前列地尔联合甲钴胺治疗糖尿病周围神经病变的临床观察

Clinical Observation of Alprostadil Combining with Mecobalamine Treating Diabetic Peripheral Neuropathy

目的:观察前列地尔联合甲钴胺治疗糖尿病周围神经病变(Diabetic perineuropathy,DPN)的临床疗效。方法:选取2010—2016年在我科住院治疗的DPN患者132例;根据治疗方式的不同随机分为试验组和对照组;试验组选用前列地尔联合甲钴胺进行治疗,对照组选用甲钴胺单药进行治疗;观察两组治疗前后的运动神经传导速度(Motor nerve conduction velocity,MCV)、感觉神经传导速度(Sensory nerve conduction velocity,SCV)、多伦多临床评分系统(Toronto clinical scoring system,TCSS)的评分情况及临床疗效。结果:(1)两组治疗后正中神经及腓总神经MCV、SCV较治疗前均明显改善(P<0.05),治疗后试验组与对照组正中神经和腓总神经的MCV、SCV比较差异无统计学意义(P>0.05);(2)两组治疗后TCSS评分均明显降低,差异有统计学意义(P<0.05),治疗后两组间比较差异无统计学意义(P>0.05);(3)两组患者治疗后总有效率差异无统计学意义(P>0.05)。结论:前列地尔联合甲钴胺治疗糖尿病周围神经病变疗效确切,但短期的联合用药与单独使用甲钴胺比较,并不能明显提高临床治疗效果。

Objective： To observe the clinical efficacy of Alprostadil combining with Mecobalamine treating the diabetic peripheral neuropathy（ DPN）. Methods： Choosing 132 patients with DPN who were randomly divided into two groups（ experiment and control group）,the experiment group was cured by Alprostadil and Mecobalamine,the control group was cured by Mecobalamin only. Observing the median nerve and peroneal nerve＇MCV,SCV,the TCSS and the clinical efficacy before and after treatment. Results：（ 1） After curation,MCV,SCV of the median nerve and peroneal nerve improve significantly（ P 〈0. 05）,which have no difference between the two groups（ P〉0. 05）;（ 2） after curation,the TCSS reduces significantly（ P〈 0. 05）,which have no difference between the two groups（ P〉0. 05）;（ 3） after curation,the total effective patients have no difference between the two groups（ P〉0. 05）. Conclusion： Alprostadil combining with Mecobalamine is safty and effective to treat the diabetic peripheral neuropathy; but short-term Alprostadil combining with Mecobalamine can ＇t improve the clinical curing effect obviously than using Mecobalamine only.