Effects of Red Light Irradiation Combined with Lower Extremity Muscle Strength Training on Lower Extremity Motor Function，TCSS Score and SOD Level in Patients with Diabetic Peripheral Neuropathy
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摘要:
目的 分析红光照射联合下肢肌力训练对糖尿病周围神经病变（DPN）患者下肢运动功能、多伦多临床评分系统（TCSS）评分及超氧化物歧化酶（SOD）水平的影响。 方法 选取合肥市第二人民医院2020年1月至2022年1月收治的100例DPN患者，按随机数字表法分为2组，观察组50例，采用红光照射治疗联合下肢肌力训练，对照组50例，仅行下肢肌力训练。统计分析2组临床疗效、下肢FMA评分、TCSS评分、SOD水平及神经传导速度数据。 结果 观察组临床总有效率为88.00%，显著高于对照组的66.00%，相比差异有统计意义（χ2 = 4.312，P = 0.038）；2组干预后 FMA评分及SOD水平明显升高（P < 0.001），TCSS评分明显下降（P < 0.001），2组干预后FMA评分、TCSS评分及SOD水平相比差异有统计意义（P < 0.01）；观察组干预后运动神经和感觉神经传导速度明显快于对照组，相比差异有统计意义（P < 0.05）。 结论 红光照射联合下肢肌力训练能够有效改善DPN患者神经病变状态，减轻氧化应激反应，提高神经传导速度，进而增强下肢运动功能。 Abstract:Objective To analyze the effect of red light irradiation combined with lower extremity muscle strength training on lower extremity motor function, Toronto Clinical Scoring System （TCSS） score and superoxide dismutase （SOD） level in patients with diabetic peripheral neuropathy （DPN）. Methods A total of 100 DPN patients admitted to our hospital from January 2020 to January 2022 were selected and divided into two groups according to the random number table method. 50 cases in the observation group received red light irradiation combined with lower limb muscle strength training, and 50 cases in the control group received the lower body strength training only. The clinical efficacy, lower extremity FMA score, TCSS score, SOD level and nerve conduction velocity data of the two groups were statistically analyzed. Results The total clinical effective rate of the observation group was 88.00%, which was significantly higher than that of the control group （66.00%）, and the difference was statistically significant （χ2 = 4.312, P = 0.038, P < 0.001）, the TCSS score was significantly decreased （P < 0.001）, and there were statistically significant differences in the FMA score, TCSS score and SOD level between the two groups after the intervention （P < 0.01）; The motor nerve and sensory nerve conduction velocity in the observation group after the intervention were significantly faster than those in the control group, and the difference was statistically significant （P < 0.05）. Conclusion Red light irradiation combined with lower extremity muscle strength training can effectively improve the neuropathy state of DPN patients, reduce oxidative stress, increase nerve conduction velocity, and then enhance the lower extremity motor function. -
表 1 2组基本临床资料比较[（
$ \bar x \pm s $ ）/n（%）]Table 1. Comparison of basic clinical data between two groups [（
$ \bar x \pm s $ ）/n（%）]项目 观察组（n = 50） 对照组（n = 50） χ2/t P 性别 男 30（60.00） 37（74.00） 0.439 0.508 女 20（40.00） 13（26.00） 年龄（岁） 64.97 ± 9.44 64.30 ± 9.60 0.352 0.726 BMI（kg/m2） 23.85 ± 2.50 24.06 ± 2.47 0.423 0.673 糖尿病病程（a） 7.80 ± 2.35 7.91 ± 2.33 0.235 0.815 DPN病程（a） 2.81 ± 1.54 2.68 ± 1.59 0.415 0.679 空腹血糖（mmol/L） 7.65 ± 2.24 7.71 ± 2.30 0.132 0.895 糖化血红蛋白（%） 8.31 ± 1.51 8.28 ± 1.49 0.100 0.921 
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表 2 2组临床疗效比较[n（%）]
Table 2. Comparison of clinical efficacy between two groups [n（%）]
组别 n 显效 有效 无效 总有效率(%) 观察组 50 26（52.00） 18（36.00） 6（12.00） 88.00 对照组 50 5（10.00） 28（56.00） 17（34.00） 66.00 χ2 4.312 P 0.038* *P < 0.05。
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表 3 2组FMA评分、TCSS评分及SOD水平比较（
$ \bar x \pm s $ ）Table 3. Comparison of FMA score，TCSS score and SOD level between the two groups （
$ \bar x \pm s $ ）组别 n FMA评分（分） TCSS评分（分） SOD（U/mL） 干预前 干预后 干预前 干预后 干预前 干预后 观察组 50 15.74 ± 1.73 30.47 ± 2.05 10.87 ± 2.03 7.21 ± 0.25 65.91 ± 8.15 100.05 ± 11.65 对照组 50 15.69 ± 1.75 26.71 ± 1.97 10.91 ± 2.01 8.69 ± 0.31 66.13 ± 8.21 93.65 ± 11.55 t 0.144 9.351 0.099 26.278 0.134 2.759 P 0.886 <0.001* 0.921 <0.001* 0.894 0.007* *P < 0.05。
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表 4 2组患者相关并发症累计发生率对比[（
$ \bar x \pm s $ ），m/s]Table 4. Comparison of cumulative incidence of related complications between two groups [（
$ \bar x \pm s $ ），m/s]组别 观察组 对照组 t P 运动神经床单速度 正中神经 干预前 43.52 ± 8.34 44.21 ± 8.72 0.404 0.687 干预后 52.37 ± 10.10 47.77 ± 9.83 2.308 0.023* 尺神经 干预前 42.18 ± 7.71 42.47 ± 8.31 0.181 0.857 干预后 51.07 ± 11.39 46.44 ± 9.23 2.233 0.028* 腓总神经 干预前 42.13 ± 7.11 42.81 ± 7.27 0.473 0.637 干预后 52.29 ± 9.35 47.27 ± 9.33 2.687 0.008* 感觉神经传导速度 正中神经 干预前 40.93 ± 6.11 41.02 ± 6.32 0.072 0.943 干预后 49.15 ± 9.07 44.85 ± 8.31 2.472 0.015* 尺神经 干预前 36.81 ± 4.17 37.07 ± 4.34 0.305 0.761 干预后 46.54 ± 8.11 42.18 ± 7.25 2.834 0.006* 腓总神经 干预前 38.55 ± 4.56 38.63 ± 4.62 0.087 0.931 干预后 47.26 ± 7.95 43.74 ± 7.71 2.248 0.027* *P < 0.05。
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