tong Soft Capsule combined with α-lipoic acid injection in the treatment of diabetic peripheral neuropathy. Methods: 98 cases of diabetic peripheral neuropathy patients were randomly divided into treatment group and control group according to the digital table method, 49 cases in each group. Both groups received routine treatment of diabetes mellitus. The control group was given α-lipoic acid injection by intravenous drip, 600 mg / time, once a day; the treatment group was treated by oral administration of Yin Dan Xin Nao Tong soft capsules, 4 capsules / time, 3 times / d; two groups of treatment are 4 weeks. The tactile sensation was measured by the monofilament method of nylon filaments. The temperature sensation was detected by Tip Thcrm temperature sensilometer. The tendon reflexes including ankle reflex and knee reflex were scored by Toronto Clinical Neuropathy (TCSS). The syndrome scores were quantified with reference to the symptom grade of diabetes The changes of motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of the median nerve and common peroneal nerve before and after treatment were measured before and after treatment. The levels of blood glucose, blood lipid, serum malondialdehyde (MDA) Nitric oxide (NO), superoxide dismutase (SOD) and endothelin (ET-1) levels. Results: The total clinical effective rate was 89.8% in the treatment group and 73.47% in the control group, which was better than that in the control group (P <0.05). The median nerve MNCV and SNCV conduction velocity in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the blood glucose of the two groups decreased after treatment (P <0.01), but there was no significant difference between the two groups. The level of blood lipids in the treatment group decreased significantly after treatment (P <0.01) Serum levels of SOD and NO in patients were significantly higher than those in the control group (P <0.05). Serum levels of MDA and ET-1 in the treatment group were lower than those in the control group (P <0.05). Conclusion: Yindan Xinnaotong soft capsules combined with α-lipoic acid injection in the treatment of diabetic peripheral neuropathy has a significant clinical effect, and its mechanism may be related to the regulation of blood lipid metabolism and MDA, SOD, NO and ET-1 levels.