目的 觀察丹參多酚酸鹽聯(lián)合前列地爾治療糖尿病痛性神經(jīng)病變的臨床療效。方法 選取2014年5月-2016年5月在廣西民族醫(yī)院治療的痛性糖尿病周圍神經(jīng)病變患者126例，隨機(jī)分為對(duì)照組和治療組，每組各63例，對(duì)照組靜脈注射前列地爾注射液，10 μg加入生理鹽水或5%葡萄糖溶液10 mL，1次/d；治療組在對(duì)照組的基礎(chǔ)上靜脈滴注注射用丹參多酚酸鹽，200 mg加入生理鹽水或5%葡萄糖溶液250～500 mL，1次/d，兩組患者均連續(xù)治療2周。治療后，觀察兩組臨床療效，同時(shí)比較兩組患者治療前后神經(jīng)傳導(dǎo)速度、視覺模擬評(píng)分（VAS）和匹茨堡睡眠質(zhì)量指數(shù)量表（PSQI）評(píng)分。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為80.9%和93.6%，兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者的正中神經(jīng)、脛神經(jīng)和腓總神經(jīng)的運(yùn)動(dòng)神經(jīng)傳導(dǎo)速度和感覺神經(jīng)傳導(dǎo)速度均高于治療前，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者VAS和PSQI評(píng)分均較治療前降低，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組VAS和PSQI評(píng)分均顯著低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 丹參多酚酸鹽聯(lián)合前列地爾治療痛性糖尿病神經(jīng)病變療效顯著，明顯改善患者自覺癥狀和睡眠質(zhì)量，顯著提高周圍神經(jīng)傳導(dǎo)速度，具有一定的臨床應(yīng)用價(jià)值。

Objective To observe the curative effect of alprostadil combined with salvianolate in treatment of painful diabetic neuropathy. Methods Patients (126 cases) with painful diabetic neuropathy in Guangxi Minzu Hospital from May 2014 to May 2016 were randomly divided into control and treatment groups, and each group had 63 cases. Patients in the control group were iv administered with Alprostadil Injection, 10 μg added into normal saline or 5% glucose injection 10 mL, once daily. Patients in the treatment group were iv administered with Salvianolate for injection on the basis of the control group, 200 mg added into normal saline or 5% glucose injection 250-500 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the efficacy was evaluated, and the nerve conduction velocity, scores of VAS and PSQI scores were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 80.9% and 93.6%, respectively, and there were differences between two groups (P<0.05). After treatment, the motor nerve conduction velocity and sensory nerve conduction velocity of median nerve, tibial nerve, and common peroneal nerve in two groups were significantly higher than those before treatment, and there were differences between two groups (P<0.05). These indicators in the treatment group were increased more significantly than those in the control group (P<0.05). After treatment, the scores of VAS and PSQI in two groups were significantly decreased (P<0.05). And these clinical symptom scores in treatment group were decreased more significantly than those in the control group (P<0.05). Conclusion Alprostadil combined with salvianolate has a significant clinical efficacy in treatment of painful diabetic neuropathy, can improve subjective symptom and sleep quality, and enhance nerve conduction velocity, which has a certain clinical application value.