尼莫地平联合阿卡波糖治疗糖尿病周围神经病变的疗效及对炎症因子的影响  

Effects of nimodipine combined with acarbose on diabetic peripheral neuropathy and inflammatory factors

作　　者：倪菁[1] 黄伟[1] 陈子溦 张星星 林源[2] 雷飞 NI Jing;HUANG Wei;CHEN Ziwei;ZHANG Xingxing;LIN Yuan;LEI Fei(Clinical Medicine, Xi'an Medical University, Xi'an 710021, China;Department of Endocrinology, The Second affiliated hospital of Xi'an Medical University Shanxi, Xi'an 710038, China;Department of Stomatology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an 710038, China)

机构地区：[1]西安医学院临床医学院,陕西西安710021 [2]西安医学院第二附属医院内分泌科,陕西西安710038 [3]西安医学院第二附属医院口腔科,陕西西安710038

出　　处：《西部医学》2021年第1期101-106,共6页Medical Journal of West China

基　　金：陕西省重点研发计划项目(2017SF-216)。

摘　　要：目的探讨尼莫地平联合阿卡波糖治疗糖尿病周围神经病变的疗效及其对炎症因子的影响。方法选取2017年5月~2018年5月西安医学院临床医学院收治的100例糖尿病周围神经病变患者,随机分为研究组和对照组,每组各50例。两组患者均给予常规治疗,对照组在常规治疗基础上给予阿卡波糖50 mg/次,tid,po。研究组在对照组治疗基础上给予尼莫地平40 mg/次,tid,po。所有患者治疗时间均为1个月。治疗后评价临床疗效。比较两组治疗前后的Toronto评分、腓总神经及正中神经的运动传导速度(MCV)、感觉传导速度(SCV)。比较两组患者治疗前后的血清缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)、游离脂肪酸(FFA)、肿瘤坏死因子(TNF-α)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)、磷髓脂碱性蛋白(MBP)水平。结果研究组临床治疗总有效率明显高于对照组,差异有统计学意义(P<0.01)。研究组治疗后Toronto评分明显低于治疗前及对照组治疗后,差异均有统计学意义(P<0.01)。研究组治疗后的腓总神经和正中神经的MCV、SCV均明显高于治疗前及对照组,差异均有统计学意义(P<0.01)。研究组治疗前后Toronto评分的差值,腓总神经和正中神经的MCV、SCV治疗前后的差值均明显高于对照组治疗前后的差值(P<0.01)。研究组治疗后血清中HIF-1α、VEGF、FFA、TNF-α、MBP水平明显低于治疗前及对照组治疗后,BDNF、NGF水平均明显高于治疗前及对照组治疗后,差异有统计学意义(P<0.01)。研究组治疗前后血清HIF-1α、VEGF、FFA、TNF-α、MBP、BDNF、NGF的差值明显高于对照组,差异有统计学意义(P<0.01)。结论在使用阿卡波糖降糖药物的基础上加用尼莫地平,能够明显改善糖尿病周围神经病变,降低炎症水平,提高患者神经传导速度与血中神经营养因子水平。Objective To explore the effects of nimodipine combined with acarbose on diabetic peripheral neuropathy and inflammatory factors.Methods 100 patients with diabetic peripheral neuropathy admitted to our hospital from May 2017 to May 2018 were selected and randomly divided into study group and control group,50 patients in each group.Patients in both groups were given conventional treatment,while patients in the control group were given acarbose(50mg/time,tid,Po)on the basis of conventional treatment.In the study group,nimodipine,40mg/time,tid,Po were given on the basis of the treatment in the control group.All patients were treated for 1 month.Clinical efficacy was evaluated after treatment.The Toronto scores,MCV and SCV of common peroneal nerve and median nerve before and after treatment were compared between the two groups.HIF-1α,VEGF,FFA,TNF-α,BDNF,NGF,MBP levels were compared between the two groups before and after treatment.Results The total effective rate in the study group was significantly higher than that in the control group(88.0%vs 64.0%)(P<0.01).The Toronto scores in the research group after treatment were significantly lower than those before and after treatment in the control group(P<0.01).After treatment,the MCV and SCV of the common peroneal nerve and median nerve in the study group were significantly higher than those before and in the control group(P<0.01).The difference between Toronto scores before and after treatment in the research group,and the difference between MCV and SCV values of common peroneal nerve and median nerve before and after treatment were significantly higher than those before and after treatment in the control group(P<0.01).The serum levels of HIF-1α,VEGF,FFA,TNF-αand MBP in the study group were significantly lower than those before and after treatment,and the levels of BDNF and NGF in the study group were significantly higher than those before and after treatment(P<0.01).Serum HIF-1α,VEGF,FFA,TNF-α,MBP,BDNF,NGF were significantly higher in the study group than in the c

关 键 词：糖尿病周围神经病变 尼莫地平 阿卡波糖 神经传导速度 

分 类 号：R587.1[医药卫生—内分泌]