摘要
目的探讨木丹颗粒联合甲钴胺对糖尿病周围神经病变(DPN)患者神经传导速度及核因子E2相关因子2(Nrf2)/血红素加氧酶-1(HO-1)信号通路的影响。方法选取2023年5月至2024年5月收治的180例DPN患者,随机数字表法分为甲钴胺组(n=90)和木丹联合组(n=90)。甲钴胺组给予甲钴胺治疗,木丹联合组给予木丹颗粒联合甲钴胺治疗,均持续治疗12周。观察并比较两组临床疗效及不良反应发生情况,比较治疗前后双侧胫神经的运动神经传导速度(MNCV)和感觉神经传导速度(SNCV)、血清氧化应激指标、血糖指标、血脂水平、Toronto临床评分系统(TCSS)以及Nrf2和HO-1 mRNA表达水平。结果甲钴胺组、木丹联合组总有效率分别为90.00%(81/90)、97.78%(88/90),木丹联合组更高(P<0.05)。治疗后,木丹联合组双侧胫神经MNCV和SNCV均较甲钴胺组高(P<0.05)。治疗后,木丹联合组8-羟基脱氧鸟苷、总胆固醇、低密度脂蛋白胆固醇、TCSS评分较甲钴胺组降低,总抗氧化能力、高密度脂蛋白胆固醇水平较甲钴胺组升高(P<0.05)。治疗后,甲钴胺组与木丹联合组糖化血红蛋白、空腹血糖、餐后2 h血糖比较均无统计学差异(P>0.05)。治疗后,木丹联合组Nrf2和HO-1 mRNA表达水平均高于甲钴胺组(P<0.05)。甲钴胺组与木丹联合组不良反应总发生率比较无统计学差异(P>0.05)。结论木丹颗粒联合甲钴胺治疗DPN患者可显著提高神经传导速度,改善临床症状,其机制可能与上调Nrf2/HO-1信号通路mRNA表达、减轻氧化应激损伤有关。
Objective To investigate the effects of Mudan granule combined with Mecobalamin on nerve conduction velocity and nuclear factor-E2-related factor 2(Nrf2)/heme oxygenase-1(HO-1)signaling pathways in patients with diabetic peripheral neuropathy(DPN).Methods A total of 180 patients with DPN admitted from May 2023 to May 2024 were selected and divided into the Mecobalamin group(n=90)and the Mecobalamin+Mudan granule combination therapy group(n=90)by the random number table method.The Mecobalamin group was treated with Mecobalamin,while the Mudan granule combination therapy group was treated with Mudan granules combined with Mecobalamin.Both groups were treated continuously for 12 weeks,to observe and compare the clinical efficacy and the occurrence of adverse reactions of the two groups.The motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of bilateral tibial nerves,serum oxidative stress indicators,blood glucose indicators,blood lipid levels,Toronto clinical scoring system(TCSS),as well as the mRNA expression levels of Nrf2 and HO-1 were compared before and after treatment.Results The total effective rates of the Mecobalamin group was higher than that in the Mudan granule combination therapy group[90.00%(81/90)vs.97.78%(88/90)](P<0.05).After treatment,the MNCV and SNCV of bilateral tibial nerves in the Mudan granule combination therapy group were both higher than those in the Mecobalamin group(P<0.05).After treatment,the 8-hydroxydeoxyguanosine,total cholesterol,lowdensity lipoprotein cholesterol and TCSS score in the Mudan granule combination therapy group were lower than those in the Mecobalamin group,while the total antioxidant capacity and high-density lipoprotein cholesterol level were higher than those in the Mecobalamin group(P<0.05).After treatment,there were no significant differences in glycated hemoglobin,fasting blood glucose,and 2-hour postprandial blood glucose between the Mecobalamin group and the Mudan granule combination therapy group(P>0.05).After treatment,the expression levels of Nrf2 and HO-1 mRNA in the Mudan granule combination therapy group were both higher than those in the Mecobalamin group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the Mecobalamin group and the Mudan granule combination therapy group(P>0.05).Conclusion Mudan granule combined with Mecobalamin can significantly accelerate nerve conduction velocity and relieve clinical symptoms in DPN patients.The mechanism may be related to up-regulating the mRNA expressions of Nrf2/HO-1 signaling pathways and relieving oxidative stress injury.
作者
燕雪
张骁
陈亮
徐燕
YAN Xue;ZHANG Xiao;CHEN Liang;XU Yan(Department of Endocrinology,the 904th Hospital of Joint Logistic Support Force of the PLA,Wuxi,Jiangsu 214000,China;Department of Cardiovascular Medicine,the 904th Hospital of Joint Logistic Support Force of the PLA,Wuxi,Jiangsu 214000,China)
出处
《临床误诊误治》
2025年第22期107-113,共7页
Clinical Misdiagnosis & Mistherapy
基金
江苏省科技项目(BK20211043)
无锡市科技发展资金项目(K20221041)。
