灯盏花素治疗糖尿病周围神经病变的疗效观察

目的 :观察灯盏花素注射液治疗糖尿病周围神经病变 (DPN)的疗效及其对红细胞醛糖还原酶 (AR)活性、血一氧化氮 (NO)水平的影响。方法 :6 4例DPN患者 ,随机分成灯盏花素治疗组 (灯盏花素 5 0mg·d- 1 )和甲钴胺对照组(甲钴胺 5 0 0 μg·d- 1 ) ,共治疗 3周 ,观察两组病人治疗前后DPN症状、体征、感觉神经传导速度 (SNCV)、红细胞AR活性及血NO水平的变化。结果 :治疗前DPN病人红细胞AR活性较正常人明显升高 ,NO水平明显下降 (P均 <0 .0 1) ,用灯盏花素注射液治疗后红细胞AR活性显著下降 ,NO水平显著升高 (P <0 .0 1) ,而用甲钴胺治疗后上述指标无明显变化。灯盏花素缓解DPN症状及体征的总有效率及显效率明显高于甲钴胺 (85 2 9%vs73.33% ,2 0 .5 9%vs10 .0 0 % ,P <0 .0 1) ,两组均能显著提高四肢感觉神经传导速度 ,但灯盏花素组提高的幅度明显大于甲钴胺对照组 (P<0 .0 1)。结论 :灯盏花素注射液能明显抑制红细胞AR活性 ,提高血NO水平 ,从而有效改善糖尿病周围神经病变症状及体征 ,使四肢感觉神经传导速度显著提高 ,且其疗效优于甲钴胺。

Efficacy of erigeron on diabetic peripheral neuropathy

Objective To investigate the efficacy of erigeron on diabetic peripheral neuropathy (DPN), and to obsreve the changes of erythrocyte aldose reductase (AR) activity and serum nitric oxide (NO) level. Methods Sixty four patients with DPN were randomly divided into two groups: erigeron treated group and mecobalamin controlled group. The treatment group received daily erigeron 50 mg, while the control group received daily mecobalamin 500 μg for 3 weeks. The changes of clinical symptoms, sensory nerve conduction velocity (SNCV), AR activity and NO level were observed. Results The AR activity was higher, but the NO level was lower in the diabetic patients before the treatment than those in the healthy controls (P<0.01); the AR activity decreased, while the NO level increased significantly after the erigeron treatment, but these parameters had no significant changes after the mecobalamin treatment. The total effective rate and marked effective rate of erigeron in relieving clinical symptoms were significantly higher than those of mecobalamin (85.29% vs 73.33%, 20.59% vs 10.00%, P<0.01). Both erigeron and mecobalamin could markedly improve SNCV, but the rising degree of SNCV in the erigeron treated group was higher than that in the mecobalamin controlled group (P<0.01). Conclusion Erigeron is able to inhibit erythrocyte AR activity and to increase serum NO level; it can relieve clinical symptoms of diabetic neuropathy, and prompt sensory nerve conduction velocity. The efficacy of erigeron on DPN is better than that of mecobalamin.