脉管复康胶囊联合甲钴胺片对糖尿病周围神经病变患者血清Hcy、CysC、hs-CRP的影响
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摘要
目的探讨脉管复康胶囊与甲钴胺片联合治疗后对糖尿病周围神经病变(DPN)患者血清同型半胱氨酸(Hcy)、胱抑素C(CysC)、超敏C反应蛋白(hs-CRP)水平的影响。方法选取在我院内分泌科就诊的2型糖尿病且合并周围神经病变患者180例,区组随机化分为单药治疗组(A组)、联合治疗组(B组)和对照组(C组)三组,每组60例。单药治疗组服用脉管复康胶囊1.8 g,每天3次;联合治疗组服用脉管复康胶囊1.8 g,每天3次,甲钴胺片0.5 mg,每天3次;对照组服用甲钴胺片0.5 mg,每天3次,治疗时间为6个月。于服药前和服药后检测相关生化指标,分析DPN患者血清Hcy、CysC、hs-CRP的变化情况。最后完成研究的病例数分别为A组56例,B组54例,C组57例。结果组内比较中,治疗后Hcy、CysC、hs-CRP水平均较治疗前下降且差异有统计学意义(P <0.05);组间比较中,治疗前三组Hcy、CysC、hs-CRP比较差异无统计学意义(P> 0.05);治疗后三组Hcy、CysC、hs-CRP均较治疗前降低,单药治疗组较对照组三项指标下降明显(P <0.05),联合治疗组比对照组指标降低更显著且差异有统计学意义(P <0.05)。结论脉管复康胶囊能够降低DPN患者Hcy、CysC、hs-CRP水平,联合甲钴胺片效果更佳,有利于临床使用。
Objectives The study was to investigate the effect of Maiguanfukang capsules combined with mecobalamin tablets on serum homocysteine(Hcy),cystatin c(cysc)and high sensitivity C-reactive protein(hsCRP)levels in patients with diabetic peripheral neuropathy(DPN).Methods A total of 180 patients with type 2diabetes and peripheral neuropathy were selected from the department of endocrinology in our hospital.All patients were randomly divided into single drug treatment group(group A),combined treatment group(group B)and control group(group C),including 60 cases in each group.The monotherapy group received 1.8g Maiguanfukuang capsules orally three times a day,while the combined treatment group was additionally given 0.5mg mecobalamin tablets orally three times a day.The control group took 0.5mg mecobalamin tablets orally three times a day.All groups were treated for six months.The levels of Hcy,CysC and hs-CRP in the three groups were measured and analyzed before and after treatment.The number of cases that completed the study was 56 in group A,54 in group B and 57 in group C.ResultsIn the intra-group comparison,the levels of Hcy,CysC and hs-CRP after treatment were lower than that before treatment with statistical significance(P<0.05).In the inter-group comparison,there was no difference in Hcy,CysC and hs-CRP levels among the three groups before treatment(P>0.05).After treatment,Hcy,CysC and hs-CRP in the three groups were lower.Compared with the control group,the Hcy,CysC and hs-CRP levels of the single drug treatment group decreased significantly(P<0.05),while levels of the combined treatment group reduced more significantly with statistical significance(P<0.05).ConclusionsMaiguanfukang capsules can reduce the levels of Hcy,CysC and hs-CRP in DPN patients,which is worthy of clinical application.
Objectives The study was to investigate the effect of Maiguanfukang capsules combined with mecobalamin tablets on serum homocysteine(Hcy),cystatin c(cysc)and high sensitivity C-reactive protein(hsCRP)levels in patients with diabetic peripheral neuropathy(DPN).Methods A total of 180 patients with type 2diabetes and peripheral neuropathy were selected from the department of endocrinology in our hospital.All patients were randomly divided into single drug treatment group(group A),combined treatment group(group B)and control group(group C),including 60 cases in each group.The monotherapy group received 1.8g Maiguanfukuang capsules orally three times a day,while the combined treatment group was additionally given 0.5mg mecobalamin tablets orally three times a day.The control group took 0.5mg mecobalamin tablets orally three times a day.All groups were treated for six months.The levels of Hcy,CysC and hs-CRP in the three groups were measured and analyzed before and after treatment.The number of cases that completed the study was 56 in group A,54 in group B and 57 in group C.ResultsIn the intra-group comparison,the levels of Hcy,CysC and hs-CRP after treatment were lower than that before treatment with statistical significance(P<0.05).In the inter-group comparison,there was no difference in Hcy,CysC and hs-CRP levels among the three groups before treatment(P>0.05).After treatment,Hcy,CysC and hs-CRP in the three groups were lower.Compared with the control group,the Hcy,CysC and hs-CRP levels of the single drug treatment group decreased significantly(P<0.05),while levels of the combined treatment group reduced more significantly with statistical significance(P<0.05).ConclusionsMaiguanfukang capsules can reduce the levels of Hcy,CysC and hs-CRP in DPN patients,which is worthy of clinical application.
引文
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[10]侯霁芯,王丹,阚竞宇,等.丹参酚酸B上调AMPK改善糖尿病小鼠血管内皮功能[J].实用医学杂志,2017,33(20):3367-3371.
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[13]刘春梅,周涛,吴鹏,等.脉管复康片对糖尿病下肢动脉闭塞症患者内皮细胞功能影响的临床研究[J].国际内分泌代谢杂志,2014,34(6):418-421.
[14]ZARIC B L,OBRADOVIC M,BAJIC V,et al.Homocysteine and Hyperhomocysteinaemia[J].Curr Med Chem,2018.
[15]LI H,ZHANG P,YUAN S,et al.Modeling analysis of the relationship between atherosclerosis and related inflammatory factors[J].Saudi J Biol Sci,2017,24(8):1803-1809.
[16]王学军,郭家龙,裴斌,等.脉管复康片治疗下肢动脉硬化性闭塞症疗效和安全性的系统评价[J].中国循证心血管医学杂志,2017,9(1):19-22,27.
[17]LI J,WANG L,WANG Q,et al.Diagnostic value of carotid artery ultrasound and hypersensitive C-reactive protein in Type 2diabetes mellitus patients with acute myocardial infarction in Chinese population[J].Medicine(Baltimore),2018,97(41):e12334.
[18]蔡红蝶,宿树兰,周卫,等.乳香属药用植物中乳香酸类化学成分、生物活性及其作用机制研究进展[J].中草药,2016,47(12):2175-2181.
[19]LIN L,GE-ER L,FANG-ZHOU Y,et al.Metabolomic profiling of the effects of Curcumae rhizoma and Sparganii rhizome on stress-led blood stasis[J].Pak J Pharm Sci,2018,31(Suppl 1):333-339.
[20]MORIKAWA T,MATSUDA H,YOSHIKAWA M.A review of anti-inflammatory terpenoids from the incense gum resins frankincense and myrrh[J].J Oleo Sci,2017,66(8):805-814.
[2]彭少林,沙永红,张美彪,等.糖尿病周围神经病变患者血清C肽与同型半胱氨酸、胱抑素C的相关性研究[J].社区医学杂志,2018,16(7):57-59.
[3]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):1-67.
[4]陈新,李晓华.红花注射液联合甲基维生素B12治疗糖尿病神经病变的疗效[J].中国老年学杂志,2013,33(14):3464-3465.
[5]中国微循环学会糖尿病与微循环专业委员会.糖尿病微循环障碍临床用药专家共识[J].药品评价,2017,14(5):5-12.
[6]ZHENG L Q,ZHANG H L,GUAN Z H,et al.Elevated serum homocysteine level in the development of diabetic peripheral neuropathy[J].Genet Mol Res,2015,14(4):15365-15375.
[7]金明月,李国姣,郭妍,等.同型半胱氨酸及血清胱抑素C与糖尿病周围神经病变的相关性[J].实用医学杂志,2018,34(08):1227-1230.
[8]NAVNEET S,CUI X,ZHAO J,et al.Excess homocysteine upregulates the NRF2-antioxidant pathway in retinal Muller glial cells[J].Exp Eye Res,2018:S14-S4835.
[9]HU Y,LIU F,SHEN J,et al.Association between serum cystatin C and diabetic peripheral neuropathy:a cross-sectional study of a Chinese type 2 diabetic population[J].Eur J Endocrinol,2014,171(5):641-648.
[10]侯霁芯,王丹,阚竞宇,等.丹参酚酸B上调AMPK改善糖尿病小鼠血管内皮功能[J].实用医学杂志,2017,33(20):3367-3371.
[11]LI G H,LI Y R,JIAO P,et al.Therapeutic potential of salviae miltiorrhizae radix et rhizoma against human diseases based on activation of Nrf2-mediated antioxidant defense system:Bioactive constituents and mechanism of action[J].Oxid Med Cell Longev,2018,2018:7309073.
[12]CHEN H L,YANG J,FU Y F,et al.Effect of total flavonoids of spatholobus suberectus dunn on PCV2 induced oxidative stress in RAW264.7 cells[J].BMC Complement Altern Med,2017,17(1):244.
[13]刘春梅,周涛,吴鹏,等.脉管复康片对糖尿病下肢动脉闭塞症患者内皮细胞功能影响的临床研究[J].国际内分泌代谢杂志,2014,34(6):418-421.
[14]ZARIC B L,OBRADOVIC M,BAJIC V,et al.Homocysteine and Hyperhomocysteinaemia[J].Curr Med Chem,2018.
[15]LI H,ZHANG P,YUAN S,et al.Modeling analysis of the relationship between atherosclerosis and related inflammatory factors[J].Saudi J Biol Sci,2017,24(8):1803-1809.
[16]王学军,郭家龙,裴斌,等.脉管复康片治疗下肢动脉硬化性闭塞症疗效和安全性的系统评价[J].中国循证心血管医学杂志,2017,9(1):19-22,27.
[17]LI J,WANG L,WANG Q,et al.Diagnostic value of carotid artery ultrasound and hypersensitive C-reactive protein in Type 2diabetes mellitus patients with acute myocardial infarction in Chinese population[J].Medicine(Baltimore),2018,97(41):e12334.
[18]蔡红蝶,宿树兰,周卫,等.乳香属药用植物中乳香酸类化学成分、生物活性及其作用机制研究进展[J].中草药,2016,47(12):2175-2181.
[19]LIN L,GE-ER L,FANG-ZHOU Y,et al.Metabolomic profiling of the effects of Curcumae rhizoma and Sparganii rhizome on stress-led blood stasis[J].Pak J Pharm Sci,2018,31(Suppl 1):333-339.
[20]MORIKAWA T,MATSUDA H,YOSHIKAWA M.A review of anti-inflammatory terpenoids from the incense gum resins frankincense and myrrh[J].J Oleo Sci,2017,66(8):805-814.