甲钴胺治疗糖尿病神经病变的临床观察

Effect of mecobalamin on diabetic neuropathies

目的观察甲钴胺对糖尿病神经病变的疗效。方法对１０８例糖尿病神经病变患者进行随机阳性对照临床观察，治疗组以甲钴胺治疗，５００μｇ肌注每周３次，４周后改口服，５００μｇ每日３次，服８周。对照组前４周以维生素Ｂ１２５００μｇ肌注每周３次，第５～１２周服腺苷辅酶Ｂ１２５００μｇ每日３次。结果治疗组自发肢体疼痛、麻木改善率达７３％及７５％，明显高于对照组的３６％及４５％，感觉减退、发热、发冷、口干、排尿障碍改善也优于对照组（５５％比２５％、５２％比１８％、５９％比３０％、５３％比１９％、６３％比２０％）；神经反射及传导障碍也有一定程度改善。且未见明显副作用。结论甲钴胺是糖尿病神经病变治疗中值得一试的安全药物。

Objective To investigate the effect of mecobalamin on diabetic neuropathies. Methods One hundred and eight patients with non insulin dependent diabetes mellitus were involved in a randomized positive control clinical trial. 62 cases were treated with mecobalamin 500 μg intramuscularly three times a week for four weeks then followed by 500 μg orally three times a day for additional eight weeks. 46 cases were treated with vitamin B 12 in the same way and served as controls. Results Twelve weeks after the treatment, spontaneous pain and numbness of limbs were improved by 73% and 75% in the mecobalamin group, which were much higher than those in the controls (36% and 45% respectively). Hypoesthesia, hotness, coldness, oral dryness and dysuria showed better response in the mecobalamin group than in the controls (55% vs 25%、52% vs 18%、59% vs 30%、53% vs 19%、63% vs 20% respectively). Mecobalamin also benefited nerve reflection and conduction velocity to a certain extent. No obvious side effects were found. Conclusion Mecobalamin might be worthy of use as a safe agent in the treatment of diabetic neuropathies.