鼠神经生长因子针剂与甲钴胺片剂序贯治疗对周围神经损伤慢性期患者神经功能康复的临床研究

目的:研究鼠神经生长因子针剂和甲钴胺片剂序贯治疗对5·12汶川地震后什邡市诊断明确的周围神经损伤慢性期(病程大于9个月)患者神经功能康复的临床疗效。方法:将汶川地震后什邡市诊断明确的周围神经损伤慢性期患者随机分为两组,疗程8周。试验Ⅰ组在1~28 d肌肉注射鼠神经生长因子,随后在29~56 d改为口服甲钴胺。试验Ⅱ组在1~28 d口服甲钴胺片剂,随后在29~56 d改为肌肉注射鼠神经生长因子针剂。分别在治疗前、治疗满28 d和56 d这3个时间节点进行肌电图检查,对两组患者动作电位潜伏期的变化进行比较分析,并观察药物不良反应。结果:试验Ⅰ组与试验Ⅱ组患者的一般人口学资料无显著性差异(P=0.48)。试验Ⅰ组与试验Ⅱ组在治疗28 d后的神经肌肉动作电位潜伏期分别为(54.3+1.7)ms和(53.6+1.9)ms,与治疗前动作电位潜伏期进行纵向比较,两组均未达到统计学意义(P1=0.21和P1=0.17)。然而,两组患者在治疗56 d后的神经肌肉动作电位潜伏期分别为(32.2+1.8)ms和(31.8+2.1)ms,与治疗前相比,两组患者的动作电位潜伏期均具有明显的统计学差异(P2=0.014和P2=0.008)。两组患者在治疗过程中均没有发生严重药物不良反应事件。结论:鼠神经生长因子针剂与甲钴胺片剂序贯使用对于治疗慢性期周围神经损伤患者是安全、有效的。

Clinical research of the efficacy analysis on sequential treatment of mouse nerve growth factor injections and sequential mecobalamin tablets in pa-tients with peripheral nerve injury in the chronic phase

Objective:To investigate the efficacy analysis on sequential treatment of mouse nerve growth factor injections and mecobalamin tablets in patients with peripheral nerve injury in the chronic phase ( More than 9 months duration) after the earthquake in Shifang City. Methods:After the earthquake on the diagnosis of peripheral nerve chronic injury clear Shifang patients were divided into two groups,Group Ⅰ:In 1-28 days intramuscular injection of mouse nerve growth factor;In 29-56 days to oral methylcobalamin tab-lets. Group Ⅱ:In 1-28 days of oral tablets mecobalamin;In 29-56 days to intramuscular injection of mouse nerve growth factor. Be-fore treatment,at least 28 days,56 days,EMG testing were performed on a comparative analysis of the test results and observed adverse drug reactions. Results:Experimental groupⅠand groupⅡwas no significant difference (P=0. 48),Experimental groupⅠand groupⅡfor 28 days after their neuromuscular action potential without significantly shorter latencies (P1 =0. 21,P1 =0. 17),the difference was not statistically significant. 56 days after treatment,neurological muscle action potential latency was shorter,and the difference was sta-tistically significant (P2 =0. 014, P2 =0. 008). Conclusion:Mouse nerve growth factor injections combined mecobalamin tablets treatment of patients with chronic peripheral nerve injury,there is a good effect to improve their neurological function.