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中国临床研究英文版:2018,31(3):400-402
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依帕司他、甲钴胺治疗糖尿病周围神经病变的疗效比较
(1.重庆市开州区人民医院内分泌科,重庆 405400;2.重庆市开州区人民医院神经内科,重庆 405400)
Effective comparison of epalrestat and mecobalamine on diabetic peripheral neuropathy
摘要
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Received:October 15, 2017   Published Online:March 20, 2018
中文摘要: 目的 比较依帕司他和甲钴胺治疗糖尿病周围神经病变(DPN)的临床疗效。方法 选取2015年4月至2016年4月开州区人民医院门诊DPN患者100例,随机分为依帕司他组(50例)和甲钴胺组(50例),治疗期间随访12周。治疗前后采用密歇根神经病变评分法(MNSI)进行症状、体征评分,同时采用肌电图测定患者右侧尺神经、正中神经和腓总神经的感觉及运动神经传导速度。比较治疗后上述指标不同随访时间点的变化。结果 (1)第4、8、12周,两组患者神经症状评分、神经体征评分和评分改善值较治疗前均有明显改善(P<0.05)。(2)依帕司他组患者在第4和12周神经症状评分改善值明显优于甲钴胺组(P<0.05),在第4、8、12周神经体征评分改善值明显优于甲钴胺组(P<0.05)。(3)依帕司他组患者在第12周正中神经、尺神经及腓总神经的运动和感觉神经传导速度均较治疗前明显改善(P<0.05),甲钴胺组尺神经-运动神经传导速度在第12周较治疗前明显改善(P<0.05)。(4)两组间安全性指标(血红蛋白、肝功能、肾功能)比较均无统计学差异(P>0.05)。结论 短期内依帕司他治疗DPN,在改善神经病变的症状体征和神经传导速度方面优于甲钴胺。
Abstract:Objective To compare the curative effect of epalrestat and mecobalamine on diabetic peripheral neuropathy(DPN).? Methods A total of 100 outpatients with DPN from April 2015 to April 2016 were enrolled and randomly divided into epalrestat group and mecobalamine group (n=50, each). All patients were followed-up for 12 weeks during treatment period. The symptoms and signs were assessed by Michigan neuropathy screening instrument (MNSI) before and after treatment. Meanwhile, electromyography was used to measure the sensory and motor nerve conduction velocity of right ulnar, median and common peroneal nerves. The changes of above-mentioned indexes at different follow-up timepoints were compared after treatment between two groups.? Results At 4-, 8-, 12- week after treatment, the improvement of neurological symptoms and signs scores were significantly superior to those before treatment in both two groups(all P<0.05). The improvement of neurological symptoms scores at 4-, 12-week after treatment and neurological signs scores at 4-, 8-, 12- week after treatment in epalrestat group were significantly better than those in mecobalamine group respectively (all P<0.05). At 12th week after treatment, the nerve conduction velocities of motor and sensory nerves of right ulnar, median and common peroneal nerves were significantly improved compared with pre-treatment in epalrestat group (all P<0.05), and the nerve conduction velocities of motor and sensory nerves of right ulnar nerve were significantly improved only compared with pre-treatment in mecobalamine group(P<0.05). There was no statistical difference in safety index including hemoglobin, liver function and renal function between two groups (all P>0.05).? Conclusions In the short-term effects, epalrestat is superior to mecobalamine in improving symptoms, signs and nerve conduction velocity of DPN patients.
文章编号:     中图分类号:R 587.1    文献标志码:B
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