CAJ | 학술논문

背景:大量基础研究和临床观察证明银杏提取物与潘生丁复方制剂有明显的改善微循环的作用,甲钴胺是临床上常用的神经修复剂,将两者联合治疗糖尿病周围神经病变疗效更佳.目的:观察银杏提取物与潘生丁复方制剂与甲钴胺联合应用对糖尿病周围神经病变患者腓总神经神经传导速度和血液流变学的改善效果.设计:以患者为观察对象,随机对照设计的验证性实验.单位:华中科技大学同济医学院附属同济医院综合科.对象:选择2002-01/2005-01在华中科技大学同济医学院附属同济医院综合科住院的2型糖尿病并发周围神经病变患者120例,随机(投币)分为治疗组和对照组各60例,患者对治疗均知情同意.方法:治疗组应用银杏提取物与潘生丁复方制剂(贵州益佰制药有限公司生产)25 mL+生理盐水250 mL静脉滴注,1次/d,同时应用甲钴胺(日本卫材株式会社产品)500μg肌肉注射,1次/d,连续应用4周;对照组用甲钴胺500μg肌肉注射,1次/d,连续应用4周.主要观察指标:治疗前1d及治疗4周后两组患者腓神经的神经传导速度,血液流变学指标(包括血黏度、红细胞压积和血小板聚集率).结果:120例全部进入结果分析.①运动神经传导速度:治疗组治疗后快于治疗前和对照组治疗后[(45.6±4.3),(38.5±3.8),(41.4±6.2)m/s,t=9.585,4.312,P＜0.01];感觉神经传导速度:治疗组治疗后快于治疗前和对照组治疗后[(45.8±4.2),(36.7±4.8),(38.2±4.9)m/s,t=11.047,9.120,P＜0.01].②治疗组治疗后全血黏度高切、低切和血浆黏度均显著低于治疗前和对照组治疗后(P＜0.01).③治疗组治疗后红细胞压积显著低于治疗前和对照组治疗后[(41.32±3.56)%,(46.32±3.43)%,(44.32±4.49)%,t=7.834,4.05,P＜0.01].④治疗组治疗后血小板聚集率显著低于治疗前和对照组治疗后[(31.35±2.11)%,(48.44±2.68)%,(45.91±3.54)%,t=38.810,27.367,P＜0.01].结论:银杏提取物与潘生丁复方制剂与甲钴胺联合应用可提高神经传导速度,降低血黏度和血小板聚集率,是治疗糖尿病周围神经病变的有效方法. 揹景:大量基礎研究和臨床觀察證明銀杏提取物與潘生丁複方製劑有明顯的改善微循環的作用,甲鈷胺是臨床上常用的神經脩複劑,將兩者聯閤治療糖尿病週圍神經病變療效更佳.目的:觀察銀杏提取物與潘生丁複方製劑與甲鈷胺聯閤應用對糖尿病週圍神經病變患者腓總神經神經傳導速度和血液流變學的改善效果.設計:以患者為觀察對象,隨機對照設計的驗證性實驗.單位:華中科技大學同濟醫學院附屬同濟醫院綜閤科.對象:選擇2002-01/2005-01在華中科技大學同濟醫學院附屬同濟醫院綜閤科住院的2型糖尿病併髮週圍神經病變患者120例,隨機(投幣)分為治療組和對照組各60例,患者對治療均知情同意.方法:治療組應用銀杏提取物與潘生丁複方製劑(貴州益佰製藥有限公司生產)25 mL+生理鹽水250 mL靜脈滴註,1次/d,同時應用甲鈷胺(日本衛材株式會社產品)500μg肌肉註射,1次/d,連續應用4週;對照組用甲鈷胺500μg肌肉註射,1次/d,連續應用4週.主要觀察指標:治療前1d及治療4週後兩組患者腓神經的神經傳導速度,血液流變學指標(包括血黏度、紅細胞壓積和血小闆聚集率).結果:120例全部進入結果分析.①運動神經傳導速度:治療組治療後快于治療前和對照組治療後[(45.6±4.3),(38.5±3.8),(41.4±6.2)m/s,t=9.585,4.312,P＜0.01];感覺神經傳導速度:治療組治療後快于治療前和對照組治療後[(45.8±4.2),(36.7±4.8),(38.2±4.9)m/s,t=11.047,9.120,P＜0.01].②治療組治療後全血黏度高切、低切和血漿黏度均顯著低于治療前和對照組治療後(P＜0.01).③治療組治療後紅細胞壓積顯著低于治療前和對照組治療後[(41.32±3.56)%,(46.32±3.43)%,(44.32±4.49)%,t=7.834,4.05,P＜0.01].④治療組治療後血小闆聚集率顯著低于治療前和對照組治療後[(31.35±2.11)%,(48.44±2.68)%,(45.91±3.54)%,t=38.810,27.367,P＜0.01].結論:銀杏提取物與潘生丁複方製劑與甲鈷胺聯閤應用可提高神經傳導速度,降低血黏度和血小闆聚集率,是治療糖尿病週圍神經病變的有效方法.
배경:대량기출연구화림상관찰증명은행제취물여반생정복방제제유명현적개선미순배적작용,갑고알시림상상상용적신경수복제,장량자연합치료당뇨병주위신경병변료효경가.목적:관찰은행제취물여반생정복방제제여갑고알연합응용대당뇨병주위신경병변환자비총신경신경전도속도화혈액류변학적개선효과.설계:이환자위관찰대상,수궤대조설계적험증성실험.단위:화중과기대학동제의학원부속동제의원종합과.대상:선택2002-01/2005-01재화중과기대학동제의학원부속동제의원종합과주원적2형당뇨병병발주위신경병변환자120례,수궤(투폐)분위치료조화대조조각60례,환자대치료균지정동의.방법:치료조응용은행제취물여반생정복방제제(귀주익백제약유한공사생산)25 mL+생리염수250 mL정맥적주,1차/d,동시응용갑고알(일본위재주식회사산품)500μg기육주사,1차/d,련속응용4주;대조조용갑고알500μg기육주사,1차/d,련속응용4주.주요관찰지표:치료전1d급치료4주후량조환자비신경적신경전도속도,혈액류변학지표(포괄혈점도、홍세포압적화혈소판취집솔).결과:120례전부진입결과분석.①운동신경전도속도:치료조치료후쾌우치료전화대조조치료후[(45.6±4.3),(38.5±3.8),(41.4±6.2)m/s,t=9.585,4.312,P＜0.01];감각신경전도속도:치료조치료후쾌우치료전화대조조치료후[(45.8±4.2),(36.7±4.8),(38.2±4.9)m/s,t=11.047,9.120,P＜0.01].②치료조치료후전혈점도고절、저절화혈장점도균현저저우치료전화대조조치료후(P＜0.01).③치료조치료후홍세포압적현저저우치료전화대조조치료후[(41.32±3.56)%,(46.32±3.43)%,(44.32±4.49)%,t=7.834,4.05,P＜0.01].④치료조치료후혈소판취집솔현저저우치료전화대조조치료후[(31.35±2.11)%,(48.44±2.68)%,(45.91±3.54)%,t=38.810,27.367,P＜0.01].결론:은행제취물여반생정복방제제여갑고알연합응용가제고신경전도속도,강저혈점도화혈소판취집솔,시치료당뇨병주위신경병변적유효방법.
BACKGROUND: Many basic researches and clinical observations prove that compound preparation of gingko extract and dipyridamole has an obvious effect on microcirculation. Methycobal is commonly used to repair nerve on clinic. Combination of compound preparation and methycobal has a great effect on treating diabetic peripheral neuropathy (DPN).OBJECTIVE: To observe the improved effect of combination of compound preparation and methycobal on conduction velocity of common peroneal nerve and hemorheology of DPN patients.DESIGN: Randomized controlled design and validated experiment on the basis of patients.SETTING: Department of Comprehensive Medicine, Tongji Hospital of Tongji Medic.al College, Huazhong University of Science and Technology.PARTICIPANTS: A total of 120 patients with type 2 diabetes mellitus (DM) combined with DPN were selected from the Department of Comprehensive Medicine in Tongji Hospital of Tongji Medical College affiliated to Huazhong University of Science and Technology between January 2002 and January 2005. Subjects were randomly divided into treatment group and control group with 60 in each group. All cases were consent.METHODS: Cases in the treatment group were venously dripped with 25 mL compound preparation and 250 mL saline (Guizhou Yibai Pharmacology Company Limited) once a day; meanwhile, 500 μg methycobal (Eisai Community, Japan) was intramuscularly injected into cases once a day for 4 successive weeks. Cases in the control group were intramuscularly injected with 500 μg methycobal once a day for 4 weeks.MAIN OUTCOME MEASURES: Conduction velocity of peroneal nerve and hemorheological indexes (blood viscosity, hematocrit and aggregative rate of platelet) of patients in the two groups at 1 day before treatment and at 4 weeks after treatment.RESULTS: A total of 120 patients were involved in the final analysis. ① Conduction velocity of motor nerve was faster in treatment group after treatment than that before treatment and that in control group after treatment [(45.6±4.3), (38.5±3.8), (41.4±6.2) m/s, t=9.585, 4.312, P ＜ 0.01]; conduction velocity of sensory nerve was faster in treatment group after treatment than that before treatment and that in control group after treatment [(45.8±4.2), (36.7±4.8), (38.2±4.9) m/s, t=11.047, 9.120, P ＜ 0.01]. ② Values of high-shearing blood viscosity, low-shearing blood viscosity and plasma viscosity were lower in treatment group after treatment than those before treatment and those in control group after treatment (P ＜ 0.01). ③Value of hematocrit was lower in treatment group after treatment than those before treatment and those in control group after treatment [(41.32 ±3.56)%,(46.32±3.43)%, (44.32±4.49)%, t=7.834,4.05, P ＜ 0.01]. ④ Aggregative rate of platelet was lower in treatment group after treatment than those before treatment and those in control group after treatment [(31.35±2.11)%,(48.44±2.68)%, (45.91±3.54)%, t=38.810, 27.367, P ＜ 0.01].CONCLUSION: Combination ofcompound preparation and methycobal can increase nerve conduction velocity and decrease blood viscosity and aggregative rate of platelet, and it is also an effective method for treating DPN.