木丹颗粒联合甲钴胺治疗糖尿病神经病变的临床研究  

Clinical study of mudan granule plus mecobalamin in patients with diabetic peripheral neuropathy

作　　者：贾荣梅 高倩 杨丽梅[3] 伊敬东 李玉芝 Jia Rongmei;Gao Qian;Yang Limei;Yi Jingdong;Li Yuzhi(Department of Internal Medicine,Hengshui Fifth People's Hospital,Hengshui 053000,China)

机构地区：[1]衡水市第五人民医院内科,053000 [2]衡水市第五人民医院功能科,053000 [3]衡水市第五人民医院神经内科,053000

出　　处：《北京医学》2020年第3期201-204,共4页Beijing Medical Journal

基　　金：衡水市科技计划(2017014013C-38)。

摘　　要：目的探讨木丹颗粒联合甲钴胺治疗糖尿病神经病变(diabetic peripheral neuropathy,DPN)的效果。方法选取2016年12月至2017年12月衡水市第五人民医院确诊的DPN患者160例,随机分为对照组和治疗组,每组80例。对照组给予甲钴胺注射液500μg/d肌内注射,治疗2周后序贯口服甲钴胺片500μg,3次/d,治疗12周。治疗组在对照组基础上口服木丹颗粒7 g/次,3次/d,治疗12周。比较两组治疗前和治疗12周后总症状评分(total symptoms score,TSS)、神经传导速度、NOD样受体NLRP3(NACHT,LRR and PYD domains-containing protein 3)炎性小体及其下游炎性因子IL-1β和IL-18的水平。结果治疗12周后,对照组和治疗组TSS评分均较治疗前降低[(4.19±2.11)分比(5.70±2.28)分;(2.50±1.78)分比(5.71±2.70)分,P均<0.05],且治疗组低于对照组(P<0.05)。两组SCV和MCV均较治疗前升高(P<0.05),且治疗组高于对照组(P<0.05)。两组治疗前NLRP3、IL-1β及IL-18水平比较,差异无统计学意义(P>0.05);治疗12周后,两组NLRP3、IL-1β及IL-18水平均较治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。结论木丹颗粒联合甲钴胺治疗DPN可有效改善患者的临床症状,提高神经传导速度,同时可降低炎性因子的水平。Objective To explore the effect of mudan granule plus mecobalamin in patients with diabetic peripheral neuropathy(DNP).Methods One hundred and sixty patients with DPN were divided into the control group and the treatment group.The control group were given mecobalamin injection 500μg/d for two weeks,and then mecobalamin tablets 500μg,three times one day for 12 weeks.Base on the control group,the treatment group were given Mudan granule plus 7 geach time,three times one day for 12 weeks.The total symptoms score(TSS),peripheral nerve conduction velocity and NLRP3 inflammasome and its downstream inflammatory cytokines of IL-1βand IL-18 were compared before treatment and treatment for 12 weeks between the two groups.Results After 12 weeks treatment,TSS were reduced in the two groups[(4.19±2.11)vs.(5.70±2.28),(2.50±1.78)vs.(5.71±2.70),P<0.05],and TSS in the treatment group was lower than that in the control group(P<0.05).Sensory conduction velocity(SCV)and motor conduction velocity(MCV)were increased in the two groups(P<0.05),SCV and MCV in the treatment group were higher than those in the control group(P<0.05).The differences were no statistical significance on NLRP3 inflammasome and its downstream inflammatory cytokines of IL-1βand IL-18 between the two groups before treatment(P<0.05).NLRP3 inflammasome and its downstream inflammatory cytokines of IL-1βand IL-18 were reduced in the two groups(P<0.05),IL-1βand IL-18 in the treatment group were lower than those in the control group(P<0.05).Conclusions Mudan granule plus mecobalamin in patients with DNP can improve clinical symptoms,increase peripheral nerve conduction velocity,and reduce the levels of inflammatory factor。

关 键 词：糖尿病神经病变 木丹颗粒 甲钴胺 神经传导速度 NLRP3炎性小体 

分 类 号：R587.2[医药卫生—内分泌] R747.9[医药卫生—内科学]