加巴喷丁联合腺苷钴胺治疗糖尿病痛性神经病变的临床初步观察  

An observational study of the combination therapy of Gabapentin and Cobamamide in treatment of painful diabetic neuropathy

作　　者：王爱荣[1] 马云龙[1] 刘波涛[2] 

机构地区：[1]北京市和平里医院麻醉科,100013 [2]中日友好医院疼痛科

出　　处：《中国糖尿病杂志》2017年第5期420-423,共4页Chinese Journal of Diabetes

摘　　要：目的观察加巴喷丁联合腺苷钴胺治疗糖尿病痛性神经病变(PDN)的临床初步效果。方法选取已确诊PDN的T2DM患者96例,随机分为对照组(Con)、腺苷钴胺组、加巴喷丁+腺苷钴胺组,每组各32例,均积极控制FPG和HbA_1c。Con组予维生素B_1治疗。收集临床和生化资料,视觉模拟评分(VAS)评估疼痛程度,肌电图检查评估正中神经和腓总神经运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)的变化,匹兹堡睡眠质量指数量表(PSQI)评估睡眠质量。结果治疗前各组MNCV、SNCV和疼痛程度比较,差异无统计学意义(P>0.05);治疗后腺苷钴胺组、加巴喷丁+腺苷钴胺组均有改善,且加巴喷丁+腺苷钴胺组MNCV、SNCV高于腺苷钴胺组,VAS低于腺苷钴胺组(P<0.05)。Con组改善不明显(P>0.05)。结论加巴喷丁联合腺苷钴胺治疗PDN可减轻疼痛、提高神经传导速度和改善睡眠质量。Objective To investigate the effect of combination therapy of Gabapentin and Cobamamide in treatment of painful diabetic neuropathy （PDN）. Methods A total of 96 patients with type 2 diabetes （T2DM） and PDN were enrolled in this study and randomly divided into control group （Con,n=32）, Cobamamide group, （n = 32）, and Gabapentin＋ Cobamamide group, （n= 32）. FPG and HbA1 c were actively controlled in each group. Con group was treated with vitamin Ba. Clinical and biochemical data of all the subjects were collected. The degree of pain was assessed by visual analogue scale （VAS）. The changes of median nerve, peroneal nerve motor nerve conduction velocity （MNCV）, and sensory nerve conduction velocity （SNCV） were evaluated by EMG assessment. The assessment of sleep quality was done by Pittsburgh sleep quality index scale （PSQI）. Results There was no significant differences of baseline MNCV, SNCV and the degree of pain among the three groups （P〉0.05）. After treatment,all the above index were improved in both Cobamamide group and Gabapentin＋Cobamamide group. MNCV and SNCV were higher in Gabapentin＋Cobamamide group than in Cobamamide group （P 〈0. 05）. There were no significantly improvement of MNCV and SNCV in Con group （P〉0.05）. Conclusion The combination therapy of Gahapentin and adenosine cobalt amine could reduce pain, improve nerve conduction velocity, and improve the quality of sleep.

关 键 词：加巴喷丁 糖尿病痛性神经病变 疼痛程度 神经传导速度 睡眠 

分 类 号：R587.2[医药卫生—内分泌]