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[摘要]
目的 研究硫辛酸注射液聯(lián)合小牛血清去蛋白注射液治療Ⅱ型糖尿病周圍神經(jīng)病變(DPN)的療效。方法 收集延安大學(xué)咸陽醫(yī)院門診及住院DPN患者90例,隨機(jī)分成兩組,對照組與治療組各45例,兩組均積極控制血糖、血脂、血壓,在此基礎(chǔ)上治療組給予硫辛酸600 mg加入生理鹽水250 mL靜脈滴注,1次/d,以及小牛血清去蛋白注射液20 mL加入生理鹽水250 mL靜脈續(xù)點(diǎn),1次/d。對照組單純給予硫辛酸600 mg加入生理鹽水250 mL靜脈滴注,1次/d,兩組均連續(xù)治療4周。測定患者治療前后的正中神經(jīng)、尺神經(jīng)、脛神經(jīng)、腓總神經(jīng)的運(yùn)動神經(jīng)傳導(dǎo)速度(MCV)和感覺神經(jīng)傳導(dǎo)速度(SCV);測定兩組治療前后尿微量白蛋白、超敏C反應(yīng)蛋白含量變化;分別對患者四肢的燒灼感、刀割樣刺痛、刺痛、麻木4個陽性的感覺神經(jīng)系統(tǒng)癥狀的嚴(yán)重程度(無、輕、中、重)及頻率(偶爾、經(jīng)常、持續(xù))進(jìn)行評分;分別在治療前后做肝腎功能檢查,記錄腱反射、深淺感覺治療前后變化情況。結(jié)果 治療后兩組患者神經(jīng)傳導(dǎo)速度比治療前均有所提高,差異有統(tǒng)計學(xué)意義(P<0.05),且治療組比對照組提高更明顯,組間差異具有統(tǒng)計學(xué)意義(P<0.05);治療后兩組自覺癥狀評分均有改善,差異有統(tǒng)計學(xué)意義(P<0.05、0.01),治療組比對照組改善更明顯,組間差異具有統(tǒng)計學(xué)意義(P<0.01);治療后兩組C反應(yīng)蛋白及尿微量白蛋白均有一定程度的下降,與治療前比較差異具有統(tǒng)計學(xué)意義(P<0.05);與對照組治療后比較,治療組下降更顯著,組間差異有統(tǒng)計學(xué)意義(P<0.05);治療組總有效率為93.3%,明顯高于對照組總有效率68.9%,組間差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 硫辛酸注射液聯(lián)合小牛血清去蛋白治療DPN療效顯著,能改善神經(jīng)傳導(dǎo)速度,減輕自覺癥狀,值得進(jìn)一步的推廣應(yīng)用。
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[Abstract]
Objective To study the effect of Thioctic Acid Injection combined with calf serum albumin injection in the treatment of diabetic peripheral neuropathy (DPN) in patients with type Ⅱ diabetes mellitus. Methods The outpatient and inpatient DPN patients (90 cases) in Yan'an University Xianyang Hospital were randomly divided into two groups, control group and treatment group of 45 cases, the blood glucose, blood lipid, and blood pressure of patients in two groups were actively controlled,. The patients in treatment group were treated with Thioctic Acid Injection (600 mg in 250 mL saline) by iv drip, once daily, and combined with calf serum albumin injection (20 mL join 250 mL saline) by vein points, once daily. The patients in control group were treated with Thioctic Acid Injection (600 mg join 250 mL saline) by iv drip, once daily, both groups were treated for four weeks. The motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) of the median nerve, ulnar nerve, tibial nerve, and common motor nerve were measured before and after treatment. The contents of urinary micro albumin and high sensitive C reactive protein were measured before and after treatment in two groups; Respectively score for patients with limb burning feeling, knife cut the severity of pain, tingling, numbness of four positive sensory nervous system symptoms (none, mild, moderate, and severe) and frequency (occasionally, regular, and continuous). Liver and kidney function tests were done before and after treatment, and the changes of tendon reflex and depth of feeling before and after treatment were recorded. Results After treatment, two groups of patients with nerve conduction velocity were increased than those before treatment, the difference was statistically significant (P<0.05), and treatment group increased more significantly than in the control group, the difference between the two groups with statistical significance (P<0.05). After treatment, the subjective symptom score of the two groups were improved, the difference was statistically significant (P<0.05, 0.01), the treatment group improved more than the control group, the difference between the groups was statistically significant (P<0.01). After treatment, C-reactive protein and urinary albumin had a certain degree of decline after treatment, compared with that before treatment with statistical significance (P<0.05); Compared with the control group, the treatment group decreased more, the difference between two groups has statistical significance (P<0.05). The total effective rate of treatment group was 93.3%, significantly higher than the control group with total effective rate was 68.9% (P<0.05). Conclusion Thioctic Acid Injection combined with calf serum albumin injection is significantly effective in treatment of DPN, which could improve the nerve conduction speed, reduce the symptoms, it is worth to further popularization and application.
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