摘要
目的分析肌电生物反馈肌肉强化治疗联合甲钴胺和胰激肽原酶治疗糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的效果。方法选取2018年2月至2020年7月亳州市人民医院收治的124例DPN患者为研究对象。使用随机数字表法将其分别纳入观察组和对照组,每组各62例。两组患者均在常规降糖、调脂治疗的基础上接受甲钴胺和胰激肽原酶治疗,观察组患者在此基础上联合肌电生物反馈肌肉强化治疗。两组患者均持续治疗4周。比较两组患者治疗前后血糖、临床症状、肌电学指标、肌肉能力和不良反应发生情况。结果治疗4周后,两组患者空腹血糖、餐后2 h血糖、糖化血红蛋白水平、神经病变主觉症状量表(total symptoms scale,TSS)各项目评分和总分均显著低于本组治疗前(均P<0.05),正中神经、尺神经、胫神经运动神经传导速度(motor nerve conduction velocity,MNCV)和感觉神经传导速度(sensory nerve conduction velocity,SNCV)均显著大于本组治疗前(均P<0.05)。观察组患者治疗4周后TSS各项目评分和总分均显著低于对照组(均P<0.05),正中神经、尺神经、胫神经MNCV和SNCV均显著大于对照组(均P<0.05)。治疗4周后,观察组患者峰力矩、双下肢骨骼肌质量、6 m步行速度均显著大于治疗前和同期对照组(均P<0.05),对照组患者治疗前后肌肉能力未见明显变化(P>0.05)。两组患者治疗期间均未见不良反应发生。结论在甲钴胺和胰激肽原酶的基础上,联合肌电生物反馈肌肉强化治疗DPN,能够在不影响治疗安全性的前提下增强患者肌肉能力、改善肌电学指标,从而进一步缓解其临床症状。
Objective To analyze the effect of electromyographie biofeedback muscle strengthening therapy combined with mecobalamin and pancreatic kininogenase in the treatment of diabetic peripheral neuropathy(DPN).Method From February 2018 to July 2020,124 cases of DPN patients admitted Bozhou People's Hospital were selected as the research subjects.According to the random nubmer talbe method,they divided into observation group and control group,with 62 cases in each group.On the basis of conventional hypoglycemic and lipid-lowering therapy,mecobalamin and pancreatic kininogenase were given,and observation group patients were given electromyographie biofeedback muscle strengthening therapy.Patients in both groups received continuous treatment for 4 weeks.The blood glucose,clinical symptoms,electromyographic indexes,muscle capacity before and after treatment and the incidence of adverse reactions were compared between the two groups.Result Four weeks after treatment,the fasting plasma glucose,2 hours postprandial plasma glucose,glycated hemoglobin A1c levels,total symptoms scale(TSS)scores of each item and total scores in the two groups were significantly lower than those before treatment(all P<0.05),the motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of median nerve,ulnar nerve and tibial nerve were significantly higher than those before treatment(all P<0.05).Four weeks after treatment,the TSS score of each item and total score in observation group were significantly lower than those in control group(all P<0.05),the MNCV and SNCV of median nerve,ulnar nerve and tibial nerve were significantly higher than those in control group(all P<0.05).Four weeks after treatment,the peak torque,skeletal muscle mass of both lower limbs and the 6 m walking speed in observation group were significantly larger than those before treatment and control group in the same period(all P<0.05),while no significant change was noticed in the muscular ability of control group before and after treatment(P>0.05).No adverse reactions occurred during the treatment in both groups.Conclusion On the basis of mecobalamin and pancreatic kininogenase,combined with electromyographie biofeedback muscle strengthening therapy in the treatment of DPN,can improve the patient's muscle capacity and muscle electrical indicators,and further alleviate the clinical symptoms without affecting the safety of treatment.
作者
甘田
周玉森
李新杰
Gan Tian;Zhou Yusen;Li Xinjie(Department of Endocrinology,Bozhou People's Hospital,Anhui,Bozhou 236800,China)
出处
《中国医学前沿杂志（电子版）》
2021年第9期84-88,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
肌电生物反馈肌肉强化治疗
甲钴胺
胰激肽原酶
糖尿病周围神经病变
Electromyographie biofeedback muscle strengthening therapy
Mecobalamin
Pancreatic kininogenase
Diabetic peripheral neuropathy
