B族维生素治疗尿毒症性神经病变的疗效观察

Clinical observation of vitamins B in treatment of uremic neuropathy

目的探讨B族维生素治疗尿毒症性神经病变的临床疗效。方法选取2011年12月—2013年12月在西安市西电集团医院治疗的尿毒症性神经病变患者180例,随机分为治疗组和对照组,每组90例。对照组行维持性血液透析并联合滤过治疗,治疗组患者在对照组基础上给予B族维生素,包括皮下注射维生素B12注射液500μg/次,肌肉注射维生素B1注射液100 mg/次,2次/周。两组均持续治疗3个月。比较两组患者治疗后神经病变的改善情况。结果治疗后,两组患者周围神经症状均得到改善,治疗组自发性疼痛、麻木、感觉消退和不安腿综合征的改善率均高于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者自主神经症状均得到改善,治疗组腹泻、低血压、排汗异常、睡眠障碍的改善率均高于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者胫神经、正中神经、腓总神经的感觉神经传导速度均有显著提高,同组治疗前后差异有统计学意义(P<0.05),且治疗后治疗组的改善程度优于对照组,两组比较差异有统计学意义(P<0.05)。结论 B族维生素治疗尿毒症性神经病变有较好的临床疗效,能够改善患者周围神经和自主神经症状,提高感觉神经传导速度,提高患者生存质量,值得临床推广应用。

Objective To investigate the clinical efficacy of vitamins B in the treatment of uremic neuropathy. Methods Patients with uremic neuropathy （180 cases） of Xi＇an XD Group Hospital from December 2011 to December 2013 were randomly divided into treatment and control groups （n = 90）. The patients in the control group were accepted maintenance hemodialysis and filtration treatment. The patients in the treatment group were given vitamins B, including sc administered with B12 Injection （0.5 mg/time）, and im administered with B1 Injection （100 mg/time）, twice one week. The patients in the two groups were treated continuously for 3 months. Situation of neuropathy improvement were compared between two groups after treatment. Results After treatment, peripheral nerve symptoms were improved in both groups, and the improvement rates of spontaneous pain, numbness, fade and restless legs syndrome in the treatment group were higher than those in the control group, with the significant difference between the two groups （P 〈 0.05）. After treatment, autonomic nerve symptoms were improved in two groups, and improvement rates of diarrhea, low blood pressure, abnormal sweating, and sleep disorders in the treatment group were higher than those in the control group, with the significant difference between the two groups （P 〈 0.05）. After treatment, sensory nerve conduction velocity of tibial nerve, median nerve, and phil total nerve were increased significantly in two groups, and the differences were statistically significant in the same group before and after the treatment （P 〈 0.05）. After treatment, situation improvement in treatment group was better than that in the control group, with the significant difference between the two groups （P 〈 0.05）. Conelusion Vitamins B has good curative effect in the treatment of uremic neuropathy, can improve peripheral nerve and autonomic nerve symptoms, while can improve the sensory nerve conduction velocity and the survival quality, which is worthy of clinical popularization and application.