论文部分内容阅读
目的探讨甲钴胺联合依帕司他治疗2型糖尿病周围神经病变(DPN)的疗效及可能机制。方法选择符合1999年WHO制定的糖尿病诊断标准,及2009年中国医师协会内分泌代谢科医师提出的DPN诊断标准的2型糖尿病合并周围神经病变患者90例。按照1∶1∶1的比例随机分成甲钴胺治疗(M)组,依帕司他(E)组及甲钴胺联合依帕司他(M+E)组。每组30例。3组患者均在有效控制血糖的基础上,分别给予甲钴胺、依帕司他、甲钴胺加依帕司他治疗12周。观察患者治疗前后症状改善情况及神经传导速度等变化。结果治疗12周后,M、E、M+E组显效率分别为13.33%、20.68%、27.59%,有效率分别为20%、17.85%、37.93%,总有效率分别为33.33%、39.28%、65.51%。M+E组总有效率明显高于M、E组,差异有统计学意义(P<0.05)。3组患者治疗后感觉神经传导速度(SNCV)和运动神经传导速度(MNCV)均较治疗前明显增快(P<0.01),且提高幅度M+E组较M、E组大(P<0.05)。结论甲钴胺与依帕司他均可改善DPN患者的症状及周围神经传导速度,但两者联用效率更高,传导速度改善更明显。
Objective To investigate the efficacy and possible mechanism of mecobalamin combined with epalrestat in the treatment of type 2 diabetic peripheral neuropathy (DPN). Methods Ninety patients with type 2 diabetes mellitus and peripheral neuropathy were selected according to the diagnostic criteria of diabetes developed by WHO in 1999 and DPN diagnostic criteria proposed by endocrinologists and physicians of Chinese Medical Association in 2009. The rats were randomly divided into 1 group: Mecobalamin (M) group, Epalrestat (E) group and Mecobalamin group (M + E). 30 cases in each group. All three groups were given mecobalamin, epalrestat, mecobalamin plus epalrestat for 12 weeks on the basis of effective blood glucose control. Observed before and after treatment in patients with symptoms and nerve conduction velocity and other changes. Results After 12 weeks of treatment, the effective rates of M, E and M + E groups were 13.33%, 20.68% and 27.59%, respectively. The effective rates were 20%, 17.85% and 37.93% respectively. The total effective rates were 33.33% and 39.28% , 65.51%. The total effective rate of M + E group was significantly higher than that of M and E groups, the difference was statistically significant (P <0.05). The sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) of three groups were significantly higher than those before treatment (P <0.01), and the magnitude of increase was higher in M + E group than in M and E groups ). Conclusion Both mecobalamin and epalrestat can improve the symptoms and peripheral nerve conduction velocity in patients with DPN, but the combination of mecobalamin and epalrestat is more efficient and the conduction velocity is more obviously improved.