鼠神经生长因子联合依帕司他及甲钴胺治疗糖尿病周围神经病变的临床观察

The clinical therapeutic observation of mouse nerve growth factor combined with epalrestat and mecobalamin in the patients with diabetic peripheral neuropathy

目的观察鼠神经生长因子联合依帕司他及甲钴胺治疗糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的疗效。方法选取160例DPN患者,随机分为A、B、C、D 4组,A组患者(对照组)仅给予甲钴胺治疗,B组患者给予甲钴胺+依帕司他治疗,C组患者给予甲钴胺+鼠神经生长因子治疗,D组患者给予鼠神经生长因子+依帕司他+甲钴胺治疗,疗程均为4 w,比较4组患者临床症状、神经传导速度、感觉定量检测变化情况及治疗有效率差异。结果 4组患者治疗后神经症状评分均下降(P<0.05),神经传导速度均增加(P<0.05),4个不同部位的温度觉阈值、振动觉阈值平均值均较治疗前明显改善(P<0.05);D组患者的神经症状评分下降程度、神经传导速度增加程度、温度觉阈值、振动觉阈值改善程度、治疗有效率均明显优于A组、B组、C组(P<0.05),B组、C组患者的神经症状评分下降程度、神经传导速度增加程度、温度觉阈值、振动觉阈值改善程度、治疗有效率均明显优于A组(P<0.05),B组患者与C组患者比较,差异无统计学意义(P>0.05)。结论鼠神经生长因子联合依帕司他及甲钴胺治疗DPN临床疗效显著。

Objective To observe the clinical efficiency of mouse nerve growth factor （mNGF） combined with epalrestat and mecobalamin in the patients with diabetic peripheral neuropathy（DPN）.Methods A total of 160 DPN patients who were diagnosed diabetes over 10 years were randomly divided into 4 groups. Group A received mecobalamin,Group B was given mecobalamin combined with epalrestat,Group C was given mecobalamin combined with mNGF,Group D received mecobalamin、epalrestat combined with mNGF injection. After 4 weeks,all patients’clinical symptoms and changes of nerve conduction velocity（NCV）,quantitative sensory testing（QST） were recorded. Effective rates were compared among all groups. Results The neurological symptom assessment score（NSS）in all four groups was reduced（P〈0.05）. NCV,the thermal threshold（TT） and vibratory threshold（VT） in all groups were improved（P〈0.05）. Group D had bigger reduction in NSS and improvement in NCV,TT,VT than group A,B and C（P〈0.05）. The total effective rate was higher in Group D compared with in A,B and C （P〈0.05）. The effective rate in Group B and C was much more than Group A （P〈0.05）.Conclusion Mecobalamin combined with mNGF and epalrestat was more effective in the treatment of DPN.