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目的:探讨不同剂量甲钴胺联合单唾液酸四己糖神经节苷脂(GM1)治疗糖尿病周围神经病变的疗效。方法:收取2013年3月至2016年3月我院收治的糖尿病周围神经病变患者116例作为研究对象,按照随机数字表法分为A、B组各58例。A组患者使用高剂量甲钴胺联合GM1治疗,B组患者使用常规剂量甲钴胺联合GM1治疗。对两组治疗效果、神经电生理、不良反应以及患者生活质量进行观察与比较。结果:A组患者治疗显效率和总有效率分别为63.79%和96.55%,显著高于B组的39.66%和84.48%,差异有统计学意义(P<0.05)。治疗后两组患者腓神经及正中神经运动神经传导速度(MCV)以及感觉神经传导速度(SCV)均显著提高,与治疗前相比有显著差异,且A组变化幅度明显高于B组,差异有统计学意义(P<0.05)。A组不良反应发生率为6.70%,B组为3.45%,两组相较差异不显著(P>0.05)。治疗后A组生活质量得分高于B组,差异有统计学意义(P<0.05)。结论:高剂量甲钴胺联合GM1治疗糖尿病周围神经病变与常规剂量相比具有更好的疗效,有助于患者生活质量的提高,值得临床推广应用。
Objective: To investigate the efficacy of different dosages of mecobalamin combined with monosialotetrahexosyl ganglioside (GM1) in the treatment of diabetic peripheral neuropathy. Methods: One hundred and sixty-six patients with diabetic peripheral neuropathy admitted to our hospital from March 2013 to March 2016 were enrolled in this study. According to the random number table, 58 patients were divided into A and B groups. Patients in group A were treated with high-dose mecobalamin in combination with GM1, and patients in group B were treated with conventional mecobalamin and GM1. The therapeutic effects, neuroelectrophysiology, adverse reactions and quality of life of the two groups were observed and compared. Results: The effective rate and total effective rate of group A were 63.79% and 96.55% respectively, which was significantly higher than that of group B (39.66% and 84.48%, P <0.05). After treatment, the motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) in the two groups were significantly increased compared with those before treatment, and the changes in group A were significantly higher than those in group B There was statistical significance (P <0.05). The incidence of adverse reactions in group A was 6.70%, while in group B was 3.45%, there was no significant difference between the two groups (P> 0.05). After treatment, the quality of life in group A was higher than that in group B, the difference was statistically significant (P <0.05). CONCLUSION: High dose of mecobalamin combined with GM1 in diabetic peripheral neuropathy has better curative effect than conventional dose, which is helpful to improve the quality of life of patients and deserves clinical application.