西格列汀联合依帕司他治疗糖尿病周围神经病变的效果观察

裴静德

【摘要】 目的：探讨磷酸西格列汀片联合依帕司他在糖尿病周围神经病变（diabetic peripheral neuropathy，DPN）中的效果。方法：选择2015年6月-2017年7月本院收治的DPN患者150例，根据治疗方案不同分为对照1组、对照2组和观察组，每组50例。对照1组采用甲钴胺静推治疗，对照2组采用依帕司他治疗，观察组采用磷酸西格列汀片联合依帕司他治疗。比较三组临床疗效及对神经功能、氧化应激的影响。结果：治疗后4周，观察组正中神经与腓总神经MNCV及SNCV均高于对照1组与对照2组（P<0.05），对照2组正中神经与腓总神经MNCV及SNCV均高于对照1组（P<0.05）；观察组SOD、NO水平均高于对照1组和对照2组（P<0.05），观察组MDA水平低于对照1組和对照2组（P<0.05），对照2组SOD、NO水平均高于对照1组（P<0.05），对照2组MDA水平低于对照1组（P<0.05）；观察组不良反应发生率与对照1组、对照2组比较，差异均无统计学意义（P>0.05）。结论：磷酸西格列汀片联合依帕司他用于DPN有助于改善神经功能，改善氧化应激及NO水平，且药物安全性较高，值得推广应用。

【关键词】 糖尿病周围神经病变； 磷酸西格列汀片； 依帕司他； 神经功能； 氧化应激

Effect Observation of Sitagliptin Combined with Epalrestat in the Treatment of Diabetic Peripheral Neuropathy/PEI Jingde.//Medical Innovation of China，2018，15（14）：033-037

【Abstract】 Objective：To investigate the effect of Sitagliptin Phosphate Tablets combined with Epalrestat on diabetic peripheral neuropathy（DPN）.Method：A total of 150 cases with DPN in our hospital from June 2015 to July 2017 were selected and divided into control group 1，control group 2 and observation group，according to the different treatment，50 cases in each group.The control group 1 was treated with Mecobalamin，the control group 2 was treated with Epalrestat，and the observation group was treated with Sitagliptin Phosphate Tablets and Epalrestat.The clinical efficacy and the effects on neurological function and oxidative stress were compared among the three groups.Result：4 weeks after treatment，MNCV and SNCV of the median nerve and common peroneal nerve in the observation group were higher than those in the control group 1 and the control group 2（P<0.05），MNCV and SNCV of the median nerve and common peroneal nerve in the control group 2 were higher than those in the control group 1（P<0.05）.The levels of SOD and NO in the observation group were higher than those in the control group 1 and the control group 2（P<0.05），the level of MDA in the observation group was lower than those in the control group 1 and the control group 2（P<0.05），the levels of SOD and NO in the control group 2 were higher than those in the control group 1（P<0.05），the level of MDA in the control 2 group was lower than that in the control group 1（P<0.05）.There was no significant difference in adverse reactions 4 weeks after treatment in the three groups（P>0.05）.Conclusion：The combination of Sitagliptin Phosphate Tablets and Epalrestat in the treatment of DPN can improve neurological function，improve oxidative stress and NO levels，and the drug is safe and should be widely applied.

【Key words】 Diabetic peripheral neuropathy； Sitagliptin Phosphate Tablets； Epalrestat； Neuronal function； Oxidative stress

First-authors address：Songzi Combine Traditional Chinese and Western Medicine Hospital，Songzi 434200，China

doi：10.3969/j.issn.1674-4985.2018.14.008

糖尿病周围神经病变（diabetic peripheral neuropathy，DPN）是临床上2型糖尿病患者中常见的慢性并发症，属于是一种糖尿病微血管疾病，临床发病率达80%～100%，发病后如果得不到及时治疗、干预，可累及感觉、运动和自主神经，临床表现为四肢对称性复发性神经病变，部分患者表现为单神经病变，影响患者神经功能正常发挥，典型症状为冷热觉减退、皮肤麻木感、针刺样疼痛，影响患者健康及生活[1]。目前，临床上对于DPN尚无根治性治疗药物，甲钴胺虽然能改善患者神经功能，但是并不能从根本上实现疾病治疗，导致患者预后较差[2]。研究表明：将磷酸西格列汀片联合依帕司他用于DPN患者效果理想，有助于改善患者神经功能，降低氧化应激水平，但是不同学者试验结果存在争议[3]。……