甲钴胺与马来酸桂哌齐特联合治疗糖尿病下肢神经病变的疗效观察

关键词：甲钴胺 马来酸桂哌齐特 糖尿病 神经病变 肌电图

Keywords:mecobalamin  cinepazide maleate  diabetes  neuropathy  electromyography

摘要：

      目的：探讨甲钴胺与马来酸桂哌齐特在2型糖尿病合并下肢周围神经病变治疗中的疗效及血管内皮功能的变化.方法：选择2型糖尿病合并下肢周围神经病变的病例60例,随机分甲钴胺治疗组（1组）和甲钴胺与马来酸桂哌齐特治疗组（2组）,每组30例,1组给予甲钴胺治疗,2组在甲钴胺治疗的基础上加用马来酸桂哌齐特治疗,疗程14天,治疗前后观察临床症状,测定血管内皮细胞功能和肌电图.结果：经过治疗,1组运动传导速度、感觉传导速度,以及临床症状有一定程度的改善,但差异无显著性意义（P＞0.05）,2组治疗后运动传导速度、感觉传导速度明显增快,同时临床症状改善明显（P＜0.01）;两组治疗前血内皮素、D-二聚体和C反应蛋白（CRP）均高于正常,治疗前后比较差异有显著性意义（P＜0.05）,而1组血内皮素、D-二聚体和CRP均有一定程度的下降但差异无显著性意义（P＞0.05）.结论：甲钴胺与马来酸桂哌齐特联合治疗在2型糖尿病合并下肢周围神经病变治疗中可改善血管内皮的功能和下肢周围神经病变,缓解临床症状,疗效显著.

Abstract:

      Objective: To observe the therapeutic effect of Cinepazide Maleate(CM) and mecobalamin and changes of endothelial function on peripheral neuropathy in lower limb in diabetic patients.Method: Sixty diabetic patients with peripheral neuropathy in lower limb were randomly divided into two groups including treatment group(group 2)and control group(group 1),each with 30 cases. Group 2 received the combined therapy of CM and mecobalamin,meanwhile group 1 were administrated mecobalamin for 14 days. The clinical presentation were observed and the changes of endothelial function and electromyographic were tested pre-and post-therapy in both groups. Result:There was a significant improvement in MCV,SCV and clinic presentation in group 2(P<0.01),but no significant change in group 1(P>0.05) after therapy.The plasma levels of endothelin,D-dimer and C reactive protein(CRP) was higher in both groups before therapy.The plasma levels of endothelin,D-dimer and CRP decreased in group 2 after therapy(P<0.05),meanwhile the plasma levels of endothelin and D-dimer and CRP were lower in group 1 but no significant difference(P>0.05).Conclusion:Combined therapy of CM and mecobalamin can improve the clinic presentation, vascular endothelial function and peripheral neuropathy in lower limb in diabetic patients.