目的 探讨木丹颗粒联合左卡尼汀治疗糖尿病周围神经病变的临床疗效。方法 选取2021年8月-2023年8月河北省第八人民医院收治的糖尿病周围神经病变患者116例,随机分为对照组(58例)和治疗组(58例)。对照组患者口服左卡尼汀口服溶液,20 mL/次,3次/d。在对照组基础上,治疗组口服木丹颗粒,1袋/次,3次/d。两组治疗28 d。观察两组患者临床疗效,比较治疗前后两组患者症状缓解时间,多伦多临床神经病变评分量表(TCSS)评分,周围神经炎性因子纤维蛋白胶凝-3(ficolin-3)、同型半胱氨酸(Hcy)、神经特异性烯醇化酶(NSE)和胰岛素样生长因子-1(IGF-1)水平。结果 治疗后,治疗组临床总有效率为98.28%,明显高于对照组总有效率(82.75%,P<0.05)。治疗后,治疗组症状缓解时间均明显早于对照组(P<0.05)。治疗后,两组TCSS评分均明显降低(P<0.05),且与对照组比较,治疗组TCSS评分降低更明显(P<0.05)。治疗后,两组患者NSE、Hcy水平明显降低,而ficolin-3和IGF-1水平明显高于(P<0.05),且治疗组患者水平明显好于对照组(P<0.05)。结论 左卡尼汀与木丹颗粒协同治疗,可对周围神经末梢病变改善有效,并促进机体炎性反应减弱。

Objective To explore the clinical effect of Mudan Granules combined with levocarnitine in treatment of peripheral neuropathy. Methods Patients (116 cases) with peripheral neuropathy in Eighth People's Hospital of Hebei Province from August 2021 to August 2023 were randomly divided into control (58 cases) and treatment (58 cases) group. Patients in the control group were po administered with Levocarnitine Oral Solution, 20 mL/time, three times daily. Patients in the treatment group were po administered with Mudan Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 28 d. After treatment, the clinical evaluations were evaluated, symptom relief time, TCSS scores, the levels of ficolin-3, NSE, Hcy and IGF-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.28%, which was significantly higher than that of the control group (82.75%, P < 0.05). After treatment, the TCSS score in two groups was significantly decreased (P < 0.05), and the TCSS score of the treatment group was decreased more significantly than that of the control group (P < 0.05). After treatment, the levels of NSE and Hcy were significantly decreased, while the levels of ficolin-3 and IGF-1 were significantly higher in two groups (P < 0.05), and the levels of these indicators in the treatment group were significantly better than that in the control group (P < 0.05). Conclusion The synergistic treatment of levocarnitine and Mudan Granules can effectively improve the pathological changes of peripheral nerve endings and promote the weakening of systemic inflammatory response.

R977

河北省中医药管理局科研计划项目（2019172）