单唾液酸四己糖神经节苷脂钠与鼠神经生长因子治疗糖尿病周围神经病变的疗效比较

Comparison on the therapeutic effect of GM1 and mNGF in the treatment of diabetic peripheral neuropathy

目的探讨单唾液酸四己糖神经节苷脂钠(GM1)与鼠神经生长因子(mNGF)治疗糖尿病周围神经病变(DPN)的疗效比较。方法将120例患者分为三组,在控制血糖的基础上,对照组采用甲钴胺注射液,观察组分别采用GM1(观察组1)、mNGF(观察组2)治疗,疗程均为4周。治疗前后观察临床疗效,检测感觉神经传导速度(SCV)、运动神经传导速度(MCV)的变化及红细胞醛糖还原酶(AR)活性、血清中神经生长因子(NGF)、胰岛素生长因子-Ⅰ(IGF-Ⅰ)的含量变化。结果观察组治疗有效率(80%、77.5%)高于对照组(67.5%)(P<0.05),治疗后神经传导速度均高于对照组(P<0.05),且观察组1高于观察组2(P<0.05)。三组患者经治疗后,AR水平显著降低(P<0.01),NGF和IGF-Ⅰ显著升高(P<0.01)。观察组的AR低于对照组,NGF、IGF-Ⅰ高于对照组(P<0.05)。观察组2的NGF水平较前升高5.47倍,显著高于观察组1(P<0.01),但IGF-Ⅰ要低于观察组1 23.84 ng/L(P<0.05)。结论GM1治疗糖尿病周围神经病变疗效优于mNGF和甲钴胺。

Objective To evaluate the therapeutic-effect of-Monosialo four hexose ganglioside sodium （ GM1 ） and mouse nerve growth factor（mNGF） on diabetic peripheral neuropathy（DPN）. Methods 120 patients were divided into 3 groups based on the control of blood sugar. Patients in control group were injected by mecobalamine, and the patients in the two observation group respectively using GM1 （group 1 ） and mNGF （group 2）, treatment lasted for 4 weeks. The clinical curative effect of all patients were examined, including sensory nerve conduction velocity （ SCV）, motor nerve conduction velocity （ MCV）, the activity of AR was detected and the changes of NGF and IGF - I concentration were also detected. Results The effective rates of observation groups （80%, 77.5% ） were higher than control group （67.5 % ） （P 〈 0.05）. The nerve conduction velocity of observation groups were higher than the control group after treatment （P 〈 0. 05 ）, while group 1 was higher than group 2 （P 〈 0. 05 ）. After treatment, the level of AR were significantly reduced （P 〈 O. O1 ）, on the contrast NGF and IGF - I significantly increased （P 〈 O. O1 ） than before. The level of AR of observation groups were lower than the control group, and the contents of NGF and IGF - I were higher than the control group （ P 〈 O. 05）. The level of NGF of observation group 2 was 5.47 times higher than that before treatment, and it was significantly higher than the observation group 1 （P 〈0.01 ）, but the content of IGF - I was （23.84 ng/L） lower than observation group 1 （ P 〈 0. 05 ）. Conclusions The treatment effect of GM1 on diabetic peripheral neuropathy, was more obvious than mNGF and mecobalamine.