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目的:探讨消麻止痛胶囊对糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)患者神经传导速度的改善作用及其作用机制。方法:将收治的102例糖尿病周围神经病变患者随机分为对照组50例和治疗组52例,对照组患者给予口服甲钴胺500 mg和安慰剂,3次/d;治疗组口服甲钴胺500 mg,3次/d和消麻止痛胶囊4粒,3次/d,连续治疗4周为1个疗程。3个疗程后评价疗效,测定患者正中神经、腓总神经运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)的变化,对醛糖还原酶(AR),一氧化氮(NO)和超氧化物歧化酶(SOD)活性的变化进行比较,并通过多伦多临床神经病变评分(toronto clinical scoring system,TCSS)症状评分和VAS疼痛评分对病情进行评估。结果:治疗组总有效率为90.4%,明显优于对照组(74.0%),差异有统计学意义(P<0.05);两组患者治疗后MNCV和SNCV较治疗前均有所提高,其中治疗组比较差异有统计学意义(P<0.05);治疗组AR水平明显降低(P<0.05),NO和SOD升高显著(P<0.05),且治疗组AR,NO和SOD水平与对照组比较差异有统计学意义(P<0.05);治疗后对照组和治疗组TCSS评分分别为(6.27±1.17)分和(4.52±0.93)分,VAS评分为(5.33±0.64)分和(4.26±0.53)分,治疗组明显低于对照组,差异有统计学意义(P<0.05)。结论:消麻止痛胶囊联合甲钴胺可明显改善DPN患者的神经传导速度,有助于糖尿病周围神经病变的治疗,这可能与患者体内AR,NO和SOD活性的变化有关。
Objective: To investigate the effect of Xiaomazhitong capsule on nerve conduction velocity in patients with diabetic peripheral neuropathy (DPN) and its mechanism. Methods: A total of 102 patients with diabetic peripheral neuropathy were randomly divided into control group (n = 50) and treatment group (n = 52). Patients in the control group were given methylcobalamin 500 mg and placebo 3 times a day. 500 mg, 3 times / d and Xiaomazhitong capsule 4, 3 times / d, continuous treatment for 4 weeks for a course of treatment. After 3 courses of treatment, the curative effect was evaluated. The changes of median nerve, peroneal nerve motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) were measured. The changes of aldose reductase (AR), nitric oxide Changes in SOD activity were compared and assessed by the Toronto clinical neurological scoring system (TCSS) symptom score and VAS pain score. Results: The total effective rate of the treatment group was 90.4%, which was significantly better than that of the control group (74.0%), the difference was statistically significant (P <0.05); MNCV and SNCV were improved after treatment in both groups, (P <0.05). The level of AR in treatment group was significantly lower than that in control group (P <0.05), while the level of NO and SOD in treatment group was significantly higher than that in control group (P <0.05). After treatment, the TCSS scores of the control group and the treatment group were (6.27 ± 1.17) points and (4.52 ± 0.93) points respectively, the VAS score was (5.33 ± 0.64) points and (4.26 ± 0.53) points respectively ) Points, the treatment group was significantly lower than the control group, the difference was statistically significant (P <0.05). Conclusion: Xiamazhitong capsule combined with mecobalamin can significantly improve the nerve conduction velocity in patients with DPN, which is helpful for the treatment of diabetic peripheral neuropathy, which may be related to the changes of AR, NO and SOD activity in patients.