硫酸锌联合甲钴胺治疗糖尿病周围神经病变的临床观察

Effect observation of zinc sulfate combined with mecobalamin on treatment of patients with diabetic peripheral neuropathy

目的探讨硫酸锌和甲钴胺单独应用及二者联合应用治疗糖尿病周围神经病变(DPN)的临床效果。方法选取DPN患者105例,随机分为硫酸锌组、甲钴胺组合联合组,每组35例,3组患者均给予控制血糖、血压等糖尿病综合治疗。分别应用硫酸锌片、甲钴胺片及硫酸锌片联合甲钴胺片治疗DPN,观察患者临床症状及体征,测定患者治疗1月后正中神经和腓总神经的运动传导速度(MNCV)和感觉传导速度(SNCV)。结果治疗后,联合组正中神经和腓总神经的MNCV均显著高于硫酸锌组和甲钴胺组(P<0.05);联合组正中神经SNCV显著高于硫酸锌组和甲钴胺组(p<0.05),联合组腓总神经的SNCV与硫酸锌组和甲钴胺组比较差异无统计学意义(P=0.259)。联合组临床总有效率显著高于其他2组(P=0.002)。结论硫酸锌联合甲钴胺片治疗DPN对正中神经和腓总神经MNCV及正中神经的SNCV改善程度要优于单独应用硫酸锌和甲钴胺片。

Objective To explore the clinical effect of zinc sulfate, mecobalamin and combined therapy on treatment of patients with diabetic peripheral neuropathy （ DPN）. Methods A total of 105 DPN patients were selected and randomly divided into zinc sulfate group, mecobalamin group and combined group, 35 cases in each group. All the patients were given conventional treatment such as blood glucose control, blood pressure control. On this basis, patients in the three groups were giv- en zinc sulfate tablets, mecobalamin tablets, and zinc sulfate plus mecobalamin tablets respectively. Clinical symptoms and signs were observed, and motor nerve conduction velocity （MNCV） and senso- ry nerve conduction velocity （SNCV） of median nerve and peroneal nerve were determined. Results After treatment, the MNCV values of median nerve and common peroneal nerve in combined group were significantly higher than those in zinc sulfate group and mecobalamin group （ P 〈 0.05 ）. The SNCV value of median nerve in combined group was significantly higher than that in zinc sulfate group and mecobalamin group （P 〈 0.05）. There was no significant difference in SNCV value of common peroneal nerve among three groups （P = 0. 259）. The total effective rate of the combined group was significantly higher than that of the other two groups （ P = 0. 002）. Conclusion Zinc sulfate com- bined with mecobalamin tablets is much better than single application of two drugs in improving SNCV of median nerve and peroneal nerve and SNCV of median nerve in treatment of patients with DPN.