山莨菪碱与前列腺素E1治疗糖尿病周围神经病变的疗效

目的 比较大剂量山莨菪碱与常规剂量前列腺素E1治疗糖尿病周围神经病变（DPN）的临床疗效.方法 将40例DPN患者按治疗方法的不同分为A、B2组,每组20例.2组均采用常规治疗,包括糖尿病饮食、口服降糖药物或胰岛素控制血糖及调脂降压等,并采用甲钴胺注射液和依帕司他片治疗.在此基础上,A组加用山莨菪碱注射液治疗,B组加用前列腺素E1注射液治疗.观察2组治疗前后正中神经、腓肠神经的运动神经传导速度（MNCV）、感觉神经传导速度（SNCV）及Toronto评分的情况.结果 2组治疗后Toronto得分和正中神经、腓肠神经的MNCV及SNCV与治疗前比较差异均有统计学意义（均P＜0.01）,2组治疗后Toronto得分和正中神经、腓肠神经的MNCV及SNCV比较差异均无统计学意义（均P＞0.05）.A组治疗后12例出现口干、面色潮红、视物模糊、心率增快及排尿困难等,但均可耐受,并完成治疗；B组治疗后3例出现低热、头痛及静脉炎,但均可耐受,并完成治疗.结论 山莨菪碱与前列腺素E1治疗DPN对改善患者的症状和体征、提高MNCV和SNCV均有效,且不良反应少,但2种方法的疗效未见显著差异.

Curative Effects of Anisodamine and Prostaglandin E1 on Diabetic Peripheral Neuropathy

Objective To compare the clinical effects of high-dose anisodamine and conventional- dose prostaglandin E1 on diabetic peripheral neuropathy （DPN）. Methods Forty DPN patients were divided into two groups, with 20 patients in each group. All patients received conventional treatment, including diabetic diet,oral antidiabetic drug, blood glucose control with insulin, blood lipid regulation, blood pressure lowering, mecobalamin injection,and epalrestat tablets. In addition, group A and group B were given anisodamine injection and prostaglandin E~ injection, respectively. Motor nerve conduction velocity （MNCV） and sensory nerve conduction velocity （SNCV） of median nerve and sural nerve were measured and the scores of Toronto clinical scoring system were evaluated before and after treatment. Results The scores of Toronto and MNCV and SNCV of median nerve and sural nerve after treatment were significantly different from those before treatment in both groups （P〈0.01）. However, there were no significant differences in these parameters between the two groups after treatment （P〉0.05）. In group A, 12 patients had thirst,face flushing,vision blurring, heart rate increase and dysuria. In group B,3 patients had mild fever, headache and phlebitis. All the adverse events were tolerable and all patients completed treatment. Conclusion Both anisodamine and prostaglandin E1 can significantly improve the clinical symptoms and signs,increase MNCV and SNCV and lead to less adverse reactions in DPN patients. But there is no significant difference in the curative efficacy between the two treatment methods.