银杏达莫联合甲钴胺治疗糖尿病周围神经病变的临床分析

Clinical effects of ginkgo leaf extract and dipyridamole injection combined with methycobal on diabetic pcripheral neuropathy

目的 观察银杏达莫和甲钴胺联合治疗糖尿病周围神经病变的临床疗效.方法 将我院2006年1月至2008年12月收治的82例糖尿病周围神经病变的患者随机分为3组,在控制血糖、降压、降血脂等治疗基础上,银杏达莫组给予银杏达莫20 ml/d,甲钴胺组给予甲钴胺500μg/d静脉滴注,联合用药组同时给予银杏达莫20 ml/d＋甲钴胺500 μg/d静脉滴注,疗程均为4周.观察治疗前后3组患者临床症状、体征和神经传导速度的变化.结果 联合用药组总有效率达76.5%（26/34）,银杏达莫组和甲钴胺组总有效率分别为44.O%（11/25）及34.8%（8/23）,联合用药组与其他2组比较差异有统计学意义（P均〈0.05）;治疗后联合用药组神经传导速度较甲钴胺组和银杏达莫组明显改善（正中神经、腓总神经运动神经传导速度分别为（38.68±4.10）、（39.55±4.34）m/s与（34.35±2.74）、（32.78±2.66）m/s与（36.56±4.71）、（33.24±3.26）m/s;感觉神经传导速度分别为（37.44±4.42）、（34.26±4.01）m/s与（33.26±2.65）、（32.13±3.33）m/s与（34.80±4.43）、（31.04±4.62）m/s,P均〈0.05）.结论 银杏达莫联合甲钴胺可明显改善糖尿病周围神经病变的临床疗效.

Objective To investigate the effects of ginkgo leaf extract and dipyridamole injection combined with methycobal in treating diabetic peripheral neuropathy （DPN）.Methods From Jan.2006 to Dec.2008 in our hospital,Eighty-two patients with DPN were divided randomly into 3 groups：Group A （treated with ginkgo leaf extract and dipyridamole injection 20 ml/d saline dropping）,group B （treated with methycobal 500 μg/d for 4 weeks）,and group C（treated with 20 ml/d ginkgo leaf extract and dipyridamole injection and methycobal 500 μg/d with normal saline liquid vein dropping for 4 weeks）.Clinic symptom,physical sign and nerve conduction velocity （NCV） were assessed before and after treatment.Results The total effective rate was higher in group C （76.5%,26/34） than that in group A （44.O%,11/25） and group B （34.8%,8/23）（P〈0.05）.After treatment in group C,B and A,the motor nerve conduction velocity（MNCV） of median nerve was （38.68±4.10）m/s,（34.35±2.74）m/s and （36.56±4.71）m/s,the MVCN of nervus peroneus communis was （39.55±4.34）m/s,（32.78±2.66） m/s and （33.24±3.26） m/s,the sensory nerve conduction velocity （SNCV） of median nerve was （37.44±4.42）m/s,（33.26±2.65）m/s and （34.80±4.43）m/s,and the SNCV of nervus peroneus communis was （34.26±4.01）m/s,（32.13±3.33）m/s and （31.04±4.62）m/s.The improvement of NCV in group C was better thanthat of group A and B （P〈0.05）.Conclusions Ginkgo leaf extract and dipyridamole injection combined with methycobal can significantly improve the clinical efficiency of diabetic peripheral neuropathy.