糖尿病周围神经病变应用不同药物治疗的疗效分析

Application of Diabetic Peripheral Neuropathy Efficacy of Different Drugs

目的观察胰岛素、复方丹参联合美西律和弥可保与前列腺素E1(PGEl)联合治疗糖尿病周围神经病变的临床疗效。方法 58例糖尿病合并周围神经病变患者随机分为胰岛素组和弥可保组,胰岛素组:给予胰岛素16～56 U/d皮下注射,待患者空腹血糖正常,连续三次尿糖阴性时改用小剂量优降糖2.5mg/d,三餐前30min口服,同时每天1次静脉滴注复方丹参20ml,美西律200mg,3次/d口服4,周1个疗程。弥可保组组用弥可保500μg肌注,每日1次,连用4周后改为隔日1次,总疗程12周,前列腺素El 10ml静脉注射,每日1次,连用2周。结果胰岛素组显效26例,占86.7%,好转3例,占10%,无效1例,占3%。总有效率为96.7%。弥可保组显效17例,占60.7%,好转7例,占25%,无效4例,占14.3%。总有效率为80.0%。两组在显效率和总有效率上相比较差异有统计学意义,P<0.05。结论胰岛素、复方丹参联合美西律治疗糖尿病合并周围神经病变疗效可靠,毒副反应小,适合推广。

Objective To observe clinical of Danshen united mexiletine and methylcobalamin and prostaglandin E1（PGEl） for treatment of diabetic peripheral neuropathy efficacy.Methods Totally 58 patients with diabetic peripheral neuropathy were randomly divided into groups and methylcobalamin insulin group,insulin group：insulin,16～56U/d subcutaneously when patients with normal fasting blood glucose and three consecutive negative urine use small doses of Youjiangtang 2.5 mg/d,orally 30 min before meals,and daily intravenous infusion of Danshen 1 20ml,mexiletine 200 mg,3 times/d,4 weeks of a course of treatment.Methylcobalamin group with Methylcobalamin 500 μg intramuscularly,1 day,4 weeks later changed to every other day 1 time,total 12 weeks,prostaglandin El 10 ml intravenous injection,one daily,once every 2 weeks.Results 26 cases markedly insulin group,accounting for 86.7%,improved in 3 cases,accounting for 10%,1 patient no effect,3%.The total effective rate was 96.7%.In Methylcobalamin group 17 cases markedly,accounting for 60.7%,improved in 7 cases,25%,4 cases no effect,accounting for 14.3%.The total effective rate was 80.0%.The two groups in markedly effective rate and total efficiency compartion has statistically significant difference,P0.05.Conclusion Insulin,Danshen united mexiletine for treatment of diabetic peripheral neuropathy is reliable toxicity is small,suitable for promotion.