上肢易卡压部位神经电生理检查对银杏达莫联合甲钴胺治疗糖尿病周围神经病作用的评估价值  

Neurophysiological study of nerve entrapment sites in the upper limbs---evaluation value in Ginkgo leaf extract and dipyridamole injection combined with methylcobalam improving nerve conduction in diabetic peripheral neuropathy

作　　者：王晓勤[1] 施晓耕 刘存杰[1] 王晓萍[1] 郑菊阳[3] 樊东升[3] 

机构地区：[1]河北联合大学附属医院神经外科,唐山063000 [2]广州中医药大学第二附属医院脑功能科,广州510405 [3]北京大学第三医院神经内科,北京100191

出　　处：《中华神经医学杂志》2013年第6期613-616,共4页Chinese Journal of Neuromedicine

基　　金：广东省自然科学基金（9451040701003684）

摘　　要：目的通过上肢易卡压部位神经电生理检查探讨银杏达莫联合甲钴胺对2型糖尿病患者周围神经病变的治疗作用。方法选择河北联合大学附属医院内分泌科自2008年1月至2011年6月收治的208例2型糖尿病合并糖尿病周围神经病（DPN）患者为研究对象，采用随机数字表法将其分为治疗组（103例1和对照组（105例1，2组患者同时采用糖尿病饮食、运动及降糖等基础治疗方案，对照组加用口服甲钴胺1000μg，每日3次；治疗组在对照组治疗基础上联合应用银杏达莫注射液20mL静脉滴注，每日1次。2组患者均连续应用4周。治疗前及治疗后4周，观察正中神经、尺神经感觉神经传导速度（SCV）、感觉神经电位（SNAP）、运动神经传导速度（MCV）、肌肉复合动作电位（CMAP）及远端潜伏期（DML）等指标变化。结果2组患者治疗后正中神经远端DML缩短、SCV增快、SNAP波幅增加，尺神经肘上下段MCV、SCV均较治疗前增快且SNAP波幅增高；治疗组各项指标均优于对照组，差异有统计学意义（P〈0．05）。结论易卡压部位神经电生理检查是评价DPN疗效的敏感指标，银杏达莫注射液与甲钴胺联合应用对于DPN具有良好的治疗作用。Objective To explore the effect of Ginkgo leaf extract and dipyridamole injection combined with methylcobalam on nerve conduction velocity of nerve entrapment sites in the upper limbs in patients with diabetic peripheral neuropathy （DPN）. Methods Two hundred and eight type 2 diabetic patients with DPN, admitted to our hospital from January 2008 to June 2011, were selected in our study, and randomly divided into an observation group （n=103） and a control group （n=105）. Dietary regulation, exercises and glucose control were conducted in both groups. In the control group, patients were given methylcobalamin at the dose of 1000 μg, three times a day. In the observation group, patients were given methylcobalamin （1000 Ixg, three times a day） plus Ginkgo leaf extract and dipyridamole injection of 20 mL once a day. All treatments lasted for four weeks. The sensory conduction velocity （SCV）, motor conduction velocity （MCV） and sensory nerve action potential （SNAP）, compound muscle action potential （CMAP） and distal motor latency （DML） of median and ulnar nerves were measured and compared before and four weeks after the treatments. Results The DML was shortened, and SCV and amplitude of median nerve were improved. Segmental MCV of above-below elbow, SCV and amplitudeof ulnar nerve were significantly improved in both groups after the treatments as compared with those before treatment （P〈0.05）; the total effective rate of the observation group was significantly higher than that of the control group （P〈0.05）. Conclusion The nerve electrophysiological characteristics of nerve compression sites in the upper limbs is sensitive for assessing injury and treatment effect in patients with DPN; the combination of Ginkgo leaf extract and dipyfidamole injection and methylcobalam is superior than methylcobalam alone in improving the nerve conduction of diabetic patients.

关 键 词：神经卡压 神经电生理 银杏达莫 甲钴胺 糖尿病周围神经病 

分 类 号：R587.2[医药卫生—内分泌]