叶酸联合双氯芬酸钠治疗叶酸缺乏所致痛性周围神经病变患者的疗效

Effect of folic acid and diclofenac sodium in the treatment of painful peripheral neuropathy caused by deficiency of folic acid

目的比较双氯芬酸钠结合叶酸与单纯叶酸补充疗法治疗痛性周围神经病变的效果。方法叶酸缺乏所致痛性周围神经病变患者114例，随机分为单纯叶酸补充疗法组（叶酸组，n=57）和双氯芬酸钠联合叶酸补充疗法组（联合组，n=57），于治疗前和治疗结束后采用神经病变多伦多临床评分系统及肌电图与VAS评估患者神经损伤及疼痛程度，记录患者夜间睡眠时间，并在治疗前后对患者行血清叶酸浓度测定。结果治疗后联合组总有效率93．0％（53／57例）高于叶酸组91．2％（52／57例），但差异无统计学意义（P〉0．05）。组间比较治疗后多伦多神经病变评分症状项差值、夜间睡眠时间及VAS评分的比较差异有统计学意义（P〈0．05）。结论双氯芬酸钠结合叶酸补充疗法治疗叶酸缺乏所致痛性周围神经病变，在缓解症状及疼痛方面优于单纯叶酸补充疗法。

Objective To observe the effect of folic acid replacement therapy with or without diclofenac sodium in the treatment of painful peripheral neuropathy caused by deficiency of folic acid. Methods One hundred and fourteen patients with folic acid deficiency painful peripheral neuropathy were randomly divided into 2 groups, only folic acid replacement therapy group （folic acid group） and dielofenac sodium with folic acid replacement therapy group （combined group）, 57 patients in each group. Nerve injury and pain intensity were evaluated with eleetromyogram and VAS before and after the treatment, and evaluated by Toronto clinical scoring system （TCSS） for neuropathy. Patients＇ night sleep time, serum folic acid concentration were recorded. Results The effective rate in combined group （93.0%, 53/57 cases） is slightly better than that in folie acid group （91.2%, 52/57 cases） , but there was no statistical significance （P 〉 0.05）. The symptom difference of TCSS for neuropathy, night sleep time and VAS difference between the two groups after treatment were of statistical significance （P 〈 0.05）. Conclusion Relieving symptom and pain with diclofenac sodium and folic acid replacement therapy is better than only folio acid replacement therapy in treating peripheral neuropathy caused by folic acid deficiency.