前列地尔联合腺苷钴胺治疗糖尿病周围神经病变30例疗效评价

Efficacy of Alprostadil Combined with Cobamamide for Treating Type 2 Diabetic Peripheral Neuropathy in 30 Cases

目的观察前列地尔联合腺苷钴胺治疗老年2型糖尿病周围神经病变的临床疗效。方法将60例患者随机分为对照组和观察组,各30例。两组患者均给予腺苷钴胺肌肉注射治疗,观察组加用前列地尔10μg溶于0.9%氯化钠注射液100 m L中静脉滴注,每日1次。3周为1个疗程,治疗1个疗程。观察两组患者治疗前后肌电图指标运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)、多伦多临床神经病变评分(TCSS)水平变化,评价临床疗效,记录不良反应变化。结果观察组总有效率为73.33%,显著高于对照组的50.00%(P<0.05);与对照组相比,观察组神经传导时间及神经病变情况显著下降(P<0.05);两组患者不良反应发生率有显著性差异(P<0.05)。结论前列地尔联合腺苷钴胺治疗老年2型糖尿病周围神经病变疗效显著,不良反应较少,值得临床推广。

Objective To observe tbe clinical efficacy of alprostadil combined witb cobamamide for treating elderly type 2 diabetic neu-ropatby（T2DN）. Methods Totally 60 elderly patients were randomly divided into tbe observation group and tbe control group,30 cases in eacb group. Tbe two groups were treated by intramuscular injection of cobamamide. Tbe treatment group was added witb alprostadil 10 μg,dissolving in 0. 9% sodium cbloride injection 100 mL by intravenous drip,once daily witb consecutive 3 weeks as 1 course of treatment. Tbe treatment lasted for 1 course. Tbe cbanges of electromyograpby（EMG） indexes motor nerve conduction velocity （MNCV） and sensory nerve conduction velocity（SNCV）,and Toronto clinical grading of neuropatby（TCSS）scores after treatment were observed in tbe two groups. Tbe clinical efficacy was evaluated and tbe adverse reactions were recorded. Results Tbe total effective rate in tbe ob-senation group was 73. 33%,wbicb was significantly bigber tban 50. 00% in tbe control group（ P 〈 0. 05）;compared witb tbe control group,tbe nerve conduction time and neuropatby in tbe treatment group were significantly decreased（ P 〈 0. 05）;tbe adverse reactions bad significant difference between tbe two groups （ P 〈 0. 05 ） . Conclusion Alprostadil combined witb cobamamide for treating elderly T2DN bas obvious effect and few adverse reactions,and deserves to be clinically promoted.