目的 探討芪丹通絡(luò)顆粒聯(lián)合硫辛酸注射液治療糖尿病周圍神經(jīng)病變的臨床療效。方法 選取2015年5月-2018年5月在成都市青白江區(qū)人民醫(yī)院治療的86例糖尿病周圍神經(jīng)病變患者，根據(jù)用藥差別分為對照組（43例）和治療組（43例）。對照組靜脈滴注硫辛酸注射液，12 mL加入生理鹽水250 mL，2次/d；治療組在對照組的基礎(chǔ)上口服芪丹通絡(luò)顆粒，8 g/次，3次/d。兩組患者均經(jīng)4周治療。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者M(jìn)DNS和TCSS評分，神經(jīng)傳導(dǎo)速度，及血清同型半胱氨酸（Hcy）、核因子-κB（NF-κB）、內(nèi)皮素-1（ET-1）和一氧化氮（NO）水平。結(jié)果 治療后，對照組臨床有效率為62.79%，顯著低于治療組的86.05%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。經(jīng)治療，兩組MDNS評分、TCSS評分均明顯降低（P<0.05），且治療組下降更明顯（P<0.05）。經(jīng)治療，兩組患者正中神經(jīng)和腓總神經(jīng)的運(yùn)動神經(jīng)傳導(dǎo)速（MNCV）、感覺神經(jīng)傳導(dǎo)速度（SNCV）均明顯增快（P<0.05），且治療組傳導(dǎo)速度明顯快于對照組（P<0.05）。經(jīng)治療，兩組患者血清Hcy、NF-κB、ET-1水平均明顯降低（P<0.05），NO水平明顯升高（P<0.05），且治療組患者血清Hcy、NF-κB、ET-1和NO水平明顯好于對照組（P<0.05）。結(jié)論 芪丹通絡(luò)顆粒聯(lián)合硫辛酸注射液治療糖尿病周圍神經(jīng)病變可有效改善患者癥狀，促進(jìn)神經(jīng)功能恢復(fù)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical effect of Qidan Tongluo Granules combined with thioctic acid in treatment of diabetic peripheral neuropathy. Methods Patients (86 cases) with diabetic peripheral neuropathy in Chengdu Qingbaijiang District People's Hospital from May 2015 to May 2018 were divided into control (43 cases) and treatment (43 cases) groups based on different treatments. Patients in the control group were iv administered with Thioctic Acid Injection, 12 mL added into normal saline 250 mL, twice daily. Patients in the treatment group were po administered with Qidan Tongluo Granules on the basis of the control group, 8 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the MDNS scores, TCSS scores, the nerve conduction velocity, the serum level of Hcy, NF-κB, ET-1, and NO in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 62.79%, which was significantly lower than 86.05% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the MDNS and TCSS scores in two groups were significantly decreased (P < 0.05), and the scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the MNCV and SNCV of median nerve and common peroneal nerve in two groups were significantly faster (P < 0.05), and the conduction velocity in the treatment group was significantly faster than that in the control group (P < 0.05). After treatment, the serum level of Hcy, NF-κB, and ET-1 in two groups was significantly decreased (P < 0.05), but NO level was significantly increased (P < 0.05), and the level of Hcy, NF-κB, ET-1, and NO in the treatment group was significantly better than those in the control group (P < 0.05). Conclusion Qidan Tongluo Granules combined with Thioctic Acid Injection in treatment of diabetic peripheral neuropathy can effectively improve the symptoms, promote the recovery of nerve function, which has a certain clinical application value.

R971