大剂量甲钴胺联合灯盏花注射液治疗糖尿病足对 TNF-α、CRP 水平及 AT-Ⅲ活性的影响

摘要

目的：观察大剂量甲钴胺联合灯盏花注射液对糖尿病足（DF）患者血清肿瘤坏死因子-α（TNF-α）、C 反应蛋白（CRP）水平及抗凝血酶Ⅲ（AT-Ⅲ）活性的影响。方法240例 DF 患者按随机数字表法分为4组：大剂量甲钴胺＋灯盏花注射液治疗组60例（Ⅳ组），常规剂量甲钴胺＋灯盏花注射液治疗组60例（Ⅲ组），单纯灯盏花注射液治疗组60例（Ⅱ组），单纯常规剂量甲钴胺治疗组60例（Ⅰ组），4周为1疗程。治疗前后检测 TNF-α、CRP 水平及 AT-Ⅲ活性并进行对比分析。结果治疗前4组血清TNF-α、CRP 及 AT-Ⅲ检测结果之间差异无统计学意义（P ＞0．05）；分别行治疗前后比较，4组治疗后血清 TNF-α及 CRP 结果均较治疗前降低，AT-Ⅲ水平升高，差异有统计学意义（P ＜0．05）；Ⅳ组与Ⅰ、Ⅱ、Ⅲ组治疗后比较，差异有统计学意义（P ＜0．05）。结论甲钴胺联合灯盏花注射液能降低 DF 患者血清中炎性因子如 TNF-α及 CRP 的水平，并使 AT-Ⅲ活性升高，尤其是甲钴胺浓度增加时效果更显著。因此，采取增加甲钴胺浓度联合灯盏花注射液的治疗方法能更明显地降低 DF 的炎症反应，且安全性好，是提高治疗 DF 的有效手段之一。%Objective To observe the influence of large dose of mecobalamin combining with breviscapin injection on the levels of serum tumor necrosis factor-α(TNF-α)and C-reactive protein (CRP)and the antithrombin Ⅲ(AT-Ⅲ)activity in the patients with diabetic foot(DF).Methods 240 cases of DF were divided into 4 groups according to the random number table method,60 cases in each group:the large dose of mecobalamin plus breviscapin injection group (group Ⅳ);the routine dose of mecobalamin plus brevis-capin injection group (group Ⅲ);the simple breviscapin injection group (group Ⅱ)and the routine dose of mecobalamin group (groupⅠ).4 weeks were taken as a course of treatment.The TNF-α,CRP levels and the AT-Ⅲ activity before and after the treat-ment were detected and performed the comparative analysis.Results The levels of TNF-α,CRP and AT-Ⅲ before treatment had no statistically significant differences among in the four groups (P >0.05).Compared with the results before treatment,the levels of TNF-αand CRP after treatment in 4 groups were obviously decreased and the AT-Ⅲ level was significantly increased,the differ-ences had statistical significance (P <0.05);compared with the group Ⅰ,Ⅱ and Ⅲ,the difference in the group Ⅳ had statistical significance(P <0.05).Conclusion Mecobalamin combined with breviscapin injection is able to decrease the serum inflammatory factors such as TNF-αand CRP,and increase the AT-Ⅲ activity in the patients with DF,which is more significant when increasing the mecobalamin concentration.Therefore,adopting the therapeutical scheme of increasing the mecobalamin concentration combined with breviscapin injection could obviously decrease the inflammatory reaction of DF with good safety,which is one of effective meas-ures for increasing the curative effect of DF.