不同剂量甲钴胺联合前列地尔脂微球载体治疗糖尿病周围神经病变的疗效观察——附62例报告  

Efficacy of different dosage of combined mecobalamin and lipo-prostaglandin E1 therapy on diabetic peripheral neuropathy:a report of 62 cases

作　　者：徐谷根[1] 杨茵[1] 李敏[1] 欧阳文莺[1] 傅晓英[1] 

机构地区：[1]广东省第二人民医院内分泌科,510317

出　　处：《新医学》2010年第3期157-159,共3页Journal of New Medicine

摘　　要：目的:观察不同剂量甲钴胺联合前列地尔脂微球载体治疗糖尿病周围神经病变(DPN)的疗效。方法:92例DPN患者随机分为高剂量甲钴胺组(A组,31例)、常规剂量甲钴胺组(B组,31例)和对照组(C组,30例)。3组患者均采用饮食控制、口服降糖药或注射胰岛素治疗,并给予前列地尔脂微球载体制剂10μg静脉滴注,每日1次辅助治疗。在此基础上,A组予甲钴胺1000μg肌内注射,每日1次;B组予甲钴胺500μg肌内注射,隔日1次;对照组给予维生素B120.5mg肌内注射,每日1次。3组总疗程均为4周。比较3组的疗效及神经传导速度。结果:A组的显效率、总有效率分别为65%、97%,B组的显效率、总有效率分别为39%、84%,C组则分别为17%、57%,A、B组的显效率及总有效率均高于C组(P<0.01),其中A组的显效率及总有效率均优于B组(P<0.05)。A、B组治疗后的运动神经传导速度及感觉神经传导速度均比C组明显提高(P<0.01)。治疗过程中,A组出现轻度胃肠道不适1例,B组出现头晕1例、一过性静脉炎1例,均于停药后缓解。结论:甲钴胺联合前列地尔脂微球载体治疗DPN疗效良好,不良反应少,且高剂量甲钴胺疗效优于常规剂量甲钴胺。Objective ： To observe the efficacy of different dosage of mecobalamin therapy combined with lipoprostaglandin E1 （Lipo PGE1 ） on patients with diabetic peripheral neuropathy （DPN）. Methods： Ninety-two patients with DPN were randomly assigned into high-dose of mecobalamin group （ group A, n = 31 ） , regular-dose of mecobalamin group （group B, n = 31 ） and control group （group C, n = 30）. All patients were treated with alimentary control, oral blood glucose lowering drugs or insulin injection treatment, and intravenous injection of Lipo PGE1. In addition, mecobalamin 1 000μg intramuscular injection once a day, mecobalamin 500μg intramuscular injection q. o. d, and vitamin B120. 5 mg intramuscular injection once a day were given to patients in group A, B and C, respectively. The duration of treatment were 4 weeks for all groups. Efficacy and nerve conductive velocity were assessed for comparison. Results： The mecobalamin significantly increased the excellence rate and total effective rate in a dose-dependent manner in treating DPN, with 65% and 97% in group A, 39% and 84% in group B, 17% and 57% in group C. Furthermore, mecobalamin therapy groups showed significantly greater improvement in conduction velocities of motor and sensory nerves than the control group （P 〈 0. 01 ）. One case of mild gastro- intestinal symptom in group A, one case of dizziness and one case of transient phlebitis in group B were reported during the treatment, and all were resolved after drug withdrawal. Conclusion： Combination of mecobalamin and Lipo PGE1 has a curative effect for DPN, Furthermore, high dose meeobalamin is better than regular dose.

关 键 词：糖尿病 周围神经病变 甲钴胺 前列地尔脂微球载体制剂 

分 类 号：R587.2[医药卫生—内分泌]