摘要
目的探讨强化降糖治疗对2型糖尿病(T2DM)患者并发糖尿病周围神经病变(DPN)的影响。方法选取2019年1-6月在江苏大学附属武进医院住院治疗的T2DM并发DPN患者,根据多伦多临床评分系统(TCSS)评分将患者分为轻度DPN(100例)、中重度DPN(60例),按随机数字表法进一步分别分为强化降糖组和对照组,轻度DPN患者两组各50例,中重度DPN患者两组各30例。对照组采用常规控制血糖联合甲钴胺治疗,强化降糖组采用严格控制血糖联合甲钴胺治疗,对比两组患者治疗前后空腹血糖(FPG)、糖化血红蛋白(HbA1c)及TCSS评分变化;比较治疗前后周围神经的运动神经传导速度(MCV)及感觉神经传导速度(SCV)。结果轻度DPN患者:治疗后,对照组和强化降糖组FPG、HbA1c水平及TCSS评分均较治疗前明显下降(P<0.05),且强化降糖组上述指标明显低于对照组(P<0.05);治疗后,对照组MCV、SCV较治疗前无明显变化(P>0.05),强化降糖组尺神经SCV、腓浅神经SCV、胫神经MCV、腓肠神经SCV均明显高于治疗前(P<0.05),且强化降糖组上述指标明显高于对照组(P<0.05)。中重度DPN患者:治疗后,对照组和强化降糖组FPG、HbA1c水平较治疗前明显降低(P<0.05),且强化降糖组治疗后上述指标明显低于对照组(P<0.05),两组治疗后TCSS评分和肌电图MCV、SCV无明显差异(P>0.05)。结论强化降糖联合甲钴胺治疗可有效缓解T2DM并发轻度DPN患者的病情,改善临床症状和周围神经传导功能。
Objective To explore the effect of intensive hypoglycemic therapy on the treatment of type 2 diabetes mellitus(T2DM)complicated with peripheral neuropathy.Methods Patients with T2DM complicated with DPN hospitalized in Wujin Hospital Affiliated to Jiangsu University from January to June 2019 were enrolled in this study.According to the Toronto Clinical Scoring System(TCSS)score,100 cases were with mild DPN,and 60 cases were with moderate to severe DPN.All patients were randomly divided into the intensive hypoglycemic group and the control group according to the random number table.Among patients with mild DPN,there were 50 cases in each group.Among patients with moderate to severe DPN,there were 30 cases in each group.The control group was treated with routine blood glucose control combined with mecobalamin,and the intensive hypoglycemic group was treated with strict blood glucose control combined with mecobalamin.The fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c)levels and TCSS scores before and after treatment were compared between the two groups.The motor nerve conduction velocity(MCV)and sensory nerve conduction velocity(SCV)of peripheral nerve before and after treatment were compared between the two groups,as well.Results In patients with mild DPN:after treatment,the FPG,HbA1c levels and TCSS scores in the control group and the intensive hypoglycemic group were significantly lower than those before treatment(P<0.05),and the above indicators in the intensive hypoglycemic group were significantly lower than those in the control group(P<0.05);there was no statistically significant differencein the MCV and SCV between before and after treatment in the control group(P>0.05),while the SCV of ulnar nerve,SCV of superficial peroneal nerve,MCV of tibial nerve and SCV of sural nerve in the intensive hypoglycemic group after treatment were significantly higher than those before treatment(P<0.05),and the above indicators in the intensive hypoglycemic group were significantly higher than those in the control group after treatmen(P<0.05).In patients with moderate to severe DPN:after treatment,the levels of FPG and HbA1c in the control group and the intensive hypoglycemic group were significantly lower than those before treatment(P<0.05),and the above indicators in the intensive hypoglycemic group were significantly lower than those in the control group(P<0.05);there was no statistically significant difference in TCSS score,electromyographyMCV and SCV between the two groups after treatment(P>0.05).Conclusion Intensive hypoglycemic therapy combined with mecobalamine can effectively alleviate the condition of patients with T2DM complicated with mild DPN,and improve clinical symptoms and peripheral nerve conduction function.
作者
詹力
赵红如
ZHAN Li;ZHAO Hongru(Department of Neurology,Wujin Hospital Affiliated to Jiangsu University,Changzhou,Jiangsu 213017,China;Department of Neurology,the First Affiliated Hospital of Soochow University,Jiangsu,Suzhou 215006,China)
出处
《重庆医学》
CAS
2020年第22期3811-3816,共6页
Chongqing medicine
关键词
糖尿病
2型
强化降糖治疗
甲钴胺
周围神经病变
神经传导
diabetes mellitus,type 2
intensive hypoglycemic therapy
mecobalamin
peripheral neuropathy
neural conduction
tcss scores
