大剂量甲钴胺联合α-硫辛酸对糖尿病周围神经病变患者周围神经传导功能的影响

Effect of High-dose Mecobalamine Combined with α-thioctic Acid on Peripheral Nerve Conduction Function of Diabetic Peripheral Neuropathy

目的探讨大剂量甲钴胺联合α-硫辛酸对糖尿病周围神经病变患者周围神经传导功能的影响。方法选取2013年4月至2014年4月新疆阿克苏地区第一人民医院收治的121例糖尿病周围神经病变患者为研究对象,按照随机数字表法分为对照组(n=57)和观察组(n=64)。对照组采用大剂量甲钴胺(1000μg)静脉滴注,每日1次,连续治疗14 d;观察组采用大剂量甲钴胺(1000μg)联合α-硫辛酸静脉滴注,每日1次,连续治疗14 d。比较两组患者的临床疗效、神经感觉传导速度(SNCV)、运动传导速度(MNCV)、密西根神经病变筛选表(MNSI)评分及不良反应发生情况。结果治疗后,观察组腓总神经的SNCV、MNCV高于对照组[(37.4±3.1)m/s比(31.8±1.7)m/s,(39.9±2.2)m/s比(36.0±0.9)m/s],正中神经的SNCV、MNCV高于对照组[(41.0±2.3)m/s比(36.1±1.1)m/s,(42.8±1.4)m/s比(38.8±0.8)m/s],差异有统计学意义(P<0.05)。观察组MNSI评分显著低于对照组比较[(3.8±1.2)分比(2.2±0.3)分],差异有统计学意义(P<0.05)。观察组总有效率高于对照组[93.7%(60/64)比77.2%(44/57)],差异有统计学意义(P<0.05),观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生率相比较差异无统计学意义(P>0.05)。结论采用大剂量甲钴胺联合α-硫辛酸治疗可有效改善糖尿病周围神经病变患者周围神经传导功能,值得临床推广使用。

Objective To evaluate the effect of high-dose mecobalamine combined with α-thioctic acid on peripheral nerve conduction function of diabetic peripheral neuropathy. Methods Total of 121 patients with diabetic peripheral neuropathy admitted to the First People＇s Hospital of Xinjiang Aksu Area during Apr. 2013 and Apr. 2014 were included in the study and divided into a control group （n =57） and an observation group （n = 64） according to the random number table method. High-dose mecobalamine （ 1000 μg, intravenous infu- sion,once per day for 14 days continuously） combined with α-thioctic acid were used in the observation group and high-dose mecobalamine alone（ 1000 μg,intravenous infusion,once per day for 14 days continuously） was used in the control group. The curative effect, nerve sensory conduction velocity （ SNCV ） , motor conduction velocity（MNCV） ,Michigan neuropethy screening table（MNSI） score and adverse reactions were compared between the two groups. Results After treatment, the SNCV and MNCV with common peroneal nerve of observation group were statistically higher than those of control group [ （37.4± 3.1 ） m/s vs （31.8 ± 1.7） m/s,（39.9±2.2） n,./s w （36.0 ±0.9） m/s], the SNCV and MNCV with median nerve were higherthan those of control group[ （41.0 ±2.3） m/s vs （36.1 ±1.1） m/s,（42.8 ±1.4） m/s vs （38.8 ± 0. 8 ） m/s ] （P 〈 0. 05 ）. The MNSI score of the observation group decreased significantly, statistically signifi- cantly different from the control group [ （3.8± 1.2） scores vs （2. 2 ± 0. 3 ） scores ] （P 〈0. 05 ）. The cura- tive effect of the observation group was significantly higher than control group I 93. 7% （60/64） vs 77.2% （44/57） ] （ P 〈 O. 05 ）. Incidence of adverse reactions of the two groups had no statistically significant differ- ence（ P 〉 0. 05 ）. Conclusion Using high-dose mecobalamine combined with α-thioctic acid can effectively improve the diabetic peripheral nerve conduction function,thus is worthy of the clinical promotion.