鼠神经生长因子联合甲钴胺治疗糖尿病周围神经病变的临床观察

Clinical observation of mouse nerve growth factor combined with Methylcobalamin in the treatment of diabetic peripheral neuropathy

目的：观察鼠神经生长因子（NGF）联合甲钴胺治疗糖尿病周围神经病变（DPN）的临床效果。方法：选择在我院接受治疗的DPN患者84例，随机分成观察组和对照组各42例，对照组单独给予甲钴胺治疗，观察组在此基础上增用鼠NGF治疗，疗程4周。比较治疗前后正中神经和腓总神经的运动传导速度（MNCV）、感觉传导速度（SNCV），血清高敏C反应蛋白（hs—CRP）及多伦多临床评分系统（TCSS评分）变化。结果：治疗前两组正中神经及腓总神经MNCV、SNCV比较，差异无统计学意义（P〉0．05）。治疗后两组的MNCv及SNCV均明显增加，观察组正中神经及腓总神经的MNCV、SNCV明显大于对照组，差异有统计学意义（P〈0．05）。治疗前两组的hs—CRP及TCSS评分比较，差异无统计学意义（P〉0．05）。治疗后两组hs—CRP无统计学差异，TCSS评分低于对照组，差异有统计学意义（P〈0．05）。观察组用药后的不良反应总发生率与对照组相比，差异无统计学意义（P〉0．05）。结论：联合应用甲钴胺以及鼠NGF治疗DPN患者，能够获得较好的疗效，安全性较高，值得在临床上给予推广应用。

Objective： To observe the effects of mouse nerve growth factor combined with Methylcobalamin in the treatment of diabetic peripheral neuropathy. Methods： A total of 84 cases of diabetic peripheral neuropathy treated in our hospital were selected and divided into observation group （42 cases） and control group （42 cases） randomly. The control group was treated with Mecobalamin alone, observation group was also given NGF treatment. After 4 weeks curative effect before and after the treatment were evaluated and compared including indexed of median nerve and peroneal nerve motor conduction velocity （MNCV） and sensory conduction velocity （SNCV） and high-sensitivity C-reactive protein （hs CRP） and Toronto clinical sco ring system （TCSS）, and after the drug adverse reactions. Results： Before treatment, the level of MNCV and SNCV of the two groups were not significantly different. After treatment, MNCV and SNCV levels of both groups were significantly increased, but median nerve and peroneal nerve MNCV and SNCV water average of the observation group were significantly higher than those in the control group, the difference was statistically significant （P〈 0.05）. The level of hs-CRP and TCSS before treatment in the two groups were not significantly different （P〉 0.05）. After treatment, there was no significant difference in hs-CRP. TCSS seore was significantly lower than that of control group （P〈 0.05）. The total adverse reaction rate of the observation group was 16.67% （7/42）, compared with the control group 7.14% （3/42）, the difference was not statistically significant （P〉 0.05）. Conclusion： Methycobal combined with mouse nerve growth factor （NGF） show better curative effects for DPN patients with great safety, it is worthy of popularization and application in clinic.