大剂量甲钴胺联合胰激肽原酶对糖尿病周围神经损害恢复的影响

Effect on high dose mecobalamin and pancreatic kininogenase in the treatment of diabetic peripheral nerve damage recovery

目的探讨大剂量甲钴胺联合胰激肽原酶对糖尿病周围神经损害恢复的临床疗效。方法选取本院2008年11月～2011年11月收治的糖尿病周围神经损害患者64例,随机分为两组,采用维生素B12(肌内注射0.5mg/次,1次/d,疗程14d)和胰激肽原酶(口服120U/次,3次/d,疗程14d)治疗患者32例为对照组,采用甲钴胺(静脉滴注1500μg/250mL0.9%氯化钠注射液,1次/d,疗程14d)和胰激肽原酶治疗患者32例为观察组,比较两组患者治疗后的临床疗效和神经传导速度变化。结果观察组总有效率(96.9%)明显高于对照组(59.4%),观察组运动神经传导速度和感觉神经传导速度均明显高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率(12.5%)高于对照组(3.1%),但差异无统计学意义(P>0.05)。结论大剂量甲钴胺联合胰激肽原酶用于糖尿病周围神经损害治疗具有显著的临床疗效,可以明显提高神经传导速度且不良反应发生率较低,值得临床推广使用。

Objective To investigate the clinical efficacy on high dose mecobalamin and pancreatic kininogenase in the treatment of diabetic peripheral nerve damage recovery. Methods Sixty four patients with diabetic peripheral nerve damage were selected in the hospital from November 2008 to November 2011, who were randomly divided into two groups. 32 patients used Vitamin B12 （muscle injection, 0.5 mg/time, 1 time/d, course of 14 d） and pancreatic kininogenase （oral, 120 U/time, 3 times/d, course of 14 d ） in the treatment as the control group. 32 patients used mecobalamin （intravenous infusion,1 500μg/ 250 mL saline, 1 time/d, course of 14 d ） and pancreatic kininogenase in the treatment as the observation group. Clinical efficacy and nerve conduction velocity were compared between two groups after the treatment. Results Total effective rate in the observation group （96.9%） was significantly higher than that in the control group （59.4%）. The motor nerve conduc- tion velocity and sensory nerve conduction velocity in the observation group were significantly higher than those in the con- trol group. The difference was statistically significant （P 〈 0.05）. The incidence of adverse reactions in the observation group （12.5%） was higher than that in control group （3.1%）. The difference was not statistically significant （P 〉 0.05）. Conclusion High dose mecobalamin and pancreatic kininogenase in the treatment for diabetic peripheral nerve damage has significant clinical efficacy, which can obviously improve the nerve conduction velocity. The incidence of adverse reaction is lower. It is worthy of clinical use.