胰激肽原酶联合普瑞巴林治疗痛性糖尿病周围神经病变的临床效果

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摘要目的评估胰激肽原酶联合普瑞巴林治疗痛性糖尿病周围神经病变（PDPN）的效果和安全性。方法选取2017年1～12月在湖北省中西医结合医院内分泌科就诊的68 例PDPN 患者作为研究对象，采用随机数字表法将其分为对照组和治疗组，每组各34 例。两组患者均予以控制血糖等内科基础治疗，对照组在此基础上加用普瑞巴林治疗，治疗组加用胰激肽原酶联合普瑞巴林治疗，持续观察8 周。治疗前后采用视觉模拟量表（VAS）评分评估两组患者的疼痛强度变化，测量并比较两组患者的感觉神经传导速度（SNCV）和运动神经传导速度（MNCV），记录药物不良反应发生情况。结果两组患者治疗前的VAS 评分比较，差异无统计学意义（P＞0.05）；两组患者治疗后的VAS 评分均低于同组治疗前，差异有统计学意义（P＜0.05）；治疗组患者治疗后的VAS 评分低于对照组，差异有统计学意义（P＜0.05）。两组患者治疗前的SNCV 比较，差异无统计学意义（P＞0.05）；两组患者治疗后的SNCV 均高于同组治疗前，差异有统计学意义（P＜0.05），且治疗组患者治疗后的SNCV 高于对照组，差异有统计学意义（P＜0.05）。两组患者治疗前的MNCV 比较，差异无统计学意义（P＞0.05）；治疗组患者治疗后的MNCV 高于同组治疗前，差异有统计学意义（P＜0.05）；对照组患者治疗后的MNCV 与同组治疗前比较，差异无统计学意义（P＞0.05）；治疗组患者治疗后的MNCV 高于对照组，差异有统计学意义（P＜0.05）。两组患者的不良反应总发生率比较，差异无统计学意义（P＞0.05）。结论胰激肽原酶联合普瑞巴林较单独使用普瑞巴林治疗PDPN 改善疼痛的效果更佳，同时能提高患者的SNCV 和MNCV，效果优于单用普瑞巴林治疗者，临床应用安全。

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关键词 ：糖尿病周围神经病变, 神经痛, 胰激肽原酶, 普瑞巴林

Abstract：Objective To evaluate the effect and safety of Pancreatic Kininogenase combined with Pregabalin in the treatment of painful diabetic peripheral neuropathy (PDPN). Methods From January to December 2017, 68 patients with PDPN treated in the Endocrinology Department of Hubei Provincial Hospital of Integrated Chinese and Western Medicine were selected as the research subjects, and they were divided into the control group and the treatment group by the random number table method, with 34 cases in each group. The patients in the two groups were given basic medical treatment such as blood glucose control. On the basis of this, the control group was treated with Pregabalin and the treatment group was treated with Pancreatic Kininogenase and Pregabalin for 8 weeks. Visual analogue scale (VAS)was used to evaluate the pain intensity changes between the two groups before and after treatment. Sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) were measured and compared between the two groups. The incidence of adverse drug reactions was recorded. Results There was no statistically significant difference in the VAS score between the two groups before treatment (P＞0.05). After treatment, the VAS scores in the two groups were lower than those in the same group before treatment, the differences were statistically significant (P＜0.05), and the VAS score in the treatment group after treatment was lower than that in the control group, the difference was statistically significant (P＜0.05). There was no significant difference in the SNCV before treatment between the two groups (P＞0.05). The SNCV after treatment in the two groups was higher than that in the same group before treatment, and the difference was statistically significant (P＜0.05). And the SNCV after treatment in the treatment group was higher than that in the control group, the difference was statistically significant (P＜0.05). There was no significant difference in MNCV before treatment between the two groups (P＞0.05). The MNCV after treatment in the treatment group was higher than that in the same group before treatment, and the difference was statistically significant (P＜0.05). There was no significant difference in MNCV between the control group before and after treatment (P＞0.05). The MNCV after treatment in the treatment group was higher than that in the control group, with statistically significant difference (P＜0.05). There was no significant difference in the total incidence rate of adverse reactions between the two groups (P＞0.05). Conclusion Pancreatic Kininogenase combined with Pregabalin has a better effect on pain improvement than Pregabalin alone in the treatment of PDPN. At the same time, it can improve the SNCV and MNCV of patients. The effect is better than that of Pregabalin alone, and it is safe for clinical application.

Key words： Diabetic peripheral neuropathy Neuralgia Pancreatic Kininogenase Pregabalin

收稿日期: 2020-03-03

基金资助:国家自然科学基金青年科学基金项目（81601580）

作者简介: 曹春丽（1986-），女，湖北随州人，硕士，主治医师，主要从事糖尿病及并发症的临床诊治和基础研究

引用本文:

曹春丽；张静；吴淑琼；熊付. 胰激肽原酶联合普瑞巴林治疗痛性糖尿病周围神经病变的临床效果[J]. 中国当代医药, 2020, 27(29): 4-7.
CAO Chun-li1 ZHANG Jing1 WU Shu-qiong1▲ XIONG Fu2. Clinical effect of Pancreatic Kininogenase Combined with Pregabalin in the treatment of painful diabetic peripheral neuropathy. 中国当代医药, 2020, 27(29): 4-7.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2020/V27/I29/4

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