弥可保和维生素B_(12)治疗眼肌麻痹性斜视

Methylcobalamin for the treatment of paralytic strabismus comparing with Vitamine B_(12)

目的 对照观察弥可保和普通维生素B12治疗眼肌麻痹性斜视的临床效果,评估弥可保的治疗有效性和优越性。方法 96 例眼肌麻痹患者,随机分为弥可保治疗组52 例和普通维生素B 治疗组44 例。弥可保和普通维生素B 均以相同剂量500μg联合维生素B1 100 mg 1 次·d-1肌肉注射,连续3周,之后改口服剂量500μg联合维生素B1 10 mg 3次·d-1,分别在用药后每隔2 周随诊复查患者的主观症状、眼位偏斜和眼肌运动状况,以及复视相情况。结果 弥可保组治疗后痊愈39例,治疗后好转8 例,总有效率90.39%;普通维生素B12治疗组中痊愈31 例,治疗后好转6 例,总有效率84 09%;弥可保组的治愈率及总有效率均高于普通维生素B12治疗组,但2 组差异无显著性(P>0.05)。而弥可保组39例治愈者的疗程时间平均(6.77±3.48)周,较普通维生素B12组的(8.71±4.54)周明显缩短,2 组的治疗时间差异有显著性(P<0.05))。2组间在治疗各种不同原因所引起的眼肌麻痹的疗效上无明显差别。2 组的疗效均与致病原因、病损程度和病变范围等因素有关。结论 弥可保治疗眼肌麻痹性斜视的临床疗效是肯定的。它治疗的总有效率高于普通维生素B12,且治疗时间缩短。

Objective To compare the effect and advantage of methylcobalamin for the treatment of paralytic strabismus prospectively with Vitamine B_(12).Methods Ninty-six patients were randomized to receive either methylcobalamin (52 cases)or Vitamine B_(12) (44 cases).Firstly the intramuscular dosage was 500 μg once daily for three weeks and then kept the same dosage of methylcobalamin and 10 mg Vitamine B_(12) orally three times daily.All patients were followed with subjective symptoms,position of gaze,ocular movement and diplopia from 1 or 2 weeks to 1 month.Results Thirty-nine patients with methylcobalamin were recovered and 31 with Vitamine B_(12).Eight patients were improved with methycobalamin and 6 with Vitamine B_(12).The total percentage of effectiveness was 90.39% with methylcobalamin and 84.09% with Vitamine B_(12).There was no significant differences(P>0.05).The mean duration of treatment was(6.77±3.48)weeks with methylcobalamin and much shorter than(8.71±4.54)weeks with Vitamine B_(12).There were significant differences(P<0.05) and was related with the cause,severity and extension of the disease.Conclusion Methylcobalamin for the treatment of paralytic strabismus and diplopia is ascertaining and it is more effective than Vitamine B_(12) and the duration of treatment is much shorter.