目的 探讨谷红注射液联合依帕司他治疗糖尿病周围神经病变的临床研究。方法 选取2022年10月—2024年10月武汉市中医医院收治的98例糖尿病周围神经病变患者，按照随机数字法将患者分为对照组和治疗组，每组各49例。对照组患者给予依帕司他片，50 mg/次，3次/d。治疗组在对照组的基础上给予谷红注射液，10 mL加入0.9%氯化钠注射液200 mL中稀释后静脉滴注，1次/d。两组用药28 d。观察两组的临床疗效和临床症状缓解时间，比较两组治疗前后餐后2 h血葡萄糖（2 hPG）、空腹血浆葡萄糖（FPG）、糖化血红蛋白（HbA1c）、多伦多临床系统评分（TCSS）、视觉模拟疼痛（VAS）评分法、同型半胱氨酸（Hcy）、血清超氧化物歧化酶（SOD）、胰岛素样生长因子-1（IGF-1）、血清胱抑素C（Cys-C）水平。结果 治疗后，治疗组总有效率是97.96%，显著高于对照组的81.63%（P＜0.05）。治疗后，与对照组对比，治疗组手脚麻木、局部刺痛、肌肉无力、异常出汗缓解时间均较短（P＜0.05）。治疗后，两组患者2 hPG、FPG、HbA1c水平均显著降低（P＜0.05）；治疗后，与对照组对比，治疗组2 hPG、FPG、HbA1c水平均较低（P＜0.05）。治疗后，两组TCSS评分、VAS评分均显著降低（P＜0.05）；治疗后，与对照组对比，治疗组TCSS评分、VAS评分均较低（P＜0.05）。治疗后，两组Hcy、Cys-C水平显著降低，而SOD、IGF-1显著升高（P＜0.05）；治疗后，与对照组对比，治疗组Hcy、Cys-C水平均较低，而SOD、IGF-1水平较高（P＜0.05）。结论 谷红注射液联合依帕司他治疗糖尿病周围神经病变的协同治疗疗效明显，缓解神经病变症状及疼痛，可有效保护神经组织，并能改善局部血液微循环，抑制炎症反应，值得借鉴应用。

Objective To investigate the therapeutic effect of Guhong Injection combined with epalrestat in treatment of diabetic peripheral neuropathy.Methods A total of 98 patients with diabetic peripheral neuropathy admitted to Wuhan Hospital of Traditional Chinese Medicine from October 2022 to October 2024 were selected. The patients were divided into control group and treatment group according to random number method, with 49 cases in each group. Patients in control group were given Epalrestat Tablets, 50 mg each time, three times daily. Patients in treatment group were given Guhong Injection on basis of control group. 10 mL was diluted with 200 mL of 0.9% sodium chloride injection and then intravenously infused once daily. The two groups were treated for 28 d. The clinical efficacy and the remission time of clinical symptoms of two groups were observed. The change of 2 hPG, FPG, HbA1c, TCSS score, VAS score, Hcy, SOD, IGF-1, and Cys-C before and after treatment in two groups were compared.Results After treatment, the total effective rate of treatment group was 97.96%, significantly higher than 81.63% of control group (P < 0.05). After treatment, compared with control group, the relief time of numbness in hands and feet, local tingling pain, muscle weakness and abnormal sweating in treatment group was shorter (P < 0.05). After treatment, the levels of 2 hPG, FPG, and HbA1c in both groups were significantly decreased (P < 0.05). After treatment, compared with control group, the levels of 2 hPG, FPG, and HbA1c in treatment group were all lower (P < 0.05). After treatment, the TCSS scores and VAS scores of both groups decreased significantly (P < 0.05). After treatment, compared with control group, the TCSS score and VAS score of treatment group were both lower (P < 0.05). After treatment, the levels of Hcy and Cys-C in both groups decreased significantly, but SOD and IGF-1 increased significantly (P < 0.05). After treatment, compared with control group, the levels of Hcy and Cys-C in treatment group were lower, but the levels of SOD and IGF-1 were higher (P < 0.05).Conclusion The synergistic therapeutic effect of Guhong Injection combined with epalastat in treatment of diabetic peripheral neuropathy is obvious, and can relieve the symptoms and pain of neuropathy, effectively protect nerve tissue, improve local blood microcirculation, and inhibit inflammatory responses. It is worthy of reference and application.

R971

湖北省卫生健康委员会中医药科研项目（ZY2021Q037）