前列地尔联合甲钴胺治疗糖尿病周围神经病的疗效分析(1)
【摘要】 目的：观察前列地尔联合甲钴胺治疗糖尿病周围神经病变的疗效。方法：选取2012年3月-2013年7月收治于笔者所在科室的52例糖尿病并发周围神经病变患者，按照随机数字表法将其分为观察组和对照组各26例，在血糖控制满意的基础上，两组均给予静脉注射前列地尔10 μg，1次/d，观察组在此基础上给予肌肉注射甲钴胺500 μg，1次/d，疗程均为2周。于一疗程治疗结束后，观察比较两组患者的疗效、治疗前后血液流变学及血脂指标变化情况。结果：经治疗后，观察组的治疗总有效率92.3%(24/26)明显高于对照组的57.7%(15/26)，差异有统计学意义(字2=11.724，P=0.000)。观察组治疗后的血液流变学和血脂指标均明显低于治疗前和对照组，差异均有统计学意义(P<0.05)。结论：采用前列地尔联合甲钴胺治疗糖尿病周围神经病的疗效显著，能更好地恢复周围神经，且副作用小，方便安全，值得临床推广。
【关键词】 糖尿病周围神经病； 前列地尔； 甲钴胺
中图分类号 R587.2 文献标识码 B 文章编号 1674-6805(2014)35-0027-02
【Abstract】 Objective：To observe the efficacy of Alprostadil combined with Mecobalamine in the treatment of diabetic peripheral neuropathy.Method：52 patients with diabetes complicating with DPN admitted to our department from March 2012 to July 2013 were selected，they were randomly divided into the observation group and the control group according to the random number table method，26 cases in each group.On the basis of satisfactory glycemic control，the two groups were given Alprostadil 10 μg via intravenous injection once a day，the observation group was given Mecobalamine 500 μg via intramuscular injection once a day on the basis of control group.Both groups were treated for 2 weeks.After a course of treatment，the clinical efficacy and changes of hemorheology and blood lipid indexes before and after treatment were observed and compared.Result：After treatment，the total effective rate of observation group was 92.3%(24/26)，it was significantly higher than 57.7%(15/26) of control group，the difference was statistically significant(字2=11.724，P=0.000).The hemorheology and blood lipid indexes of observation group after treatment were significantly lower than before treatment and the control group，the differences were statistically significant(P<0.05).Conclusion：The curative effect of Alprostadil combined Mecobalamine in the treatment of DPN is remarkable，can better recover peripheral nerve，and the side effect is small，convenient and safe，is worthy of clinical promotion.
【Key words】 Diabetic peripheral neuropathy； Alprostadil； Mecobalamine
糖尿病周围神经病(diabetic peripheral neuropathy，DPN)是糖尿病(diabetic mellitus，DM)最常见且具有多种临床表现的慢性并发症，在糖尿病中的发病率在50%～90%，严重影响患者的生存质量[1]。目前尚缺乏疗效显著的治疗方法。近年来，前列地尔联合甲钴胺治疗DPN的报道较多，笔者所在科室2012年3月-2013年7月选用该方案治疗并取得了良好疗效，现报告如下。
1 资料与方法
1 一般资料
选取2012年3月-2013年7月收治于笔者所在科室的52例糖尿病并发周围神经病变患者，均符合WHO糖尿病诊断标准及DPN诊断标准[2-3]，除严重心、肝、肺病和免疫性疾病及精神障碍者。按照随机数字表法将所有患者分为观察组和对照组各26例。观察组26例患者中，男12例，女14例，年龄47～75岁，平均53.5岁；对照组26例患者中，男9例，女17例，年龄45～69岁，平均50.4岁。两组患者的年龄、性别、病程及病情等一般资料比较差异均无统计学意义(P>0.05)，具有可比性。(于京涛 徐岑岑)