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目的:探讨单唾液酸四己糖神经节苷脂钠联合血管保护剂对老年糖尿病周围神经病变(DPN)患者神经病变评分及神经传导速度影响。方法:选取绍兴市中心医院内分泌科2013年1月-2013年12月收治老年DPN患者150例,采用随机数字表法分为对照组和治疗组,每组各75例;对照组患者采用甲钴胺注射液静脉滴注治疗;治疗组患者则采用单唾液酸四己糖神经节苷脂钠静脉滴注联合血管保护剂羟苯磺酸钙口服治疗;比较两组患者临床疗效,治疗前后密歇根糖尿病神经病变评分量表(MDNS)评分、密歇根神经病变筛查量表(MNSI)评分及神经传导速度等。结果:对照组和治疗组患者临床治疗总有效率分别为76.00%(57/75),93.33%(70/75);治疗组患者临床疗效显著优于对照组,差异有统计学意义(P<0.05);对照组患者治疗前后MDNS评分分别为(21.46±4.50)分,(18.75±3.88)分;治疗组患者治疗前后MDNS评分分别为(21.39±4.47)分,(15.10±2.54)分;对照组患者治疗前后MNSI评分分别为(5.51±1.49)分,(4.47±1.18)分;治疗组患者治疗前后MNSI评分分别为(5.56±1.52)分,(2.52±0.86)分;两组患者治疗后MDNS评分和MNSI评分较治疗前均显著降低,且治疗组患者MDNS评分和MNSI评分均低于对照组,差异有统计学意义(P<0.05);对照组患者治疗后正中神经SCV和腓总神经SCV分别为(34.81±4.28)m/s,(35.17±4.59)m/s;治疗组患者治疗后正中神经SCV和腓总神经SCV分别为(41.36±6.30)m/s,(39.20±6.48)m/s;对照组患者治疗后正中神经MCV和腓总神经MCV分别为(42.51±5.68)m/s,(37.33±5.09)m/s;治疗组患者治疗后正中神经MCV和腓总神经MCV分别为(45.67±6.12)m/s,(42.35±6.64)m/s;两组患者治疗后正中神经SCV、腓总神经SCV、正中神经MCV及腓总神经MCV等神经传导速度较治疗前均显著提高,且治疗组患者神经传导速度均高于对照组,差异有统计学意义(P<0.05)。结论:单唾液酸四己糖神经节苷脂钠联合血管保护剂用于老年DPN患者治疗可有效缓解临床症状体征,改善神经功能损伤,并有助于提高神经传导速度。
Objective: To investigate the effect of monosialotetrahexosyl ganglioside combined with vasoprotective agents on neuropathy score and nerve conduction velocity in elderly patients with diabetic peripheral neuropathy (DPN). Methods: 150 cases of elderly patients with DPN were selected from Department of Endocrinology, Central Hospital of Shaoxing from January 2013 to December 2013. The patients were divided into control group and treatment group with 75 cases in each group by random number table. Intravenous infusion of amine injection; the treatment group patients were treated with monosialotetrahexosyl ganglioside sodium intravenous infusion of vascular protective agent calcium dobesilate; the clinical efficacy of two groups were compared before and after treatment of Michigan diabetes Neurological Disease Rating Scale (MDNS) score, Michigan Neurological Disease Screening Scale (MNSI) score and nerve conduction velocity. Results: The total effective rate of clinical treatment in control group and treatment group was 76.00% (57/75) and 93.33% (70/75), respectively. The clinical efficacy of treatment group was significantly better than that of control group (P < (21.46 ± 4.50) and (18.75 ± 3.88) points before and after treatment in the control group. The MDNS scores in the treatment group before and after treatment were (21.39 ± 4.47) and (15.10 ± 2.54) The MNSI scores before and after treatment were (5.51 ± 1.49) and (4.47 ± 1.18) points respectively. The MNSI scores before and after treatment in the treatment group were (5.56 ± 1.52) and (2.52 ± 0.86) points, respectively. After treatment, MDNS score and MNSI score were significantly lower than before treatment, and the treatment group MDNS score and MNSI score were lower than the control group, the difference was statistically significant (P <0.05); control group patients after treatment of median nerve SCV and common peroneal nerve SCV were (34.81 ± 4.28) m / s and (35.17 ± 4.59) m / s, respectively; SCV and SCV of the median nerve in the treatment group were (41.36 ± 6.30) m / s and (39.20 ± 6.48) The mean MCV and MCV in the control group were (42.51 ± 5.68) m / s and (37.33 ± 5.09) m / s, respectively. After treatment, the median nerve MCV and (45.67 ± 6.12) m / s and (42.35 ± 6.64) m / s respectively. The nerve conduction velocities of SCV, SCV, MCV and MCV of the common nerve in the two groups after treatment Compared with before treatment were significantly increased, and the treatment group patients with nerve conduction velocity were higher than the control group, the difference was statistically significant (P <0.05). CONCLUSIONS: Sodium monosialotetrahexosyl ganglioside combined with vasoprotective agent for the treatment of senile DPN patients can effectively alleviate clinical symptoms and signs, improve nerve function impairment, and help to improve nerve conduction velocity.