目的 探討糖脈康顆粒聯(lián)合甲鈷胺、依帕司他治療神經(jīng)源性膀胱的臨床療效。方法 選取2012年8月—2014年7月中國人民解放軍海軍總醫(yī)院收治的110例糖尿病神經(jīng)源性膀胱患者,隨機分組,對照組在一般治療基礎上口服甲鈷胺片0.5 mg,3次/d;口服依帕司他片50 mg,3次/d;治療組在對照組的基礎上沖服糖脈康顆粒5 g,3次/d。兩組均連續(xù)治療8周。比較兩組糖尿病相關(guān)指標、紅細胞醛糖還原酶(AR)、尿動力學、肌電/誘發(fā)電位以及療效。結(jié)果 治療后治療組總膽固醇(TC)、糖化血紅蛋白(HbA1c)、血尿素氮(BUN)和紅細胞AR改善明顯,與對照組在HbA1c、BUN和紅細胞AR比較差異具有統(tǒng)計學意義(P < 0.01)。治療后兩組尿動力學指標均明顯好轉(zhuǎn),治療組殘余尿量、平均尿流速、最大尿流速和逼尿肌壓力均明顯優(yōu)于對照組(P < 0.05、0.01)。治療后兩組球海綿體肌反射(BCR)潛伏期明顯降低,陰部神經(jīng)軀體感覺誘發(fā)電位(SSEP)波幅增加,兩組比較BCR潛伏期和波幅、SSEP波幅差異具有統(tǒng)計學意義(P < 0.01)。治療后治療組有效率為83.64%,對照組的為74.54%,治療組明顯高于對照組(P < 0.05)。結(jié)論 糖脈康顆粒聯(lián)合甲鈷胺、依帕司他能夠改善糖尿病相關(guān)指標、尿動力學指標、神經(jīng)傳導功能,提高了臨床療效。

Objective To investigate the efficacy of Tangmaikang Granules combined with methylcobalamin and epalrestat in treatment of diabetic neurogenic bladder. Methods The patients with diabetic neurogenic bladder (DNB) (110 cases) of NAVY General Hospital from August 2012 to July 2014 were randomly divided into control and treatment groups. The patients in the control group were po administered with Mecobalamin Tablets 0.5 mg (three times daily) and Epalrestat Tablets 50 mg (three times daily) on the basis of conventional treatment. Patients in treatment group were po administered with Tangmaikang Granules on the basis of control group, 5 g/time, three times daily. Each group was treated for 8 weeks. Diabetes related indexes, erythrocyte aldose reductase (AR), urodynamics, electromyography (EMG)/ evoked potential (EP), and efficacies were compared. Results After treatment, total cholesterol, HbA1c, BUN, and erythrocyte AR in treatment group were improved better, and there were differences between two groups in HbA1c, BUN, and erythrocyte AR with statistically significant difference (P < 0.01). Urodynamics indicators in treatment group were obviously improved, and the average urine flow rate, residual urine volume, maximum urine flow rate, and detrusor pressure in the treatment group were better than those in the control group, and there were differences between two groups after treatment (P < 0.05, 0.01). There were obvious reducing in bulbocavernosus reflex (BCR) latency, but increasing in somatosensory evoked potiential (SSEP) of two groups after treatment, and there were differences between two groups (P < 0.01). The efficacies in the control and treatment groups were 83.64% and 74.54%, respectively, and there were differences between two groups (P < 0.05). Conclusion Tangmaikang Granules combined with methylcobalamin and epalrestat can improve diabetes related indexes, urodynamics, nerve conduction function, and efficacies.