摘要目的 观察羟苯磺酸钙联合单唾液酸四己糖神经节苷脂钠对老年痛性糖尿病周围神经病变患者血清白细胞介素6(IL-6)和单核细胞趋化蛋白-1(MCP-1)水平的影响.方法 选取2012年1月至2017年5月在连云港市第二人民医院治疗的老年痛性糖尿病周围神经病患者70例,采用随机数字表法分为两组,观察组和对照组各35例,观察组给予羟苯磺酸钙分散片联合单唾液酸四己糖神经节苷脂钠,治疗2周.对照组予甲钴胺注射液,治疗2周.观察比较两组临床治疗效果及治疗前后IL-6和MCP-1水平变化.结果 治疗2周后,观察组MDNS评分及MNSI评分分别为(13.09±5.38)分和(2.53±1.19)分,较对照组[(18.31±6.13)分、(4.19±1.05)分]明显降低(t=2.036、2.365,均P＜0.05);同时观察组MDNS评分及MNSI评分较治疗前[(21.26±4.28)分、(5.40±0.89)分]也明显降低(t=3.251、3.698,均P＜0.05).治疗1周后及2周后观察组的VAS-PI评分[(6.24±1.25)分、(4.13±1.69)分]均较对照组[(7.26±1.28)分、(6.34±2.65)分]明显降低(t=3.265、5.395,均P＜0.05);治疗2周后,观察组血清IL-6、MCP-1含量[(15.16 ±0.88) ng/L、(157.19±11.22) ng/L]较对照组[(17.87±1.19) ng/L、(198.21±12.07)ng/L]均明显降低(t=2.152、1.365,均P＜0.05);且观察组血清IL-6、MCP-1含量明显低于治疗前[(20.26±1.05) ng/L、(260.44±13.63) ng/L](t=1.235、0.965,均P＜0.05).结论 羟苯磺酸钙和单唾液酸四己糖神经节苷脂钠联合用药可缓解痛性糖尿病周围神经病变患者感觉异常及疼痛,这一机制可能通过降低炎性因子水平实现.

abstractsObjective To observe the efficacy of combination therapy of calcium dobesilate dispersible and monosialotetrahexosylganlioside sodium on interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) in elderly patients with painful diabetic peripheral neuropathy.Methods From January 2012 to May 2017,in the Second People's Hospital of Lianyungang 70 patients of painful diabetic peripheral neuropathy,aged ≥60 years,were analyzed in this study.They were randomly divided into observation group (35 cases) and control group (35 cases).The observation group was treated with 40mg monosialotetrahexosylganlioside sodium dissolved in 250mL physiological saline,intravenous infusion per day,and oral calcium dobesilate dispersible 0.5g twice a day for two weeks.The control group was treated with methylcobalamin injection 0.5mg per day for two weeks.The clinical treatment effects and levels of IL-6 and MCP-1 were observed and compared between the two groups.Results After two weeks of treatment,the MDNS and MNSI scores of the observation group [(13.09 ± 5.38)points,(2.53 ± 1.19)points] were significantly lower than those of the control group [(18.31 ± 6.13) points,(4.19 ± 1.05) points,t =2.036,2.365,all P ＜ 0.05] and those before treatment [(21.26 ± 4.28) points,(5.40 ± 0.89) points,t =3.251,3.698,all P ＜ 0.05].The VAS-PI scores in the observation group [(6.24 ± 1.25) points,(4.13 ± 1.69) points] were significantly lower than those in the control group[(7.26 ± 1.28) points,(6.34 ± 2.65) points] at the first and second week (t =3.265,5.395,all P ＜ 0.05).The serum levels of inflammatory cytokines IL-6 and MCP-1 in the observation group [(15.16 ±0.88) ng/L,(157.19 ± 11.22) ng,/L] were significantly lower than those in the control group[(17.87 ± 1.19) ng/L,(198.21 ± 12.07)ng/L,t =2.152,1.365,all P ＜0.05]and those before treatment[(20.26 ± 1.05) ng/L,(260.44 ± 13.63) ng,/L,t =1.235,0.965,all P ＜ 0.05].Conclusion Combination of calcium dobesilate and mono-sialotetrahexosyl ganglioside may alleviate the sensory and pain sensations in patients with painful diabetic peripheral neuropathy,possibly by reducing the level of inflammatory cytokines IL-6 and MCP-1.