| Objective To observe the effect of berberine hydrochloride tablets combined with metformin on the maximum thickness of sural nerve bundle and 8-OHDG in type 2 diabetic peripheral neuropathy.Methods All patients were randomly divided into metformin group(n=30 cases)and combination group(n=30 cases)with partial consideration of patients’ wishes.Patients in the metformin group were treated with metformin only,1.0g,oral administration,bid.The course of treatment is 6months.Patients in the combination group were treated with metformin and berberine hydrochloride.Metformin was 1.0g,oral,bid,berberine hydrochloride 0.5g,oral,tid,and the course of treatment was 6months.Observed two groups of patients with basic situation,including the proportion of gender,age,Course of disease,BMI,diastolic blood pressure and systolic blood pressure,fasting blood sugar,2 h postprandial blood glucose,Hb A1 c and urine 8-OHd G,MDA,gsh-px,SOD,and adjacent to the organization boundary unclear not pure,screen mesh structure,decreased nerve beam echo,epineurium fuzzy,sural nerve thick diameter width,sural nerve and sural nerve cross-sectional area,etc.Levels of oxidative stress:Urine levels of 8-OHDG,MDA,GSH-PX and SOD were observed before and after treatment in the two groups.Sural nerve ultrasound indicators: Abnormal signs such as unclear boundary with adjacent tissues,unclear ethmoid structure,decreased echo of nerve bundle,and fuzzy epineurium of nerve were observed before and after treatment in the two groups,as well as thick diameter of sural nerve bundle,transverse diameter of sural nerve,and sural nerve sectional area.Correlation analysis: the correlation between the difference in thickness and diameter before and after treatment and the difference in nerve conduction velocity between the metformin group and the combined treatment group(common peroneal sensory nerve,common peroneal motor nerve,median nerve sensory nerve,median nerve motor nerve).Adverse reactions: The occurrence of adverse reactions,such as vomiting,nausea,fever and rash,etc.during treatment in the two groups were observed.Results 1.Basic situation of two groups of patients before treatment,such as age,sex ratio,Course of disease,BMI,blood pressure,systolic blood pressure,fasting glucose,2 h postprandial blood glucose,Hb A1 c,urine 8-OHd G,MDA,gsh-px,SOD,and adjacent to the organization boundary is not clear,screen mesh structure is not clear,decreased nerve beam echo,epineurium fuzzy,sural nerve thick diameter width,sural nerve and sural nerve cross-sectional area such as general data contrast had no statistical difference(P > 0.05),both groups were comparable.2.There was no significant difference between the two groups in urine8-OHDG,blood MDA,GSH-PX and SOD before treatment.After treatment,the levels of 8-OHDG and MDA in the combined group were significantly lower than those in the metformin group,and the levels of GSH-PX and SOD were significantly higher than those in the metformin group.Besides,the levels of 8-OHDG and MDA after treatment were significantly lower than those before treatment in the two groups,and the levels of GSH-PX and SOD were significantly higher than those before treatment in both groups,with statistical differences(P < 0.05).3.All the 60 patients were examined by sural nerve ultrasonography before and after treatment,and satisfactory ultrasound images were obtained.The ultrasonographic manifestations of the sural nerve of the patients were as follows: unclear boundary between the adjacent tissues and the epineurium,unclear sievelike structure,decreased internal echo of the nerve,disappearance of punctal echo or indistinct echo of the nerve.Two groups of patients before treatment of sural nerve anomaly characteristics of the ultrasonic,such as screen mesh and adjacent to the organization boundary is not clear,structure is not clear,decreased nerve beam echo,epineurium fuzzy contrast had no obvious difference,the anomaly characteristics of the joint group of patients after treatment of such proportion were significantly lower than the metformin group,and the anomaly characteristics of the two groups after treatment in patients with various ultrasonic scale were significantly lower than before each treatment,and were statistically significant(P < 0.05).4.Two groups of patients before treatment of sural nerve the ultrasonic measurement values,such as thickness to diameter,transverse diameter and cross-sectional area contrast had no statistical difference(P > 0.05),the joint group of patients after treatment the ultrasonic measurements were significantly lower than the metformin group,two groups after treatment in patients with the ultrasonic measurements were significantly lower than the before each treatment,and were statistically significant(P < 0.05).5.Pearson correlation was used to analyze the correlation between the difference in thickness and diameter before and after treatment and the difference in nerve conduction velocity(common peroneal nerve sensory nerve,common peroneal nerve motor nerve,median nerve sensory nerve,median nerve motor nerve)in the metformin group and the combined treatment group.The results showed that for the two treatment methods,the difference in thickness and diameter before and after treatment was positively correlated with the difference in nerve conduction velocity.6.No adverse reactions such as vomiting,nausea,fever and rash occurred during the treatment in both groups.Conclusion Berberine hydrochloride combined with metformin can better improve the level of oxidative stress,correct the abnormal characteristics of the sural nerve ultrasonography,and improve the measured values of the sural nerve ultrasonography,which is a safe,effective and effective treatment method for type 2 diabetes patients with peripheral neuropathy.High frequency ultrasonic testing sural nerve maximum thickness to diameter can be used as type 2 diabetes peripheral neuropathy in early diagnosis and curative effect of monitoring measurements. |
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