甲钴胺联合依帕司他治疗糖尿病周围神经病变的疗效：降低炎症因子及改善肌电图指标
Therapeutic effects of mecobalamin combined with epalrestat on diabetic peripheral neuropathy: reduction of inflammatory factors and improvement in electromyogram indices.
作者信息
Song Lu, Ye Jing, Cheng Qun
机构信息
Neuroelectrophysiology Department, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital Quzhou 324000, Zhejiang, China.
Anesthesiology Department, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital Quzhou 324000, Zhejiang, China.
出版信息
Am J Transl Res. 2025 Apr 15;17(4):2898-2906. doi: 10.62347/XUBX8834. eCollection 2025.
OBJECTIVE
To evaluate the clinical efficacy of mecobalamin combined with epalrestat in treating diabetic peripheral neuropathy (DPN) and its effects on inflammatory factors and electromyogram (EMG) indices.
METHODS
Data from 100 DPN patients treated at Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital between June 2021 and December 2022 were retrospectively analyzed. Among them, the control group was 45 patients treated with mecobalamin alone. 55 patients treated with epalrestat, in addition to mecobalamin, were the observation group. Outcomes compared between the two groups included the changes in inflammatory factors, EMG indices, oxidative stress markers, blood glucose levels before and after treatment, clinical efficacy, and the incidence of adverse reactions.
RESULTS
The observation group showed a significantly higher overall response rate than the control group (P<0.05). After treatment, the observation group exhibited lower levels of C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and matrix metalloproteinase-9 (MMP-9) than control group (all P<0.05). The observation group also demonstrated higher motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) of the median nerve and nervus peronaeus communis compared to the control group (all P<0.05). Additionally, the observation group showed lower levels of propylene glycol and higher levels of superoxide dismutase compared to the control group (both P<0.05). Fasting blood glucose and 2-hour postprandial blood glucose levels in the observation group were significantly lower than those in the control group (P<0.05). Both groups exhibited a decrease in Michigan Diabetic Neuropathy Scores post-treatment compared to pre-treatment, with the observation group scoring lower than the control group (P<0.05). No difference was found between the 2 groups in the incidence of adverse reactions (P>0.05).
CONCLUSION
Mecobalamin combined with epalrestat substantially alleviates DPN, improves electromyogram indices, and reduces inflammatory factors and oxidative stress response, without increasing adverse reactions.
目的
评价甲钴胺联合依帕司他治疗糖尿病周围神经病变（DPN）的临床疗效及其对炎症因子和肌电图（EMG）指标的影响。
方法
回顾性分析2021年6月至2022年12月在温州医科大学附属衢州医院、衢州市人民医院接受治疗的100例DPN患者的数据。其中，对照组45例患者仅接受甲钴胺治疗。观察组55例患者除接受甲钴胺治疗外，还接受依帕司他治疗。比较两组治疗前后炎症因子、EMG指标、氧化应激标志物、血糖水平的变化、临床疗效及不良反应发生率。
结果
观察组总有效率显著高于对照组（P<0.05）。治疗后，观察组C反应蛋白（CRP）、降钙素原（PCT）、白细胞介素-6（IL-6）和基质金属蛋白酶-9（MMP-9）水平低于对照组（均P<0.05）。观察组正中神经和腓总神经的运动神经传导速度（MCV）和感觉神经传导速度（SCV）也高于对照组（均P<0.05）。此外，观察组丙二醛水平低于对照组，超氧化物歧化酶水平高于对照组（均P<0.05）。观察组空腹血糖和餐后2小时血糖水平显著低于对照组（P<0.05）。两组治疗后密歇根糖尿病神经病变评分均较治疗前降低，且观察组评分低于对照组（P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。
结论
甲钴胺联合依帕司他可显著缓解DPN，改善肌电图指标，降低炎症因子和氧化应激反应，且不增加不良反应。
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