摘要
目的:探讨维生素D_(2)通过提高25-羟维生素D[25(OH)D]水平提高糖尿病周围神经病变(Diabetes peripheral neuropathy,DPN)的治疗效果和安全性。方法:选取2022.2至2023.3期间于本院就诊的2型糖尿病(Type 2 diabetes mellitus,T2DM)合并DPN患者92例作为研究对象。随机将患者分为对照组和观察组,每组各46例。对照组控制血糖并采用甲钴胺片、硫辛酸注射液治疗。观察组在对照组基础上给与维生素D_(2)肌肉注射治疗。分析比较两组的周围神经运动神经传导速度(Motor nerve conduction velocity,MCV)、感觉神经传导速度(Sensory nerve conduction velocity,SCV)、血清25(OH)D水平、神经病变程度[密歇根糖尿病神经病变量表(Michigan Diabetic Neuropathy Score,MDNS)评分]和不良反应。结果:治疗后,两组的血清25-OH VD_(2)和25-OH VD3水平均较治疗前提高,且观察组的25-OH VD_(2)和25-OH VD3水平均明显高于对照组(P<0.05)。治疗后,两组的正中神经MCV、SCV和腓总神经MCV、SCV水平均较治疗前提高,且观察组的正中神经MCV、SCV和腓总神经MCV、SCV水平均明显高于对照组(P<0.05)。治疗后,两组的MDNS评分均较治疗前下降,且观察组的MDNS评分明显低于对照组(P<0.05)。两组的不良反应发生率比较无显著差异。结论:维生素D_(2)注射液治疗能提高T2DM合并DPN患者血清中25(OH)D水平,提高周围神经传导速度,改善患者临床症状且安全性高。
Objective:To investigate the efficacy and safety of vitamin D_(2)in the treatment of diabetic peripheral neuropathy(DPN)by increasing the level of 25-hydroxyvitamin D[25(OH)D].Methods:92 T2DM patients with DPN treated in our hospital during 2022.2 to 2023.3 were selected as the study objects.The patients were randomly divided into control group and observation group,with 46 cases in each group.The control group was treated with mecobalamin tablets and lipoic acid injection.Observation group was given intramuscular injection of vitamin D_(2)on the basis of control group.Peripheral motor nerve conduction velocity(MCV),sensory nerve conduction velocity(SCV),levels of serum 25(OH)D,degree of neuropathy[Michigan Diabetic Neuropathy Scale(MDNS)score]and adverse reactions were analyzed and compared between the two groups.Results:After treatment,the levels of serum 25-OH VD_(2)and 25-OH VD3 in both groups were higher than those before treatment,and the levels of 25-OH VD_(2)and 25-OH VD3 in observation group were significantly higher than those in control group(P<0.05).After treatment,the levels of median nerve MCV,SCV and common peroneal nerve MCV and SCV in both groups were higher than those before treatment,and the levels of median nerve MCV,SCV and common peroneal nerve MCV and SCV in observation group were significantly higher than those in control group(P<0.05).After treatment,MDNS scores of both groups decreased compared with those before treatment,and MDNS scores of observation group were significantly lower than those of control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:Vitamin D_(2)injection can increase the level of serum 25(OH)D in T2DM patients with DPN,increase peripheral nerve conduction velocity,improve clinical symptoms and have high safety.
作者
高瑞萍
闫晓海
张秀云
Gao Rui-ping;Yan Xiao-hai;Zhang Xiu-yun(Department of Endocrinology,Anyang Regional Hospital,Puyang 455000,Henan,China)
