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目的:以安慰剂为对照,观察神经妥乐平治疗痛性2型糖尿病神经病变的疗效。方法: 2型糖尿病神经病变病人40例,随机分为治疗组和对照组,各20例。分别静脉注射神经妥乐平或氯化钠注射液3mL,qd, 2wk,再口服神经妥乐平片剂或安慰剂(淀粉压片) 2片,bid, 10wk。比较治疗前后血糖、自发性神经痛、麻木、四肢神经传导速度、四肢末梢感觉定量等指标的改变。结果:治疗2wk,治疗组自发性神经痛有明显改善,视觉类比量表(VAS)评分下降(3. 9±s1. 3)分,P<0. 01;对照组无明显改变, 2组比较有显著差异,P<0. 01。疗程结束,治疗组自发性神经痛进一步减轻,VAS评分下降(5. 4±1. 4)分,降低幅度高于对照组( 2. 5±1. 4 )分,有73 % (11 /15 )的病人疼痛得到控制。67 %(10 /15)的病人麻木症状改善,疗效优于对照组,P<0. 01。四肢神经传导速度改变不明显,冷、热、振动觉得到不同程度的改善或延缓降低。治疗过程中未出现明显不良反应。结论:神经妥乐平对2型糖尿病神经损害的自发性疼痛有较好的疗效,对冷、热、振动感觉恢复有一定的作用。
OBJECTIVE: To compare the efficacy of neurotropin in the treatment of painful type 2 diabetic neuropathy with placebo as control. Methods: Forty patients with type 2 diabetic neuropathy were randomly divided into treatment group and control group, with 20 cases in each group. The rats were intravenously injected with 3 mL of neurotrauma or sodium chloride injection qd, 2wk, and then oral neurotropin tablets or placebo (starch tablet) 2 tablets bid 10wk. Before and after treatment, blood glucose, spontaneous neuralgia, numbness, limb nerve conduction velocity, peripheral sensory quantitative changes and other indicators. Results: After treatment for 2 weeks, the spontaneous neuralgia in the treatment group was significantly improved. The visual analog scale (VAS) score was decreased (3. 9 ± s 1.3), P <0.01; there was no significant change in the control group; There was a significant difference, P <0.01. At the end of the course of treatment, the spontaneous neuralgia in the treatment group was further reduced and the VAS score was decreased (5.4 ± 1.4) points, with a decrease of more than 2.5 ± 1.4 in the control group (73%, 11/15 ) Of patients with pain control. 67% (10/15) patients with numbness improved, the effect is better than the control group, P <0.01. Limb nerve conduction velocity change is not obvious, cold, heat, vibration felt different degrees of improvement or delay reduction. No obvious adverse reactions occurred during the treatment. CONCLUSION: Neurotropin has a good curative effect on spontaneous pain induced by nerve damage of type 2 diabetes, and has some effects on the recovery of sensation of cold, heat and vibration.