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。     

尼麦角林与弥可保合用治疗糖尿病周围神经病变的疗效观察

目的探讨治疗2型糖尿病周围神经病变有效方法,改善病人生活质量。方法选择2型糖尿病伴有不同程度周围神经病变临床症状患者80例,随机分为两组。在常规应用口服降糖药或胰岛素的治疗基础上,治疗组加用尼麦角林8mg、弥可保500μg,各加入0．9％氯化钠注射液250ml中静脉滴注,每日一次;对照组加尼麦角林8mg加入0．9％氯化钠注射液250ml中静脉滴注,每日1次,疗程均为4周。结果治疗组显效果15例、好转17例、无效8例,治疗总有效率80．00％,与对照组比较,糖尿病周围神经病变患者临床症状明显缓解,差异有统计意义（Χ^2=3．69,P〈0．05）。治疗组周围神经病变治疗前后神经传导速度改善与对照组比较,尺神经、胫神经和腓总神经的神经传导速度明显改善,差异均有统计意义（Χ^2分别=8．00、5．16和2．56,P均〈0．05）。结论尼麦角林与弥可保合用治疗糖尿病周围神经病变是有效的方法之一。     

活血祛风除湿中药足浴联合口服甲钴胺片治疗糖尿病周围神经病变临床观察

目的：探讨活血祛风除湿中药足浴联合口服甲钴胺片治疗糖尿病周围神经病变（DPN）的临床疗效。方法采用随机数字表法将将65例2型糖尿病患者随机分为2组,均行糖尿病饮食控制、运动及教育,保持既往降糖方案,高血压者予硝苯地平控释片。对照组同时予甲钴胺片口服,治疗组在对照组基础上加用活血祛风除湿中药足浴。治疗12周。观察2组治疗前后临床症状积分、Toronto临床评分变化,测定肢体正中神经、腓总神经的运动传导速度（MNCV）及感觉传导速度（SNCV）。结果2组治疗后临床症状评分、Toronto临床评分及正中神经、腓总神经 MNCV、SNCV 均显著降低（P＜0.05,P＜0.01）。治疗组中医证候疗效总有效率为81.81%（27/33）,对照组为65.62%（21/32）,2组比较差异有统计学意义（P＜0.05）。治疗组西医疗效总有效率为84.84%（28/33）,对照组为62.50%（20/32）,2组比较差异有统计学意义（P＜0.05）。结论活血祛风除湿中药足浴联合甲钴胺片口服治疗DPN安全有效。     

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.     

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。     

Restorative effect and mechanism of mecobalamin on sciatic nerve crush injury in mice

Mecobalamin,a form of vitamin B12 containing a central metal element(cobalt),is one of the most important mediators of nervous system function.In the clinic,it is often used to accelerate recovery of peripheral nerves,but its molecular mechanism remains unclear.In the present study,we performed sciatic nerve crush injury in mice,followed by daily intraperitoneal administration of mecobalamin(65 μg/kg or 130 μg/kg) or saline(negative control).Walking track analysis,histomorphological examination,and quantitative real-time PCR showed that mecobalamin significantly improved functional recovery of the sciatic nerve,thickened the myelin sheath in myelinated nerve fibers,and increased the cross-sectional area of target muscle cells.Furthermore,mecobalamin upregulated m RNA expression of growth associated protein 43 in nerve tissue ipsilateral to the injury,and of neurotrophic factors(nerve growth factor,brain-derived nerve growth factor and ciliary neurotrophic factor) in the L4–6 dorsal root ganglia.Our findings indicate that the molecular mechanism underlying the therapeutic effect of mecobalamin after sciatic nerve injury involves the upregulation of multiple neurotrophic factor genes.     

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。     

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.     

甲钴胺片致药疹和口腔黏膜增厚及交叉过敏反应分析

<正>甲钴胺(甲基维生素B12,mecobalamin)属于维生素B12(Vit B12)类,是Vit B12的衍生物,因在中央钴分子上结合了一个甲基基团,可参与物质的甲基转运及核酸、蛋白质和脂质的代谢,促