摘要
目的:应用高频超声对α-硫辛酸联合中药封包治疗糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的疗效评估,为临床用药及评估疗效提供依据。方法:选择2018年12月~2019年12月医院收治的符合纳入和排除标准的110例DPN患者,根据不同的治疗方案分为观察组和对照组,观察组行α-硫辛酸联合中药封包治疗,对照组行单一α-硫辛酸治疗,并利用高频超声、神经传导速度(never conduction velocity,NCV)以及血清学检查综合评估两种治疗方法的效果。结果:观察组与对照组治疗后的平均血糖波动幅度(mean amplitude of glycemic excursions,MAGE)值较治疗前明显降低(P<0.05);治疗后分析,两组正中神经、尺神经及腓总神经的感觉神经传导速度(sensory nerve conduction velocity,SCV)及运动神经传导速度(motor nerve conduction velocity,MCV)值均较治疗前明显增快(P<0.05),而观察组三种神经SCV及MCV值明显高于对照组(P<0.05);治疗后与治疗前对比,观察组正中神经、尺神经及腓总神经的横截面积(cross-sectional area,CSA)明显减小(P<0.05);治疗后分析,观察组3种神经CSA均较对照组明显减小(P<0.05);治疗后的超声表现中:观察组中正中神经、尺神经及腓总神经异常构成比较治疗前明显减低(P<0.05),治疗后分析,观察组3种神经内部回声减低、模糊的构成比明显小于对照组(P<0.05);治疗前后的相关性分析中,3种神经的CSA值与潜伏期均呈正相关(P<0.05),而与SCV及波幅均呈负相关(P<0.05)。结论:α-硫辛酸联合中药封包技术对DPN神经损伤的治疗与修复效果好,可推广临床应用;高频超声可直观的反映周围神经的恢复程度,可用于DPN预后的评估。
Objective:To use high-frequency ultrasound to evaluate the efficacy ofα-lipoic acid combined with traditional Chinese medicine in the treatment of diabetic peripheral neuropathy(DPN),so as to provide a basis for clinical medication and evaluation of therapeutic effect.Methods:From December 2018 to December 2019,110 patients with DPN who met the inclusion and exclusion criteria were divided into an observation group and a control group according to different treatment plans.The control group was treated with alpha-lipoic acid,and the observation group was treated with alpha-lipoic acid combined with traditional Chinese medicine package treatment,with high-frequency ultrasound,nerve conduction velocity(NCV)and serological examination to comprehensively evaluate the effectiveness of the two treatment methods.Results:The mean amplitude of glycemic excursions(MAGE)value of the two groups after treatment was significantly lower than what it was before treatment(P<0.05);The sensory nerve conduction velocity(SCV)and motor nerve conduction velocity(MCV)values of the two groups of ulnar nerve,median nerve and common peroneal nerve after treatment were significantly faster than before treatment(P<0.05).After treatment,the three groups of nerves SCV and MCV in the observation group were significantly faster than the control group(P<0.05).The cross-sectional area(CSA)value of the ulnar nerve,median nerve and common peroneal nerve in the observation group after treatment was significantly reduced compared with before treatment(P<0.05).The CSA value was significantly smaller than the control group(P<0.05).Ultrasound abnormal performance:the ratio of abnormal neurosonic performance of the ulnar nerve,median nerve and common peroneal nerve in the observation group after treatment was significantly lower than before treatment(P<0.05).The composition ratio of internal echo reduction and vagueness in the observation group was significantly lower than that in the control group after treatment(P<0.05).In the correlation analysis,the three nerve CSA before and after treatment were negatively correlated with SCV and amplitude(P<0.05),and positively correlated with latency(P<0.05).Con-clusion:The combination ofα-lipoic acid and Chinese medicine encapsulation technology has a good effect on the treatment and repair of DPN nerve injury,and can be routinely applied in clinical treatment.High-frequency ultrasound can intuitively observe changes in peripheral nerves and can be used to evaluate the prognosis of DPN.
作者
胡培
郑光美
董正森
薛锐
丁洪成
孙德姣
肖彬
HU Pei;ZHENG Guang-mei;DONG Zheng-sen;XUE Rui;DING Hong-cheng;SUN De-jiao;XIAO Bin(Department of Ultrasound,Renmin Hospital,Hubei University of Medicine,Shiyan 442000,China;Department of Anesthesiology,Renmin Hospital,Hubei University of Medicine,Shiyan 442000,China;Department of Endocrinology,Renmin Hospital,Hubei University of Medicine,Shiyan,Hubei 442000,China)
出处
《海南医学院学报》
CAS
2021年第6期421-425,430,共6页
Journal of Hainan Medical University
基金
国家自然科学基金(81701891)
十堰市科技局引导性科研项目(18Y63)。
关键词
高频超声
Α-硫辛酸
中药封包
糖尿病周围神经病变
神经传导速度
High-frequency ultrasound
α-lipoic acid
Traditional Chinese medicine package treatment
Diabetic peripheral neuropathy
Nerve conduction velocity
