目的 探討木丹顆粒聯(lián)合左卡尼汀治療糖尿病周圍神經(jīng)病變的臨床療效。方法 選取2021年8月-2023年8月河北省第八人民醫(yī)院收治的糖尿病周圍神經(jīng)病變患者116例,隨機(jī)分為對照組(58例)和治療組(58例)。對照組患者口服左卡尼汀口服溶液,20 mL/次,3次/d。在對照組基礎(chǔ)上,治療組口服木丹顆粒,1袋/次,3次/d。兩組治療28 d。觀察兩組患者臨床療效,比較治療前后兩組患者癥狀緩解時(shí)間,多倫多臨床神經(jīng)病變評(píng)分量表(TCSS)評(píng)分,周圍神經(jīng)炎性因子纖維蛋白膠凝-3(ficolin-3)、同型半胱氨酸(Hcy)、神經(jīng)特異性烯醇化酶(NSE)和胰島素樣生長因子-1(IGF-1)水平。結(jié)果 治療后,治療組臨床總有效率為98.28%,明顯高于對照組總有效率(82.75%,P<0.05)。治療后,治療組癥狀緩解時(shí)間均明顯早于對照組(P<0.05)。治療后,兩組TCSS評(píng)分均明顯降低(P<0.05),且與對照組比較,治療組TCSS評(píng)分降低更明顯(P<0.05)。治療后,兩組患者NSE、Hcy水平明顯降低,而ficolin-3和IGF-1水平明顯高于(P<0.05),且治療組患者水平明顯好于對照組(P<0.05)。結(jié)論 左卡尼汀與木丹顆粒協(xié)同治療,可對周圍神經(jīng)末梢病變改善有效,并促進(jìn)機(jī)體炎性反應(yīng)減弱。

Objective To explore the clinical effect of Mudan Granules combined with levocarnitine in treatment of peripheral neuropathy. Methods Patients (116 cases) with peripheral neuropathy in Eighth People's Hospital of Hebei Province from August 2021 to August 2023 were randomly divided into control (58 cases) and treatment (58 cases) group. Patients in the control group were po administered with Levocarnitine Oral Solution, 20 mL/time, three times daily. Patients in the treatment group were po administered with Mudan Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 28 d. After treatment, the clinical evaluations were evaluated, symptom relief time, TCSS scores, the levels of ficolin-3, NSE, Hcy and IGF-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.28%, which was significantly higher than that of the control group (82.75%, P < 0.05). After treatment, the TCSS score in two groups was significantly decreased (P < 0.05), and the TCSS score of the treatment group was decreased more significantly than that of the control group (P < 0.05). After treatment, the levels of NSE and Hcy were significantly decreased, while the levels of ficolin-3 and IGF-1 were significantly higher in two groups (P < 0.05), and the levels of these indicators in the treatment group were significantly better than that in the control group (P < 0.05). Conclusion The synergistic treatment of levocarnitine and Mudan Granules can effectively improve the pathological changes of peripheral nerve endings and promote the weakening of systemic inflammatory response.

R977

河北省中醫(yī)藥管理局科研計(jì)劃項(xiàng)目（2019172）