摘要
目的探讨甲钴胺联合依帕司他治疗2型糖尿病周围神经病变(DPN)的疗效及可能机制。方法选择符合1999年WHO制定的糖尿病诊断标准,及2009年中国医师协会内分泌代谢科医师提出的DPN诊断标准的2型糖尿病合并周围神经病变患者90例。按照1∶1∶1的比例随机分成甲钴胺治疗(M)组,依帕司他(E)组及甲钴胺联合依帕司他(M+E)组。每组30例。3组患者均在有效控制血糖的基础上,分别给予甲钴胺、依帕司他、甲钴胺加依帕司他治疗12周。观察患者治疗前后症状改善情况及神经传导速度等变化。结果治疗12周后,M、E、M+E组显效率分别为13.33%、20.68%、27.59%,有效率分别为20%、17.85%、37.93%,总有效率分别为33.33%、39.28%、65.51%。M+E组总有效率明显高于M、E组,差异有统计学意义(P<0.05)。3组患者治疗后感觉神经传导速度(SNCV)和运动神经传导速度(MNCV)均较治疗前明显增快(P<0.01),且提高幅度M+E组较M、E组大(P<0.05)。结论甲钴胺与依帕司他均可改善DPN患者的症状及周围神经传导速度,但两者联用效率更高,传导速度改善更明显。
AIM To explore the effect of mecobalamine and epalrestat combination therapy on peripheral neuropathy in type 2 diabetic patients. METHODS Ninty type 2 diabetic patients with peripheral neuropathy were enrolled in this study. All patients were selected according to the 1999 WHO diagnostic criteria for diabetes and the 2009 diagnostic criteria proposed by Chinese Medical Association of endocrine and metabolism for diabetic peripheral neuropathy（DPN）. After blood glucose levels had reached the target, the patients were randomized to receive mecobalamine （M, n = 30）, or epalrestat （E, n = 30）, or meeobalamine and epalrestat combination therapy （M ＋ E, n = 30） for 12 weeks. At the end of the treatment, the neuropathy symptoms and nerve conduction velocity of each patient were valued through electromyography. RESULTS At the end of this study, the rates of those with significant improvement in neuropathy symptoms were 33.33 %, 39.28 % and 65.51% respectively in group M, group E and combination group（M ＋ E）. And the effective rates in group M ＋ E was significantly higher than those in the other 2 groups （ P 〈 0.05）. The sensory nerve conduction velocity （SNCV） and the motor nerve conduction velocity （MNCV） of patients were significantly increased from baseline （ P 〈 0.01 ）, especially in group M ＋ E. CONCLUSION Meeobalamine and epalrestat combination therapy could be more effective in DPN treatment.
出处
《中国临床药学杂志》
CAS
2016年第3期141-144,共4页
Chinese Journal of Clinical Pharmacy
