摘要
目的探讨依帕司他联合甲钴胺治疗老年2型糖尿病周围神经病变(DPN)的疗效。方法选取2015年4月至2016年4月在新疆医科大学第二附属医院住院及门诊就诊的老年2型糖尿病伴DPN患者158例为研究对象,采用随机数字法将其分为联合治疗组(80例)和甲钴胺组(78例)。治疗前两组患者均有效控制血糖、血压等,其中甲钴胺组单独给予甲钴胺治疗,每次0.5 mg,每日3次,饭前口服,联合治疗组在甲钴胺组基础上联合依帕司他治疗,每次50 mg,每日3次,饭前口服,两组患者均治疗3个月。比较两组患者治疗前后神经病变主觉症状问卷评分(TSS)、右侧正中神经、腓总神经感觉神经传导速度及运动神经传导速度、血清超氧化物歧化酶(SOD)、丙二醛以及血同型半胱氨酸(Hcy)水平,比较两组患者的不良反应发生情况。结果治疗后两组患者的TSS均降低(P<0.05),且联合治疗组的TSS较甲钴胺组更低[(0.94±0.34)分比(1.40±0.51)分](P<0.05);治疗后,两组患者的腓总神经及正中神经(运动支及感觉支)的传导速度明显增快,与治疗前相比差异有统计学意义(P<0.05),且联合治疗组患者腓总神经及正中神经(运动支及感觉支)的传导速度较甲钴胺组更快[腓总神经(47.2±0.9)m/s比(39.9±1.2)m/s,(44.2±1.5)m/s比(34.8±0.9)m/s;正中神经(51.3±1.0)m/s比(45.0±0.9)m/s,(45.0±1.9)m/s比(39.5±1.0)m/s](P<0.05);治疗后联合治疗组患者的SOD水平升高、丙二醛水平和Hcy水平降低,与治疗前相比差异有统计学意义(P<0.05),甲钴胺组患者的SOD水平升高、丙二醛水平降低(P<0.05),但Hcy水平与治疗前比较差异无统计学意义(P>0.05),且联合治疗组SOD水平较甲钴胺组更高[(85.1±1.3)U/L比(74.1±0.7)U/L],丙二醛和Hcy水平较甲钴胺组更低[(3.27±0.19)μmol/L比(3.93±0.20)μmol/L,(20.9±8.6)μmol/L比(28.0±11.6)μmol/L](P<0.05)。治疗过程中联合治疗组患者有2例发生恶心、呕吐,未停药,2 d后上述症状缓解;�
Objective To investigate the curative effect of epalrestat combination with mecobalamin for treatment elderly type 2 diabetic peripheral neuropathy （DPN）. Methods A total of 158 cases of elderly type 2 DPN patients who hospitalization and admitted to out-patient dept. of the Second Hospital Affiliated to Xinjiang Medical University from April 2015 to April 2016 were selected as objects, and than divided into combination group （80 cases） and mecobalamin group （78 cases） by random digits table. Before treatment, all the patients were controlled the blood glucose and pressure. Patients in mecobalamin group were merely given mecobalamin （ 0.5 mg every time, three times a day, oral administration before meals）, the combination group were given epalrestat （50 mg every time, three times a day, oral administration before meals） and mecobalamin. All the patients treatment for three months. Compared the neurological total symptoms scores （TSS） ,the sensory and motor nerve conduction velocity of median nerve and common peroneal nerve and the levels of superoxide dismutase （ SOD）, malondialdehyde （MDA） and homocysteine （Hcy） of the patients before and after treat- ment,compared the adverse reaction of the two groups too. Results After treatment, the TSS scores of the patients were declined, and combination group was lower than mecobalamin group [ （0.9 ± 0.3 ） scores vs （ 1.4 0.5 ） scores ], the sen- sory and motor nerve conduction velocity of median nerve and common peroneal nerve were faster than before （P 〈 0.05）, and combination group were faster than mecobalamin group [ common peroneal nerve （47.2 ± 0.9 ） m/s vs （ 39.9 ± 1.2） m/s, （44.2 ± 1.5） m/s vs （34.8 ±0.9） m/s, median nerve （51.3 ± 1.0） m/s vs （45.0± 0.9） m/s, （45.0 ± 1.9 ）m/s vs （ 39.5 ± 1.0 ） rn/s ] （ P 〈 0.05 ）. The MDA and Hcy levels of combination group were decreased and SOD was increased compared with before treatment （ P 〈 0.05 ）, there were sifigincent d
出处
《医学综述》
2017年第5期1013-1017,共5页
Medical Recapitulate
