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目的观察胰岛素、复方丹参联合美西律和弥可保与前列腺素E1(PGEl)联合治疗糖尿病周围神经病变的临床疗效。方法 58例糖尿病合并周围神经病变患者随机分为胰岛素组和弥可保组,胰岛素组:给予胰岛素16～56 U/d皮下注射,待患者空腹血糖正常,连续三次尿糖阴性时改用小剂量优降糖2.5mg/d,三餐前30min口服,同时每天1次静脉滴注复方丹参20ml,美西律200mg,3次/d口服4,周1个疗程。弥可保组组用弥可保500μg肌注,每日1次,连用4周后改为隔日1次,总疗程12周,前列腺素El 10ml静脉注射,每日1次,连用2周。结果胰岛素组显效26例,占86.7%,好转3例,占10%,无效1例,占3%。总有效率为96.7%。弥可保组显效17例,占60.7%,好转7例,占25%,无效4例,占14.3%。总有效率为80.0%。两组在显效率和总有效率上相比较差异有统计学意义,P<0.05。结论胰岛素、复方丹参联合美西律治疗糖尿病合并周围神经病变疗效可靠,毒副反应小,适合推广。
Objective To observe the clinical effects of insulin and compound Danshen combined with mexiletine and methycobal on prostaglandin E1 (PGE1) in the treatment of diabetic peripheral neuropathy. Methods Fifty-eight patients with diabetes mellitus and peripheral neuropathy were randomly divided into insulin group and Miqibao group. Insulin group was injected subcutaneously with insulin of 16-56 U / d. When fasting blood glucose was normal, Hypoglycemic 2.5mg / d, oral 30min before meals, while intravenous infusion of compound Danshen 20ml daily, mexiletine 200mg, 3 times / d orally 4 weeks for a course of treatment. Mi Kebao group with Mi Kebao 500μg intramuscular injection, once daily, once every 4 weeks later changed to every other day, the total course of 12 weeks, intravenous injection of prostaglandin El 10ml, once daily for 2 weeks. Results The insulin group was significantly improved in 26 cases (86.7%), improved in 3 cases (10%) and ineffective in 1 case (3%). The total effective rate was 96.7%. Mi Kebao group markedly effective in 17 cases, accounting for 60.7%, improved in 7 cases, accounting for 25%, 4 cases were ineffective, accounting for 14.3%. The total effective rate is 80.0%. There was significant difference between the two groups in apparent efficiency and total effective rate, P <0.05. Conclusion Insulin and compound Danshen combined with mexiletine are effective in treating diabetic patients with peripheral neuropathy and have small toxic and side effects, which is suitable for promotion.