依達拉奉治療糖尿病周圍神經(jīng)病變的療效觀察

[摘要] 目的 觀察依達拉奉治療糖尿病周圍神經(jīng)病變(DPN)的療效。方法 將83例患者隨機分為治療組(41例)和對照組(42例)，均在胰島素強化降糖治療基礎(chǔ)上，治療組給予依達拉奉與丹參，對照組給予甲鈷胺與丹參治療，連用2周后評估其療效。結(jié)果 治療組DPN的癥狀、體征及神經(jīng)傳導(dǎo)速度改善明顯高于對照組(P<0.01)。結(jié)論 依達拉奉可明顯改善DPN的治療效果。

[關(guān)鍵詞] 依達拉奉;糖尿病周圍神經(jīng)病變;氧化應(yīng)激

[中圖分類號] R587.1 [文獻標(biāo)識碼] A [文章編號] 1673-9701(2010)04-156-02

Therapy of Edaravone for Diabetic Peripheral Neuropathy

YUN Peng1SUN Aiping2XIAO Hu2

1.Clinic Medical College，Yangtze University，Jingzhou 434000，China; 2.Department of Endocrinology，F(xiàn)irst Affiliated Hospital，Yangtze University，Jingzhou 434000，China

[Abstract] Objective To observe the effect of edaravone for diabetic peripheral neuropathy(DPN). Methods A total of 83 DPN cases were at random divided into treatment group(n=41) and control group(n=42). The treatment group was given edaravone and Danshen and the control group was given mecobalamin and Danshen，during which the control of blood sugar with insulin were performed simultaneously in the two group. At the end of a 2-week period，the therapeutic effect was evaluated. Results In the treatment group，the improvement of DPN symptoms and nervous conducting speed are much more obvious than that in control group(P<0.01). Conclusion Edaravone can effectively better the therapeutic outcome of DPN.

[Key word] Edaravone;Diabetic peripheral neuropathy;Oxidative stress

糖尿病神經(jīng)病變是糖尿病最常見的慢性并發(fā)癥之一，病變可累及中樞神經(jīng)及周圍神經(jīng)，后者尤為常見，約28%的糖尿病患者有周圍神經(jīng)病變的證據(jù)[1]。其臨床癥狀為肢體麻木、疼痛或感覺減退等，嚴(yán)重者可合并感染，甚至導(dǎo)致截肢。目前臨床上對DPN尚無特效治療手段，現(xiàn)試用依達拉奉治療DPN取得較好效果，總結(jié)如下。

1資料與方法

1.1病例入選標(biāo)準(zhǔn)

①符合1999年WHO糖尿病診斷標(biāo)準(zhǔn);②四肢末梢感覺異常或感覺障礙，跟腱反射減弱或消失，并排除其他原因所致神經(jīng)病變;③下肢肌電圖檢查異常:感覺神經(jīng)傳導(dǎo)速度(SCV)<40 m/s，運動神經(jīng)傳導(dǎo)速度(MCV)<45m/s[2]。

1.2一般資料

符合上述標(biāo)準(zhǔn)的患者83例，其中男37例，女46例，年齡(56±7)歲，DPN病程(22±7)個月。隨機分為治療組41例和對照組42例，兩組患者的性別、年齡、DPN病程均無明顯差異(P>0.05)。

1.3治療方法

兩組患者均給予糖尿病飲食、運動治療及胰島素強化治療(胰島素泵或每日4次注射)，依據(jù)血糖調(diào)整胰島素用量至血糖盡量達標(biāo)(空腹血糖≤6.1mmol/L;餐后2h血糖≤7.8mmol/L)。在血糖穩(wěn)定1周后開始對比治療:治療組使用依達拉奉30mg及丹參20mL分別加入生理鹽水250mL中靜滴，每天1次;對照組為甲鈷胺1000μg靜推及丹參20mL加人生理鹽水250mL中靜滴，每天1次。……