摘要
目的探讨高压氧(hyperbaric oxygen,HBO)联合贝前列素治疗对糖尿病周围神经病变患者神经功能及相关因子的影响。方法选取2016年8月至2018年9月中南大学湘雅医院内分泌科收治的100例糖尿病周围神经病变患者作为研究对象,按随机数字表法分为对照组和观察组,每组50例。对照组患者应用贝前列素,观察组在对照组基础上联合HBO治疗,比较2组患者临床疗效,治疗前后的血糖指标,血清脑源性神经营养因子(BDNF)、高迁移率族蛋白B1(HMGB1)和髓鞘碱性蛋白(MBP)水平以及神经传导速度的变化。结果治疗3个疗程后,观察组总有效率(82.0%)显著高于对照组(60.0%),差异有统计学意义(P<0.05);观察组与对照组空腹血糖水平与治疗前相比显著降低(P<0.01),但2组治疗后空腹血糖和糖化血红蛋白水平差异无统计学意义(P>0.05);2组患者血清BDNF浓度显著增加,且观察组患者血清BDNF水平较对照组显著升高,差异有统计学意义(P<0.01);血清HMGB1和MBP水平显著下调,且观察组血清HMGB1和MBP水平与对照组相比显著降低(P<0.05);2组患者运动神经传导速度和感觉神经传导速度较治疗前均显著上升,差异有统计学意义(P<0.01),且观察组运动神经传导速度水平明显高于对照组(P<0.05),但与感觉神经传导速度比较无明显差异(P>0.05)。结论HBO联合贝前列治疗糖尿病周围神经病变,能够有效改善患者神经功能,缓解炎症损伤,加快神经传导速度,提高临床治疗疗效,安全性较好,值得临床推广。
Objective To explore the effects of beraprost combined with hyperbaric oxygen(HBO)on the neurologic function and other related factors in the patients with diabetic peripheral neuropathy.MethodsOne hundred patients with diabetic peripheral neuropathy treated in the hospital from August 2016 to September 2018 were recruited as research subjects,and were randomly divided into the control group and the observation group,each consisting of 50 patients.The patients of the control group were treated with beraprost,while the patients of the observation groups received HBO therapy in addition to the treatment received by the control group.Then,clinical efficacy,the levels of serum glucose,brain-derived neurotrophic factor(BDNF),high mobility group protein B1(HMGB1),myelin basic protein(MBP)and changes in nerve conduction velocity before and after treatment were compared between the patients of the 2 groups.ResultsAfter 3 courses of treatment,the total efficacy of the observation group(82.0%)was significantly higher than that of the control group(60.0%),with statistical significance(P<0.05).After treatment,the fasting blood glucose levels in both the observation and control groups all decreased markedly(P<0.05),however,no statistical significance could be noted in fasting blood glucose and glycated hemoglobin after treatment,when comparisons were made between the 2 groups(P>0.05).After treatment,the serum BDNF level of the 2 groups all significantly increased,with that of the observation group being obviously higher than that of the control group.Statistical significance could be found,when comparisons were made between the 2 groups(P<0.01).The levels of serum HMGB1 and MBP all marked decreased,with those of the observation group being obviously lower than those of the control group(P<0.05).After treatment,the motor nerve conduction velocity and sensory nerve conduction velocity of the 2 groups all increased significantly,as compared with those before treatment,also with statistical significance(P<0.01),and the motor nerve conduction velocity of the observation group was considerably higher than that of the control group(P<0.05).However,no statistical significance could be seen in sensory nerve conduction velocity,when comparisons were made between the 2 groups(P>0.05).ConclusionHyperbaric oxygen combined with beraprost could effectively improve the neurologic function of the patients with diabetic peripheral neuropathy,relieve inflammatory lesion,accelerate nerve conduction speed and improve clinical efficacy,with good safety.For this reason,it was worth further clinical promotion.
作者
廖舟宁
Liao Zhouning(Endocrine Department,Xiangya Hospital of Central South University,Changsha 410008,China)
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2019年第1期56-60,共5页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
