马来酸桂哌齐特联合腺苷钴胺治疗糖尿病下肢神经病变的疗效观察

目的探讨马来酸桂哌齐特联合腺苷钴胺治疗2型糖尿病患者合并下肢周围神经病变的效果。方法选择内分泌科及神经内科住院2型糖尿病合并下肢周围神经病变的病例40例,随机分腺苷钴胺治疗组(A组)和马来酸桂哌齐特联合腺苷钴胺治疗组(B组),各20例,疗程14d,观察患者治疗前后临床症状,测定血液流变学、肌电图及双下肢动脉血流动力学。结果 A组运动传导速度、感觉传导速度,以及临床症状有一定程度的改善,但差异无统计学意义(P>0.05),下肢血流速度无明显改善。B组治疗后运动传导速度、感觉传导速度明显增快,下肢血流速度增加,同时临床症状改善明显(P<0.01)。同时B组治疗后血小板聚集功能、红细胞聚集、血黏度降低,治疗前后比较差异有统计学意义(P<0.05)。结论马来酸桂哌齐特联合腺苷钴胺治疗在2型糖尿病合并下肢周围神经病变治疗中可缓解临床症状,改善周围神经功能及下肢血供。

Objective To evaluate the therapeutic effect of cinepazide maleate（CM） and cobamamide on diabetic peripheral neuropathy（DPN） in lower limb.Methods Forty diabetic patients with peripheral neuropathy in lower limb were randomly divided into two groups including control group（group A n=20,treated with cobamamide） and treatment group（group B n=20,treated with cinepazide mileage and cobamamide）.The course of treatment is 14 days.The clinical presentations were observed,biochemistry indexes and hemorrheology were examined,velocity of common nerve and ultrasonic Doppler of Blood vessel in low limps were tested pre-and post-therapy in both groups.Results There was a improvement in motor nerves conduction velocity MCV sensory nerves conduction velocity SCV and clinic presentation in group A but no significant change in group A（P0.05） after therapy.The blood flowing index number of low limps was no change.There was a significant improvement in MCV SCV clinic presentation and blood flowing index number of low limps in group B（P0.01） significant change in group B（P0.01） after therapy.Meanwhile platelet aggregation erythrocyte aggregability blood viscosity reduced in group B（P0.05） after therapy.Conclusion Combined therapy of cinepazide maleate and cobamamide can improve the clinic presentation,blood supply function and peripheral neuropathy in lower limb in diabetic patients.