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分析普罗布考-甲钴胺片联合治疗对糖尿病周围神经病变患者氧化应激的影响。

Analysis of the effect of probucol-mecobalamin tablets combination on oxidative stress in patients with diabetic peripheral neuropathy.

机构信息

Department of Special Examination, Shandong Provincial Third Hospital, Shandong University, Jinan, China.

Department of Endocrinology, Qingdao West Coast New Area Central Hospital, Qingdao, China.

出版信息

Neurosci Lett. 2021 Jan 10;741:135484. doi: 10.1016/j.neulet.2020.135484. Epub 2020 Nov 5.

Abstract

OBJECTIVE

This research aimed to observe the effect of probucol combined with mecobalamin tablets on oxidative stress in patients with diabetic peripheral neuropathy (DPN).

METHODS

In this prospective study, 104 patients with DPN who were treated in our hospital were included, from August 2018 to January 2020. They were divided into groups of combination (n = 52) and control (n = 52) by using a random number table. All patients took mecobalamin tablets after meals for 3 months (1 tablet/time, 3 times/d). On this basis, patients in the combination group took probucol for 3 months (4 tablets/time, 2 times/d). The observation indicators were the Toronto Clinical Scoring System (TCSS)(symptom, sensory, and reflex scores), nerve conduction velocity[sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity(MNCV) of the common peroneal nerve and median nerve], oxidative stress indicators[superoxide dismutase(SOD), malondialdehyde(MDA), glutathione peroxidase(GSH-Px) and catalase(CAT)], clinical efficacy and adverse reactions.

RESULTS

There was no significant difference in the symptom scores, sensory scores, reflex scores, and total scores between the two groups before treatment (p > 0.05), while these four indicators of the combination group were significantly lower than that in the control group after treatment (p < 0.05). These four indicators of the two groups after treatment were significantly lower than before treatment (p < 0.05). There was no significant difference in the SNCV and NMCV of the common peroneal nerve and median nerve between the two groups before treatment (p > 0.05), while the indicators of the combination group were significantly higher than that of the control group (p < 0.05) after treatment, and these indicators of the two groups after treatment were significantly higher than that before treatment (p < 0.05). There was no significant difference in SOD, MDA, GSH-Px, and CAT between the two groups before treatment (p > 0.05). After treatment, the SOD, GSH-Px, and CAT in the combination group were significantly higher than that in the control group (p < 0.05), while the MDA in the combination group was significantly lower than that in the control group (p < 0.05). After treatment, the SOD, GSH-Px, and CAT in the two groups were significantly higher than that before treatment (p < 0.05), while the MDA was lower (p < 0.05). The clinical efficacy of the combination group was significantly better than that of the control group (94.23 % vs 78.85 %, p<0.05) after treatment. There was no significant difference in the incidence of total adverse reactions between the two groups (3.85 % vs 5.77 %, p > 0.05).

CONCLUSION

The therapeutic effect of probucol combined with mecobalamin tablets for patients with DPN was significant, which could effectively improve the oxidative stress response of patients and was worthy of clinical promotion.

摘要

目的

本研究旨在观察普罗布考联合甲钴胺片对糖尿病周围神经病变(DPN)患者氧化应激的影响。

方法

前瞻性研究,纳入 2018 年 8 月至 2020 年 1 月我院收治的 104 例 DPN 患者,采用随机数字表法分为联合组(n=52)和对照组(n=52)。所有患者均饭后服用甲钴胺片,3 个月[1 片/次,3 次/d]。在此基础上,联合组患者服用普罗布考 3 个月[4 片/次,2 次/d]。观察指标为多伦多临床评分系统(TCSS)(症状、感觉和反射评分)、神经传导速度[感觉神经传导速度(SNCV)和运动神经传导速度(MNCV)的腓总神经和正中神经]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)和过氧化氢酶(CAT)]、临床疗效和不良反应。

结果

治疗前两组症状评分、感觉评分、反射评分和总分比较差异无统计学意义(p>0.05),治疗后联合组四项指标均明显低于对照组(p<0.05)。两组治疗后四项指标均明显低于治疗前(p<0.05)。治疗前两组腓总神经和正中神经的 SNCV 和 NMCV 比较差异无统计学意义(p>0.05),治疗后联合组指标明显高于对照组(p<0.05),两组治疗后均明显高于治疗前(p<0.05)。两组治疗前 SOD、MDA、GSH-Px、CAT 比较差异无统计学意义(p>0.05)。治疗后联合组 SOD、GSH-Px、CAT 明显高于对照组(p<0.05),MDA 明显低于对照组(p<0.05)。两组治疗后 SOD、GSH-Px、CAT 明显高于治疗前(p<0.05),MDA 明显低于治疗前(p<0.05)。治疗后联合组临床疗效明显优于对照组(94.23%比 78.85%,p<0.05)。两组总不良反应发生率比较差异无统计学意义(3.85%比 5.77%,p>0.05)。

结论

普罗布考联合甲钴胺片治疗 DPN 患者的疗效显著,可有效改善患者的氧化应激反应,值得临床推广。

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