尼莫地平联合阿卡波糖治疗糖尿病周围神经病变的临床研究  

Clinical trial of nimodipine combined with acarbose in the treatment of patients with diabetic peripheral neuropathy

作　　者：何兰香[1] 计莉强 郑坚[2] 张宴斌 葛敏[1] HE Lan - xiang 1a, JI Li - qiang 1a, ZHENG Jian 1b, ZHANG Yan- bin1b, GE Min1a(1.a Department of Pharmacy; b. Intensive Care Unit; a Department of Neurlogy, The First People＇s Hospital of Yuhang District, Hangzhou 311100, Chin)

机构地区：[1]杭州市余杭区第一人民医院药剂科,杭州311100 [2]杭州市余杭区第一人民医院重症监护室,杭州311100 [3]杭州市余杭区第一人民医院神经内科,杭州311100

出　　处：《中国临床药理学杂志》2018年第6期622-625,共4页The Chinese Journal of Clinical Pharmacology

基　　金：浙江省医学会临床科研基金资助项目(2013ZYC-A05)

摘　　要：目的观察尼莫地平联合阿卡波糖治疗糖尿病周围神经病变的临床疗效及对神经传导速度与神经相关生长因子的影响。方法将我院收治的76例糖尿病周围神经病变患者,随机分为试验组和对照组,每组38例。对照组给予尼莫地平40 mg,每天3次;试验组在对照组的基础上给予阿卡波糖50 mg,每天3次。所有患者均连续治疗1个月。比较2组患者的临床疗效、神经传导速度、神经相关生长因子和药物不良反应发生情况。结果治疗后,试验组的临床总有效率为89.47%(34例/38例),对照组为60.53%(23例/38例),差异有统计学意义(P<0.05)。治疗后,试验组腓总神经、正中神经运动神经传导速度(MCV)和感觉神经传导速度(SCV)分别为(45.88±4.06),(51.69±4.56),(44.12±4.09),(46.29±5.71)m·s^(-1);对照组分别为(41.16±3.83),(44.98±4.46),(39.52±3.19),(43.13±4.46)m·s^(-1),差异均有统计学意义(均P<0.05)。试验组的游离脂肪酸(FFA)、肿瘤坏死因子-α(TNF-α)、人磷髓脂碱性蛋白(MBP)水平分别为(471.45±44.28)μmol·L^(-1),(11.15±1.18)pg·mL^(-1),(1.90±0.14)μg·L^(-1);对照组分别为(542.79±46.68)μmol·L^(-1),(18.21±1.92)pg·mL^(-1),(3.41±0.38)μg·L^(-1)(均P<0.05)。试验组血管内皮生长因子(VEGF)、人脑源性神经营养因子(BDNF)水平分别为(943.39±97.85),(4.87±0.58)ng·L^(-1);对照组分别为(755.94±70.11),(3.09±0.26)ng·L^(-1),差异均有统计学意义(均P<0.05)。试验组出现腹泻1例,腹胀3例,药物不良反应发生率为10.53%(4例/38例);对照组出现轻度头晕1例,消化道反应2例,腹胀和轻度腹部不适2例,药物不良反应发生率为13.16%(5例/38例),差异无统计学意义(P>0.05)。结论尼莫地平联合阿卡波糖治疗糖尿病周围神经病变,能有效改善患者神经传导速度与神经相关生长因子,临床疗效良好,安全性高。Objective To observe the clinical efficacy of nimodipine and acarbose in the treatment of patients with diabetic peripheral neuropathy and its effect on nerve conduction velocity and nerve - related growth factor. Methods Seventy - six patients with diabetic peripheral neuropathy were randomly divided into treatment group and control group, 38 cases in each group. Patients in control group were given nimodipine 40 mg, three times a day. On the basis of control group, treatment group was given acarbose 50 mg, three times a day. All patients were treated for a month. The clinical efficacy, nerve conduction velocity, nerve -related growth factor and adverse drug reactions in two groups were compared. Results After treatment, the total effective rates in treatment group and control group were 89. 47% （34 cases/38 cases） and 60. 53% （23 cases/38 cases）, with significant difference（P 〈0. 05）. After treatment, the nerves peroneus communis, median nerve conduction velocity （MCV） and sensory nerve conduction velocity （SCV） in treatment group were （45.88 ±4. 06）, （51.69 ±4. 56）, （44. 12 ±4. 09） and （46.29 ± 5.71） m·s-1, had significant difference with those in control group, which were （41.16 ±3.83）, （44.98 ±4. 46）, （39.52 ±3. 19） and （43. 13 ± 4.46） m · s-1 （all P 〈 0.05）. The levels of free fatty acid （FFA）, tumor necrosis factor-or （TNF-ot） and myelin basic protein （MBP） in treatment group were （471.45±44.28） μmol L -1, （11.15 ± 1.18） pg · mL-1 and （1.90 ±0. 14） μg· L-1, had significant difference with those in control group, which were （542.79±46.68） μmol·L-1, （18.21 ±1.92） μg·mL-1 and （3.41 ±0.38） μg·L-1（allP〈0.05）. The levels of vascular endothelial growth factor （VEGF） and brain - derived neurotrophic factor （BDNF） in treatment group were （943.39 ± 97.85 ） and （4. 87 ± 0. 58 ） ng·L- 1, had significant difference with those in control group, which were （755.94 ±70. 11 �

关 键 词：尼莫地平 阿卡波糖 糖尿病周围神经病变 神经传导速度 神经相关生长因子 

分 类 号：R977.1[医药卫生—药品]