鼠神经生长因子联合瑞舒伐他汀治疗老年糖尿病周围神经病变临床观察Clinical observation of mouse nerve growth factor combined with rosuvastatin in the treatment of senile diabetic peripheral neuropathy
李晴;于小琪;王双艳;陈劲龙;
摘要(Abstract):
目的观察和评价鼠神经生长因子(mNGF)联合瑞舒伐他汀治疗糖尿病周围神经病变(DPN)的疗效。方法 67例老年DPN患者随机分为3组:A组(n=23)给予甲钴胺治疗,B组(n=22)给予甲钴胺+鼠神经生长因子治疗,C组(n=22)给予甲钴胺+鼠神经生长因子+瑞舒伐他汀治疗,共4周;观察各组患者治疗前后的多伦多神经症状评分(TCSS)、神经传导速度(NCV)以及肝功能和血脂变化。结果 3组治疗后均取得TCSS下降和NCV增加的显著改善(P<0.05),其中C组较A、B组改善程度更优,差异具有统计学意义(P<0.05)。结论联合使用mNGF和瑞舒伐他汀治疗老年DPN可能获得显著疗效。
关键词(KeyWords): 鼠神经生长因子;瑞舒伐他汀;糖尿病周围神经病变
基金项目(Foundation): 广州市医药卫生科技项目(编号:20151A1003)
作者(Authors): 李晴;于小琪;王双艳;陈劲龙;
参考文献(References):
- [1]HERNáNDEZ-OJEDA J,ROMáN-PINTOS L M,RODRíGUEZ-CARRíZALEZ A D.Effect of rosuvastatin on diabetic polyneuropathy:a randomized,double-blind,placebo-controlled Phase IIa study[J].Diabetes Metab Syndr Obes,2014,7:401-407.DOI:10.2147/DMSO.S65500.ECOLLECTION 2014.
- [2]VILLEGAS-RIVERA G,ROMáN-PINTOS L M,CAR-DONA-MUNOZ E G,et al.Effects of Ezetimibe/Simvastatin and Rosuvastatin on Oxidative Stress in Diabetic Neuropathy:A Randomized,Double-Blind,Placebo-Controlled Clinical Trial[J].Oxid Med Cell Longev,2015,2015:756294.doi:10.1155/2015/756294.
- [3]NIELSEN S F,NORDESTGAED B G.Use before diabetes diagnosis and risk of microvascular disease:a nationwide nested matched study[J].Lancet Diabetes Endocrinol,2014,2(11):894-900.doi:10.1016/S2213-8587(14)70173-1.
- [4]NASSAJI M,GHORBANI R,SABOORI SHKOFTEH.Previous Atorvastatin Treatment and Risk of Diabetic Foot Infection in Adult Patients:A Case-control Study[J].Wounds,2017,29(7):196-201.
- [5]CAMERON N1,COTTER M,INKSTER M,et al.Looking to the future:diabetic neuropathy and effects of rosuvastatin on neurovascular function in diabetes models[J].Diabetes Res Clin Pract,2003,61Suppl 1:S35-39.
- [6]KHALIQ F,PARVEEN A,SINGH S,et al.Terminalia arjuna improves cardiovascular autonomic neuropathy in streptozotocin-induced diabetic rats[J].Cardiovasc Toxicol,2013,13(1):68-76.doi:10.1007/s12012-012-9187-6.
- [7]OLTMAN C L,DAVIDSON E P,COPPEY L J,et al.Vascular and neural dysfunction in Zucker diabetic fatty rats:a difficult condition to reverse[J].Diabetes Obes Metab,2008,10(1):64-74.
- [8]CAMERON N,COTTER M,INKSTER M,et al.Looking to the future:diabetic neuropathy and effects of rosuvastatin on neurovascular function in diabetes models[J].Diabetes Res Clin Pract,2003,61Suppl 1:S35-9.
- [9]ROLIM L C,DA SILVA E M,FLUMIGNAN R L,et al.Acetyl-L-carnitine for the treatment of diabetic peripheral neuropathy[J].Cochrane Database Syst Rev,2019,6:CD011265.doi:10.1002/14651858.CD011265.pub2.
- [10]XIE X,LU L,ZHOU X,et al.Effect of Gua Sha therapy on patients with diabetic peripheral neuropathy:Arandomized controlled trial[J].Complement Ther Clin Pract,2019,35:348-352.doi:10.1016/j.ctcp.2019.03.018.
- [11]MANSCHOT S M,BIESSELS G J,RUTTEN G E,et al.Utrecht Diabetic Encephalopathy Study Group.Peripheral and central neurologic complications in type 2diabetes mellitus:no association in individual patients[J].J Neurol Sci,2008,264(1-2):157-162.
- [12]DAVIES M,BROPHY S,WILLIAMS R,et al.The prevalence,severity,and impact of painful diabetic peripheral neuropathy in type 2 diabetes[J].Diabetes Care,2006,29(7):1518-1522.
- [13]ZINMAN L H,NGO M,NG E T,et al.Low-intensity laser therapy for painful symptoms of diabetic sensorimotor polyneuropathy:a controlled trial[J].Diabetes Care,2004,27(4):921-924.
- [14]BRIL V,PERKINS B A.Validation of the Toronto Clinical Scoring System for diabetic polyneuropathy[J].Diabetes Care,2002,25(11):2048-2052.
- [15]BAERISWYL M,TAFFé P,KIRKHAM K R,et al.Comparison of peripheral nerve blockade characteristics between non-diabetic patients and patients suffering from diabetic neuropathy:aprospective cohort study[J].Anaesthesia,2018,73(9):1110-1117.doi:10.1111/anae.14347.
- [16]ABRAHAM A,BARNETT C,LOVBLOM L E,et al.Cramps frequency and severity are correlated with small and large nerve fiber measures in type 1diabetes[J].Clin Neurophysiol,2018,129(1):122-126.doi:10.1016/j.clinph.2017.10.029.
- [17]LALLI P,CHAN A,GARVEN A,et al.Increased gait variability in diabetes mellitus patients with neuropathic pain[J].J Diabetes Complications,2013,27(3):248-54.doi:10.1016/j.jdiacomp.2012.10.013.
- [18]YOSHIOKA K,OKADA H.Useful application of the Neuropad test for assessment of diabetic polyneuro-pathy[J].Intern Med,2012,51(23):3241-3245.
- [19]许强.鼠神经生长因子对糖尿病周围神经病变患者神经传导速度的影响[J].中国实用神经疾病杂志,2015,(23):85-86.