甲鈷胺聯(lián)合前列地爾治療老年2型糖尿病周圍神經(jīng)病變分析

陳潤龍+孫子林

摘要] 目的 觀察甲鈷胺聯(lián)合前列地爾治療老年2型糖尿病周圍神經(jīng)病變（type2-DPN）的臨床療效。方法 選取2009年6月～2013年3月入我院的90例老年tpye2-DPN患者作為研究對象，隨機(jī)分為實驗組和對照組，其中45例在常規(guī)治療的基礎(chǔ)上加用前列地爾注射液，為對照組； 45例患者采用單甲鈷胺注射液聯(lián)合前列地爾注射液進(jìn)行治療，為實驗組。兩組治療3周。分別觀察患者治療前后臨床癥狀變化，檢測正中神經(jīng)、腓總神經(jīng)的運動傳導(dǎo)速度（MCV）及感覺傳導(dǎo)速度（SCV），并且測定患者血清C-反應(yīng)蛋白水平。 結(jié)果 治療前后，實驗組正中神經(jīng)、腓總神經(jīng)的MCV及SCV與對照組相比明顯加快；實驗組患者的CRP含量與對照組相比顯著降低；實驗組顯效23例，有效16例，無效6例，有效率為86.7%；對照組顯效16例，有效15例，無效14例，有效率為68.9%。兩組有效率相比差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 甲鈷胺聯(lián)合前列地爾治療type2-DPN的臨床療效顯著，應(yīng)該在臨床上廣泛推廣。

[關(guān)鍵詞] 甲鈷胺；前列地爾；老年2型糖尿病周圍神經(jīng)病變

[中圖分類號] R587.1 [文獻(xiàn)標(biāo)識碼] B [文章編號] 1673-9701（2014）02-0132-03

Analysis on mecobalamin combined with alprostadil in the treatment of elderly type 2 diabetic peripheral neuropathy

CHEN Runlong1 SUN Zilin2

1.Department of Internal Medicine， the Second Peoples Hospital of Tonglu County， Tonglu 311519，China； 2.Clinical medical School of Southeast China University， Nanjing 361000，China

[Abstract] Objective To observe the clinical curative effect of mecobalamin combined with alprostadil in the treatment of elderly type 2 diabetic peripheral neuropathy（type2-DPN）. Methods Ninety cases of elderly type2-DPN in our hospital from June 2009 to March 2013 were as the object of study， and were randomly divided into the experimental group and the control group， of which 45 cases in the control group were treated with alprostadil injection on the basis of conventional treatment， 45 cases in the experimental group were treated with mecobalamin injection combined with alprostadil injection. The two groups were treated for 3 weeks. The clinical symptoms changes of patients were observed before and after treatment respectively， motor conduction velocity（MCV） and sensory conduction velocity（SCV） of median nerve and common peroneal nerve were detected， and serum C-reactive protein level of patients were determined. Results Compared with the control group， the MCV and SCV of median nerve and common peroneal nerve before and after the treatment in the experimental group accelerated obviously； the CRP level of patients in the experimental group reduced significantly； In the experimental group， 23 cases were significantly effective， 16 cases were effective， 6 cases were invalid， and the effective rate was 86.7%； In the control group， 16 cases were significantly effective， 15 cases were effective， 14 cases were invalid， and the effective rate was 68.9%.The difference was statistically significant in the effective rate between two groups（P<0.05）. Conclusion Mecobalamin combined with alprostadil in the treatment of type2-DPN has significant clinical curative effect， it should be widely promoted in the clinical.endprint

[Key words] Mecobalamin； Alprostadil； Elderly type 2 diabetic peripheral neuropathy

糖尿病神經(jīng)病變是與糖尿病有關(guān)的神經(jīng)性紊亂，是由于糖尿病引起的供應(yīng)神經(jīng)的微血管的損傷而產(chǎn)生[1]。可伴有糖尿病神經(jīng)病變的常見病癥包括第三神經(jīng)麻痹、單神經(jīng)病、單神經(jīng)病復(fù)、糖尿病性肌萎縮、疼痛多發(fā)性神經(jīng)病變、自主神經(jīng)病變和胸腹病變。CRP是一種由肝臟合成的急性期蛋白，應(yīng)答感染的發(fā)生或組織炎癥反應(yīng)，CRP受細(xì)胞因子的刺激，尤其是白介素-1、白介素-6以及腫瘤壞死因子迅速產(chǎn)生。國內(nèi)外大量研究表明CRP含量與2型糖尿病及其并發(fā)的大血管病變和微血管病變密切相關(guān)，是2型糖尿病發(fā)病的可靠預(yù)測因子[2]。……