甲钴胺治疗糖尿病神经病变临床观察

The effects of methylcobalamin on diabetic neuropathy

目的探讨甲钴胺对糖尿病神经病变的疗效。方法回顾性分析2004年2月至2006年8月笔者所在医院122例甲钴胺治疗的糖尿病神经病变患者的临床资料。结果注射4周后症状及体征即改善，121服8周后改善更明显；改善率分别为90．8％（下肢自发痛）、87．0％（上肢自发痛）、94．4％（感觉减退）和89．9％（麻木）；在治疗4周后，运动和感觉神经传导速度即已明显提高，并维持至12周；振动觉阈值在治疗4周后虽无明显变化，但在12周时明显下降；心脏自主神经功能测试在治疗4周和12周时无明显改善，仅有7例出现轻微副作用，但无1例因副作用退出治疗。结论甲钴胺是一种治疗糖尿病神经病变安全、有效的药物。

Objective To explore the effects of methyleabalamin on diabetic neuropathy. Methods The data of methyleobalamin treatment to 122 patients with diabetic neuropathy was analyzed retrospectively. Results The symptoms and signs improved after 4 weeks and more obviously after 8 weeks, with spontaneous pain of lower extremity 90. 8%, spontaneous pain of upper limb 87. 0% , feeling decline 94.4% and numbness 89. 9%. In the treatment of 4 weeks, the conduction velocity of motor and sensory nerve had been markedly improved, and maintained to 12 weeks; Vibration threshold didn＇t change significantly at 4 weeks, but at 12 weeks decreased significantly; There were no significant improvement of cardiac autonomic nerve function at 4 weeks and 12 weeks, only 7 cases with minor side effects, but no one withdrew because of side effects. Conclusion Methyleabalamin is safe and effective to diabetic neuropathy.