甲钴胺和胞磷胆碱片联用对糖尿病周围神经病变的疗效观察

Therapeutic effect of mecobalamine and citicoline on diabetic peripheral neuro-pathy:report of 120 cases

目的观察甲钴胺与胞磷胆碱片联用对糖尿病周围神经病变的疗效。方法 2010年10月至2011年10月间本院内分泌科收治的120例糖尿病周围神经病变患者随机分为两组(对照组60例和治疗组60例),均予降糖、降压、降脂治疗,对照组应用甲钴胺,治疗组联合应用甲钴胺和胞磷胆碱片,疗程共3个月,对比两组治疗前后血糖、血压、血脂水平,及糖尿病周围神经病变症状改善有效率和周围神经传导速率的差异。结果两组治疗后糖化血红蛋白(glycated hemoglobin Alc,HbA1c)、收缩压、舒张压、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)较治疗前均有显著下降(P<0.05),但两组之间无统计学差异(P>0.05);两组治疗后疼痛、麻木、感觉减退等症状改善均明显(P<0.05),而治疗组疗效更显著(P<0.05);两组治疗后正中神经、腓总神经、胫神经运动感觉传导速度均有统计学意义的增长(P<0.05),治疗组增长幅度更大,有统计学意义(P<0.05)。结论甲钴胺及胞磷胆碱片均可有效改善糖尿病周围神经病变症状和提高周围神经运动感觉传导速度,且两者联用有协同作用,能发挥更显著的疗效。

Objective To determine the effect of combined application of mecobalamine and citicoline to diabetic peripheral neuropathy. Methods A total of 120 patients with diabetic peripheral neuropathy admitted to our department from October 2010 to October 2011 were enrolled in this study. They were randomly as- signed into 2 matched groups. All patients were given conventional therapy to reduce blood sugar, blood pres- sure and blood grease. The control group （ n = 60 ） was given mecobalamine, while the experimental group （ n = 60 ） received combinative application of mecobalamine and citicoline. After 3-month treatment as a course, the effective power and speed of nerve conduction were compared between pre- and post-treatment. Results There was significant decrease in HbAlc, systolic pressure, diastolic pressure, TG, TC, LDL-C in the 2 groups after treatment （ P 〈 0.05 ）, but no difference was found between the 2 groups （ P 〉 0.05 ）. Symp- toms as pain, numbness and hypoaesthesia were obviously attenuated in the 2 groups （ P 〈 0. 05 ）, and more significant effect was seen in the experimental group （ P 〈 0. 05 ）. After the treatment, the velocity of motor nerve conduction was increased in the median nerve, common peroneal nerve, and tibial nerve in the 2 groups （P 〈 0. 05）, but that of experimental group was increased more （P 〈 0. 05 ）. Conclusion Both meeobalamine and citicoline can validly attenuate symptoms of diabetic peripheral neuropathy and improve the velocity of motor nerve conduction. Synergic effect is found when the 2 agents are combined together.