内科

目的评价神经妥乐平联合中药治疗痛性糖尿病神经病变（PDN）患者的疗效及其对患者血清一氧化氮（NO）、脑源性神经营养因子（BDNF）和脂联素水平的影响。方法选择2015年6月至2017年1月我院收治的PDN患者110例为研究对象，按照随机数表法分为两组。对照组患者55例，在常规治疗的基础上使用神经妥乐平治疗；观察组患者55例，在对照组患者治疗的基础上内服中药（益气通络汤）治疗。检测比较两组患者治疗前后血清NO、脂联素和BDNF水平，比较两组患者的临床治疗效果。结果治疗前，两组患者血清NO、BDNF及脂联素含量比较差异无统计学意义（P＞0.05）；治疗后，两组患者血清NO、BDNF及脂联素含量均显著升高，观察组患者三者含量均显著高于对照组，差异有统计学意义（P＜0.01）。治疗前，两组患者右侧腓浅神经（感觉）、右侧腓总神经（运动）传导速度比较差异无统计学意义（P＞0.05）；治疗后，两组患者右侧腓浅神经（感觉）、右侧腓总神经（运动）传导速度均显著提高，观察组患者二者的传导速度均显著高于对照组，差异有统计学意义（P＜0.01）。治疗后，观察组患者疼痛、感觉异常、烧灼感、麻木评分显著低于对照组，疼痛缓解时间显著短于对照组，差异有统计学意义（P＜0.05）。两组患者在治疗期间均未发生严重不良反应。结论神经妥乐平联合益气通络汤治疗痛性糖尿病神经病变患者，能够提高临床疗效，调节血清NO、脂联素及BDNF水平，减轻神经细胞损伤，治疗安全性高。

ObjectiveTo evaluate the effect of neurotropin combined with traditional Chinese drug on patients with painful diabetic neuropathy (PDN) and its effects of nitric oxide (NO), brain-derived neurotrophic factor (BDNF) and adiponectin level on serum. Methods110 cases of PDN patients admitted in our hospital from June 2015 to January 2017 were selected and randomly divided into two groups, 55 cases in each group. Patients in the control group were treated with neurotropin on the basis of routine treatment. The patients in the observation group were treated with traditional Chinese drug (Yiqi Tongluo decoction) on the basis of the treatment of the control group. The serum levels of NO, adiponectin and BDNF were compared between the two groups before and after treatment, and the clinical therapeutic effects of the two groups were compared. ResultBefore treatment, there was no significant difference in the serum levels of NO, BDNF and adiponectin in the two groups (P＞0.05). After treatment, the serum levels of NO, BDNF and adiponectin in the two groups increased significantly, and the contents of three in the observation group were significantly higher than those in the control group (P＜0.01). Before treatment, there was no significant difference in the conduction velocity of the right superficial peroneal nerve (sensation) and the right peroneal nerve (motion) between the two groups (P＞0.05). After treatment, the right peroneal nerve and right peroneal nerve conduction velocity in two groups were significantly increased. The conduction velocity of two groups in the observation group was significantly higher than that in the control group (P＜0.01). After treatment, the pain, abnormal sensation, burning sensation and numbness score in the observation group were significantly lower than those in the control group, and the pain relief time was significantly shorter than that in the control group, with a statistically significant difference (P＜0.05). There was no serious adverse reaction in the two groups of patients during the study. ConclusionNeurotropin combined with traditional Chinese drug can improve the clinical efficacy of PDN. The levels of NO, adiponectin and BDNF in serum were regulated, and it can reduce nerve cell damage. The treatment is safe.