关键词:

糖尿病神经病变, 周围神经系统疾病, 加味当归芍药散, 依帕司他片, 神经传导

Abstract:

Objective　To evaluate the therapeutic efficacy of Jiawei Danggui Shaoyao San combined with epalrestat tablets in the treatment of diabetic peripheral neuropathy (DPN) in elderly patients. Methods　A prospective study was conducted on 120 elderly DPN patients treated at Shangluo Central Hospital from January 2021 to January 2023. Using a convenience sampling method, the patients were divided into an experimental group (60 cases) and a control group (60 cases). In the control group, there were 29 males and 31 females, with an age of (69.14±4.31) years; in the experimental group, there were 30 males and 30 females, with an age of (69.39±4.26) years. The control group received epalrestat tablets, while the experimental group received Jiawei Danggui Shaoyao San and epalrestat. The treatment duration was 3 months. The TCM syndrome scores, EMG indicators of lower limbs [sensory nerve conduction velocity(SCV) and motor nerve conduction velocity(MCV)], blood glucose status [fasting plasma glucose (FPG), 2-hour postprandial glucose (2 hPG), and glycated hemoglobin(HbA1c)], neuropathy [Michigan Diabetic Neuropathy Score(MDNS) score and Toronto Clinical Scoring System(TCSS) score], oxidative stress [malondialdehyde(MDA) and superoxide dismutase(SOD)], serum levels [brain-derived neurotrophic factor(BDNF), nitric oxide(NO), endothelin-1 (ET-1), and ficolin-3], and adverse reactions were compared between the two groups. Statistical methods employed t test and χ² test. Results　After the treatment, the scores of main syndrome, secondary syndrome, MDNS, and TCSS, FPG, HbA1 c, 2 hPG, MDA, ET-1, and ficolin-3 in the experimental group were lower than those in the control group [2.19±0.37 vs. 5.24±0.85, 1.39±0.28 vs. 2.86±0.47, 13.67±2.18 vs. 17.11±2.79, 6.03±0.78 vs. 7.91±0.93, (5.08±0.66) mmol/L vs. (7.02±1.20) mmol/L, (6.77±0.92)% vs. (7.22±1.03)%, (9.13±1.61) mmol/L vs. (12.22±2.64) mmol/L, (2.48±1.75) U/ml vs. (4.19±1.82) U/ml, (24.41±3.87) ng/L vs. (34.73±4.32) ng/L, and (9.71±2.62) μg/L vs. (12.45±3.70) μg/L], and the SCV of sural nerve, MCV of common peroneal nerve, and levels of SOD, BDNF, and NO were higher [(43.01±4.13) m/s vs. (38.65±3.81) m/s, (51.91±4.91) m/s vs. (46.45±3.35) m/s, (133.21±12.33) U/ml vs. (121.31±18.03) U/ml, (6.17±0.71) ng/L vs. (4.25±0.36) ng/L, and (3.96±0.72) μmol/L vs. (3.34±0.63) μmol/L], with statistical differences (all P<0.05). The incidence rate of adverse reactions in the experimental group was lower than that in the control group [3.33%(2/60) vs. 16.67%(10/60)], with a statistical difference (χ²=5.926; P=0.015). Conclusions　Jiawei Danggui Shaoyao San combined with epalrestat tablets in the treatment of elderly patients with DPN can effectively improve their symptoms and neurological function, regulate blood glucose, reduce the degree of neuropathy, improve the level of antioxidant and regulatory factors, and have high safety.

Key words: Diabetic neuropathy, Peripheral nervous system disease, Jiawei Danggui Shaoyao San, Epalrestat tablets, Nerve conduction