目的 探讨糖脉康颗粒联合甲钴胺、依帕司他治疗神经源性膀胱的临床疗效。方法 选取2012年8月—2014年7月中国人民解放军海军总医院收治的110例糖尿病神经源性膀胱患者,随机分组,对照组在一般治疗基础上口服甲钴胺片0.5 mg,3次/d;口服依帕司他片50 mg,3次/d;治疗组在对照组的基础上冲服糖脉康颗粒5 g,3次/d。两组均连续治疗8周。比较两组糖尿病相关指标、红细胞醛糖还原酶(AR)、尿动力学、肌电/诱发电位以及疗效。结果 治疗后治疗组总胆固醇(TC)、糖化血红蛋白(HbA1c)、血尿素氮(BUN)和红细胞AR改善明显,与对照组在HbA1c、BUN和红细胞AR比较差异具有统计学意义(P < 0.01)。治疗后两组尿动力学指标均明显好转,治疗组残余尿量、平均尿流速、最大尿流速和逼尿肌压力均明显优于对照组(P < 0.05、0.01)。治疗后两组球海绵体肌反射(BCR)潜伏期明显降低,阴部神经躯体感觉诱发电位(SSEP)波幅增加,两组比较BCR潜伏期和波幅、SSEP波幅差异具有统计学意义(P < 0.01)。治疗后治疗组有效率为83.64%,对照组的为74.54%,治疗组明显高于对照组(P < 0.05)。结论 糖脉康颗粒联合甲钴胺、依帕司他能够改善糖尿病相关指标、尿动力学指标、神经传导功能,提高了临床疗效。

Objective To investigate the efficacy of Tangmaikang Granules combined with methylcobalamin and epalrestat in treatment of diabetic neurogenic bladder. Methods The patients with diabetic neurogenic bladder (DNB) (110 cases) of NAVY General Hospital from August 2012 to July 2014 were randomly divided into control and treatment groups. The patients in the control group were po administered with Mecobalamin Tablets 0.5 mg (three times daily) and Epalrestat Tablets 50 mg (three times daily) on the basis of conventional treatment. Patients in treatment group were po administered with Tangmaikang Granules on the basis of control group, 5 g/time, three times daily. Each group was treated for 8 weeks. Diabetes related indexes, erythrocyte aldose reductase (AR), urodynamics, electromyography (EMG)/ evoked potential (EP), and efficacies were compared. Results After treatment, total cholesterol, HbA1c, BUN, and erythrocyte AR in treatment group were improved better, and there were differences between two groups in HbA1c, BUN, and erythrocyte AR with statistically significant difference (P < 0.01). Urodynamics indicators in treatment group were obviously improved, and the average urine flow rate, residual urine volume, maximum urine flow rate, and detrusor pressure in the treatment group were better than those in the control group, and there were differences between two groups after treatment (P < 0.05, 0.01). There were obvious reducing in bulbocavernosus reflex (BCR) latency, but increasing in somatosensory evoked potiential (SSEP) of two groups after treatment, and there were differences between two groups (P < 0.01). The efficacies in the control and treatment groups were 83.64% and 74.54%, respectively, and there were differences between two groups (P < 0.05). Conclusion Tangmaikang Granules combined with methylcobalamin and epalrestat can improve diabetes related indexes, urodynamics, nerve conduction function, and efficacies.