参芪降糖颗粒联合银杏叶胶囊治疗糖尿病周围神经病变52例

Effect of Shenqi Jiangtang Granules Integrated Ginkgo Leaf Capsules Therapy in Treating 52 Cases with Diabetes Peripheral Neuropathy

摘要:

目的: 探讨参芪降糖颗粒、银杏叶胶囊联合甲钴胺及α-硫辛酸治疗糖尿病周围神经病变(DPN)的疗效及对氧化应激指标和血清胱抑素C(Cys-C)水平的影响。方法: 104例DPN患者随机按数字表法分为西药组和中西医结合组各52例。西药组采用甲钴胺片,0.5 mg/次,3次/d;和硫辛酸胶囊,0.6 g/次,1次/d,口服。中西医结合组在西药组治疗的基础上加服参芪降糖颗粒,2 g/次,3次/d;和银杏叶胶囊,2 粒/次,3次/d。两组疗程均为3个月。进行治疗前后临床症状积分和多伦多(Toronto clinical scoring system,TCSS)临床评分系统评价;检测治疗前后正中神经、尺神经、腓总神经、胫前神经的运动传导速度(MNCV)和感觉传导速度(SNCV),检测血清总抗氧化能力(TAOC),超氧化物歧化酶(SOD),丙二醛(MDA)和Cys-C水平。结果: 经Ridit分析,中西医结合组临床疗效优于西药组(P<0.05);治疗后中西医结合组临床症状积分和Toronto临床系统评分低于西药组(P<0.01);治疗后中西医结合组正中神经、尺神经、腓总神经、胫前神经感觉传导速度(SNCV)和运动传导速度(MNCV)均比西药组有提高(P<0.01);治疗后中西医结合组SOD,MDA和Cys-C水平低于西药组(P<0.01),TAOC水平高于西药组(P<0.01)。结论: 参芪降糖颗粒、银杏叶胶囊联合甲钴胺及α-硫辛酸治疗DPN疗效优于单纯西药治疗,其作用机制可能与减轻氧化应激损伤,降低血清Cys-C水平有关。

Abstract:

Objective: To discuss the curative effects of Shenqi Jiangtang granules, Ginkgo leaf capsules jointed with mecobalamine and α-lipoic acid in treating diabetes peripheral neuropathy (DPN) and to investigate its influence on levels of oxidative stress indicators and serum cystatin C (Cys-C). Method: One hundred and four DPN patients were randomly divided into the Western medicine group (52 cases) and the combination group (52 cases), Patients in the Western medicine group took 0.5 mg mecobalamine tablets thrice daily and 0.6 g thioctic acid capsules once daily. On the basis of therapy in the Western medicine group, patients in the combination group added 2 g Shenqi Jiangtang granules and 2 pieces of Ginkgo leaf capsules thrice daily. All patients in the two groups received 3 months of treatment. Integral scores of symptoms and Toronto (Toronto clinical scoring system, TCSS) clinical grading were conducted before and after therapy. Motor conduction velocity (MNCV) and sensory conduction velocity (SNCV) of median nerve, ulnar nerve, the common peroneal nerve, anterior tibial nerve were detected. Levels of serum total antioxidant capacity (TAOC), superoxide dismutase (SOD), malondialdehyde (MDA) and Cys-C were tested before and after treatment. Result: The curative effects in the combination group were superior to those in the western medicine group (P<0.05). After therapy, clinical symptom integral and Toronto clinical scores in the combination group were lower than those in the western medicine group (P<0.01). MNCV and SNCV of median nerve, ulnar nerve, common peroneal nerve, anterior tibial nerve in the combination group had higher improvement as compared with those in the Western medicine group (P<0.01). Levels of SOD, MDA and Cys-C in the combination group were inferior to those in the western medicine group (P<0.01), while the TAOC level was higher than that in the Western medicine group (P<0.01). Conclusion: The curative effects of Shenqi Jiangtang granules, Ginkgo leaf capsules jointed with mecobalamine and α-lipoic acid therapy is superior to using Western medicine alone in treating DPN disease. Its mechanism may be related to relieving oxidative stress injury and reducing serum Cys-C level.