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目的观察加巴喷丁联合腺苷钴胺治疗糖尿病痛性神经病变(PDN)的临床初步效果。方法选取已确诊PDN的T2DM患者96例,随机分为对照组(Con)、腺苷钴胺组、加巴喷丁+腺苷钴胺组,每组各32例,均积极控制FPG和HbA_1c。Con组予维生素B_1治疗。收集临床和生化资料,视觉模拟评分(VAS)评估疼痛程度,肌电图检查评估正中神经和腓总神经运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)的变化,匹兹堡睡眠质量指数量表(PSQI)评估睡眠质量。结果治疗前各组MNCV、SNCV和疼痛程度比较,差异无统计学意义(P>0.05);治疗后腺苷钴胺组、加巴喷丁+腺苷钴胺组均有改善,且加巴喷丁+腺苷钴胺组MNCV、SNCV高于腺苷钴胺组,VAS低于腺苷钴胺组(P<0.05)。Con组改善不明显(P>0.05)。结论加巴喷丁联合腺苷钴胺治疗PDN可减轻疼痛、提高神经传导速度和改善睡眠质量。
Objective To observe the clinical effect of gabapentin combined with adenosylcobalamin in the treatment of diabetic painful neuropathy (PDN). Methods A total of 96 patients with T2DM diagnosed with PDN were randomly divided into control group (Con), adenosylcobalamin group, gabapentin + adenosylcobalamin group, with 32 cases in each group. Both of them had positive control of FPG and HbA_1c. Con group to vitamin B_1 treatment. The clinical and biochemical data were collected and the visual analogue scale (VAS) was used to assess the degree of pain. Electromyography was performed to evaluate the changes of median nerve and peroneal nerve motor nerve conduction velocity (MNCV), sensory nerve conduction velocity (SNCV), Pittsburgh sleep quality index Table (PSQI) to assess sleep quality. Results There were no significant differences in MNCV, SNCV and pain scores between the groups before treatment (P> 0.05). After treatment, the concentrations of adenosylcobalamin and gabapentin + adenosylcobalamin were all improved, and the effects of gabapentin + adenosylcobalamin Group MNCV, SNCV higher than adenosine group, VAS lower than adenosine group (P <0.05). Con group did not improve significantly (P> 0.05). Conclusion Gabapentin plus adenosine cobalamin in the treatment of PDN can reduce pain, improve nerve conduction velocity and improve sleep quality.