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机构地区:[1]武汉大学医学院,湖北武汉430071 [2]孝感市中心医院,湖北孝感432000
出 处:《药学实践杂志》2013年第2期126-128,142,共4页Journal of Pharmaceutical Practice
摘 要:目的评价降糖合剂治疗糖尿病周围神经病变(DPN)的临床疗效,并初步探讨其作用机制。方法 60例DNP患者随机分为两组:治疗组和对照组,每组30例。在饮食控制和常规降糖治疗的基础上,对照组给予甲钴胺片0.5 mg,po,tid;治疗组在对照组基础上给予降糖合剂50 ml,po,tid。两组疗程均为4周。治疗前后观察临床症状和体征,进行外周血空腹血糖(FPG)、餐后2 h血糖(PPG2h)、糖化血红蛋白(HbA1C)、血浆黏度(PV)、内皮素(ET)、一氧化氮(NO)和神经传导速度(NCV)测定。结果治疗组临床有效率(86.67%)明显高于对照组(63.33%)(P<0.05),NCV、FPG、PPG2h、HbA1C、PV、ET、NO等检测指标治疗组治疗前后比较,均有明显改善(P<0.05);与对照组相比,治疗组治疗后NCV、PV、ET和NO均有显著差异(P<0.05)。观察期内未发现降糖合剂的不良反应。结论降糖合剂联合甲钴胺治疗DPN安全有效,其作用机制可能与保护血管内皮细胞、改善血液流变性、扩张外周微血管,增加滋养神经的微血管的血供和氧供,阻止或逆转DPN受损的外周神经纤维有关。Objective To evaluate the efficacy and explore the mechanism of Jiangtang Mixture in treatment of diabetic peripher- al neuropathy ( DPN). Methods 60 cases of DPN patients were randomly divided into treatment group and control group with 30 cases in each group. Two groups were all treated with a diet control, routine hypoglycemic therapy, the control group was treated with Methylco- balamin Tablet 0.5 mg , po, rid. While the treatment group was treated with Jiangtang Mixture 50 ml, po, tid, on the basis of the control group. The course of treatment was 4 weeks in each group. Before and after treatment, clinical signs and symptoms were observed and de- termined, including fasting plasma glucose (FPG) , the 2 hours postprandial blood glucose ( PPG2h ) , glycated hemoglobin ( HbA1c ) , plasma viscosity (PV) , endothelin (ET) , nitric oxide (NO) , and nerve conduction velocity (NCV). Results The total effective rate of the treatment group (86.67%) was significantly higher than that of the control group (63.33%) (P 〈 0.05 ). There were significant differences in levels of the indexes, such as NCV,FPG,PPG2h ,HbA1c ,PV,ET and NO in the treatment group before and after treatment (P 〈 0.05) , but only in the four indexes, such as NCV,PV,ET and NO, the treatment group compared with the control group showed significantly differences after treatment (P 〈 0.05). Adverse reactions of Jiangtang Mixture did not find in the observation period. Con- clusion Jiangtang Mixture combined with Mecobalamine to treat DPN was safe and effective. The mechanism could be related to protect vascular endothelial cell, improve blood rheology, expand the peripheral microvascular, nourish the nerve with blood and oxygen supply, prevent or reverse impaired peripheral nerve fibers of DPN.
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