银杏叶提取物与甲钴胺联用治疗糖尿病周围神经病变

目的:观察银杏叶提取物与甲钴胺联合治疗糖尿病周围神经病变的疗效.方法:选择2型糖尿病并伴有不同程度周围神经病变临床症状患者88例,随机分为两组,治疗组46例,予银杏叶提取物(舒血宁)25ml加入0.9%氯化钠溶液250ml静滴,每天一次,同时予甲钴胺500μg肌肉注射,每天一次,对照组42例,单用甲钴胺500μg肌肉注射,每天一次,连续治疗4周.观察两组患者治疗前后症状、体征和神经生理学指标.结果:治疗组症状、体征明显改善(P＜0.01),神经传导速度明显增加(P＜0.01),具有显著性差异;对照组在神经症状、体征及神经传导速度方面也有改善(P＜0.05).结论:银杏叶提取物与甲钴胺联用治疗糖尿病周围神经病变比单用甲钴胺疗效更好.     

己酮可可碱联合甲钴胺治疗糖尿病周围神经病变的临床研究

目的探讨己酮可可碱联合甲钴胺治疗糖尿病周围神经病变患者的临床疗效及其机制。方法将2018年2月—2019年2月在河北省优抚医院治疗的90例2型糖尿病周围神经病变患者随机分为对照组和治疗组,每组45例。2组均给予常规饮食控制及运动疗法,并予以口服降糖药和/或胰岛素控制血糖在正常范围。在此基础上,对照组予以甲钴胺片口服,治疗组予以甲钴胺片联合己酮可可碱缓释片口服。观察2组治疗2个月后胫后神经、腓总神经、正中神经的运动传导速度(MCV)与感觉神经传导速度(SCV)及炎性因子[血清白细胞介素-6(IL-6)、基质金属蛋白酶(MMPs)、C反应蛋白(CRP)]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、总抗氧化能力(TAOC)]的变化。结果2组治疗2个月后胫后神经、腓总神经、正中神经的MCV与SCV均显著较治疗前加快(P均<0.05),且治疗组均明显快于对照组(P均<0.05)。与治疗前比较,2组治疗2个月后血清IL-6、MMPs、CRP、MDA水平均明显降低(P均<0.05),SOD、TAOC水平均明显升高(P均<0.05);治疗2个月后与对照组比较,治疗组血清IL-6、MMPs、CRP、MDA水平更低(P均<0.05),SOD、TAOC水平更高(P均<0.05)。结论己酮可可碱联合甲钴胺可明显加快糖尿病周围神经病变患者神经传导速度,修复周围神经,机制与减轻炎性反应及氧化应激反应有关。     

通心络治疗糖尿病周围神经病变40例

[目的]观察通心络联合甲钴胺治疗DPN的临床疗效。[方法]选择80例确诊DPN患者,随机分为两组。治疗组40例,采用通心络联合甲钴胺、维生素B_1和B_6治疗;对照组40例,单纯采用甲钴胺、维生素B_1和B_6治疗。两组疗程均为4周。[结果]治疗组显效12例,有效21例,无效7例,总有效率82.5%,对照组显效7例,有效19例,无效15例,总有效率65%,两组比较有显著差异(P<0.05)。[结论]治疗组临床疗效优于对照组。     

Efficacy and safety of traditional Chinese medicine injection with mecobalamin in treating diabetic peripheral neuropathy: A protocol for systematic review and meta-analysis

Background:Diabetic peripheral neuropathy is a common complication of diabetes and the main cause of disability. At present, there is no specific therapeutic regimen. Mecobalamin is often used as a neurotrophic drug, and its long-term effects are not satisfactory when used alone. Clinical practice indicates that traditional Chinese medicine injection with mecobalamin has a therapeutic advantage in treating diabetic peripheral neuropathy while it lacks evidence-based medicine. In this scheme, the efficacy and safety of traditional Chinese medicine injection with mecobalamin in treating diabetic peripheral neuropathy has been studied.Methods:Computers were used to search the English database (PubMed, the Cochrane Library, Embase, Web of Science), and Chinese database (CNKI, Wanfang, CBMDISC, VIP). Besides, manual searching was conducted to search for Baidu Scholar, CHICTR, Google Scholar. During the establishment of the database to November 2020, a randomized controlled trial on traditional Chinese medicine injection with mecobalamin in treating diabetic peripheral neuropathy was conducted. There were 2 researchers independently conducting data extraction and quality evaluation of literature on the included studies, RevMan5.3 was performed for meta-analysis on the included literature.Results:In this study, the efficacy and safety of traditional Chinese medicine injection with mecobalamin in treating diabetic peripheral neuropathy was evaluated by the total effective rate, motor nerve conduction velocity, sensory nerve conduction velocity, adverse reactions, and glucose metabolism level.Conclusion:This study can provide an evidence-based basis on the clinical applications of traditional Chinese medicine injection with mecobalamin in the treatment of diabetic peripheral neuropathy.Ethics and dissemination:The study does not involve patient privacy or rights and does not require approval from an ethics committee. The results may be published in peer-reviewed journals or disseminated at relevant conferences.OSF Registration number:DOI 10.17605/OSF.IO/KPW5E.     

艾灸联合甲钴胺治疗糖尿病周围神经病变临床疗效观察及对患者血同型半胱氨酸的影响(英文)

目的:观察艾灸联合甲钴胺对糖尿病周围神经病的疗效以及对糖尿病周围神经病变患者血同型半胱氨酸的影响。方法:将符合纳入标准的150例糖尿病周围神经病变患者采用随机数字表随机分为艾灸组、甲钴胺组、联合组,艾灸组取太溪、三阴交、足三里、合谷、曲池进行艾灸,隔日治疗1次,10次为一疗程,治疗3个疗程;甲钴胺组口服甲钴胺片500μg/次,每日3次,20 d为1个疗程,治疗3个疗程;联合组在口服甲钴胺片基础上进行艾灸治疗。观察3组治疗前后临床症状、神经传导速度以及血同型半胱氨酸(Hcy)的变化。结果:艾灸组总有效率为74.0%(37/50),甲钴胺组总有效率为82.0%(41/50),联合组总有效率为94.0%(47/50),联合组明显优于其它两组(P0.01)。甲钴胺组及联合组治疗后较治疗前神经传导速度明显提高、血同型半胱氨酸水平下降(P0.01),联合组与艾灸组及甲钴胺组比较,神经传导速度提高、血同型半胱氨酸水平下降(P0.01)。结论:艾灸联合甲钴胺治疗糖尿病周围神经病变,不仅能改善患者的症状、提高患肢的神经传导速度,还能降低血Hcy水平,方法简单、经济、安全,值得在临床上推广。     

地塞米松磷酸钠注射剂与甲钴胺注射剂在氯化钠注射剂中的稳定性考察

目的考察地塞米松磷酸钠注射剂与甲钴胺注射剂在氯化钠注射剂中的稳定性。方法监测地塞米松磷酸钠注射剂与甲钴胺注射剂在氯化钠注射剂中配伍后于4℃、常温时自然光照射下及避光条件下12 h内的含量变化,同时考察配伍液pH值与外观的变化情况。结果与配伍后0 h比较,在避光条件下12 h内,pH、外观及两者含量均无显著变化;未避光条件下,地塞米松磷酸钠在12 h内无显著变化,5min内甲钴胺含量有显著变化,50%以上已降解。结论建议地塞米松磷酸钠注射剂不要与甲钴胺注射剂在氯化钠注射剂中配伍后用于静脉滴注。     

弥可保联合前列腺素E1治疗糖尿病周围神经病变

目的观察弥可保与前列腺素E1（PGE1）联合治疗糖尿病周围神经病变的临床疗效及神经电生理改善情况。方法50例糖尿病合并周围神经病变患者随机分为治疗组和对照组,在常规治疗的基础上,治疗组加用弥可保500μg肌注,每日1次,连用4周后改为隔日1次,总疗程12周,前列腺素E1 10μg静脉注射,每日1次,连用2周;对照组加用维生素B12 500μg肌注,每日1次,连用4周后改为隔日1次,总疗程12周。在治疗前后分别测定运动神经传导速度（MCV）和感觉神经传导速度（SCV）。结果与对照组比较,治疗组临床症状和体征明显改善,总有效率高于对照组（P〈0.05）,MCV和SCV亦显著增加（P〈0.05）。结论弥可保与前列腺素E1能改善糖尿病周围神经病变患者的临床症状,提高神经传导速度。     

糖络方联合弥可保治疗2型糖尿病周围神经病变的临床观察

目的观察益气养阴活血通络之糖络方联合弥可保治疗2型糖尿病周围神经病变的疗效。方法将65例患者随机分成治疗组（中西药组）和对照组（西药组）,均在西药降血糖基本达标的同时,对照组单纯口服弥可保,治疗组口服弥可保的基础上加用糖络方内服,治疗8周。结果总有效率及治疗后证候积分比较,治疗组优于对照组,差异有统计学意义（P〈0．05）;治疗后肌电图比较,治疗组优于对照组,差异有统计学意义（P〈0．01）。结论益气养阴活血通络之糖络方联合弥可保治疗2型糖尿病周围神经病变疗效优于单用弥可保,是治疗该病的有效方剂之一。     

Salviae miltiorrhizae and ligustrazine hydrochloride injection combined with mecobalamin for treating diabetic peripheral neuropathy: A protocol for systematic review and meta-analysis

Objective:Currently, it is unclear whether the salviae miltiorrhizae (Danshen Salvia) and ligustrazine hydrochloride (Chuanxiong Chuanxiong) (SMLH) injection combined with mecobalamin can improve diabetic peripheral neuropathy (DPN). We conducted a systematic analysis to evaluate the clinical effects of SMLH injection combined with mecobalamin for treating DPN.Methods:Seven databases, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Database (Wang Fang), Chinese Biomedical Literature Database (CBM), and VIP Database for Chinese Technical Periodicals (VIP) were searched for systematic literature retrieval. Each database was searched up to 2020 to identify randomized controlled trials on DPN treated with SMLH injection combined with mecobalamin. We used the RevMan 5.3 and Stata 14.0 software to assess the risk of bias in the included trials.Results:A total of 15 publications, including 1349 samples, were reviewed. The total effective rate of SMLH injection combined with mecobalamin was 31% higher than that of mecobalamin alone (95% confidence interval [CI] = 1.23–1.38; P < .00001). The experimental group showed a significant increase in the motor conduction velocity (MCV) of the peroneal nerve (weighted mean difference [WMD] = 4.81, 95% CI 3.53–6.09; P < .00001). In addition, SMLH injection combined with mecobalamin showed a statistical significant effect on the sensory conduction velocity (SCV) of the peroneal nerve (WMD = 5.03, 95% CI = 4.16–5.90; P < .00001), and MCV of the median nerve (WMD = 5.38, 95% CI = 4.05–6.72; P < .00001). The WMD for the change in SCV in the median nerve was 4.89 m/s (95% CI = 3.88–5.89; P < .00001). The P-values of the Egger and Begg tests were 0.967 and 0.961, respectively, indicating no publication bias. Subgroup and sensitivity analyses indicated that the results for MCV and SCV of the peroneal nerve and the median nerve were stable.Conclusion:SMLH injection combined with mecobalamin can improve DPN, compared with mecobalamin alone.     

阿魏酸钠联合甲钴胺治疗糖尿病周围神经病变的 疗效观察

目的:观察阿魏酸钠联合甲钴胺治疗2型糖尿病周围神经病变(DPN)的临床疗效。方法:将78例DPN患者随机分为对照组和观察组,各39例。对照组给予甲钴胺(0.5 mg)肌注治疗,1次/日;观察组给予阿魏酸钠(300 mg)静脉滴注联合甲钴胺(0.5 mg)肌注治疗,1次/日;2组均治疗14 d。比较2组治疗前、后运动神经传导速度(MCV)和感觉神经传导速度(SCV)及有效率。结果:治疗后,2组正中神经和腓总神经的MCV和SCV均较同组治疗前提高(P0.05),且观察组正中神经和腓总神经的MCV和SCV快于对照组(P0.05)。对照组的总有效率为56.41%,低于观察组的87.18%(P0.05)。结论:阿魏酸钠与甲钴胺联合治疗能有效增强甲钴胺治疗DPN的临床疗效。