摘要【目的】探讨二甲双胍联合甲钴胺治疗糖尿病性周围神经病理性疼痛(DPNP)患者的临床疗效及对患者神经传导速度的影响。【方法】选取本院2021年7月至12月收治的100例DPNP患者,按照随机数字表法分成对照组和观察组,每组50例。对照组予以甲钴胺治疗,观察组予以二甲双胍联合甲钴胺治疗。比较两组一般资料、生化指标、视觉模拟评分法(VAS)评分、神经传导速度及不良反应发生情况。【结果】两组性别、年龄、病程、有吸烟史占比比较,差异均无统计学意义(P>0.05);两组治疗前、治疗12周、24周后体重指数比较,差异均无统计学意义(P>0.05)。治疗12周、24周后,两组空腹血糖(FPG)、餐后2 h血糖、糖化血红蛋白(HbA1c)水平及VAS评分低于治疗前,且观察组低于对照组。治疗12周、24周后,两组空腹C肽(FCP)、餐后2 h C肽水平高于治疗前,且观察组高于对照组(P<0.05)。治疗12周、24周后,两组胫神经、腓神经的运动神经传导速度(MCV)和感觉神经传导速度(SCV)大于治疗前,且观察组大于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】二甲双胍联合甲钴胺治疗DPNP患者,可明显降低患者血糖水平,减轻疼痛,改善神经传导速度,且用药安全可控。
Abstract：【Objective】To investigate the clinical efficacy of metformin combined with mecobalamin in treating patients with diabetic peripheral neuropathic pain (DPNP) and its effect on nerve conduction velocity. 【Methods】One hundred DPNP patients admitted to our hospital from July to December 2021 were divided into the control group (50 cases, treated with mecobalamin) and the observation group (50 cases, treated with metformin combined with mecobalamin) using a random number table method. General data, biochemical indicators, Visual Analogue Scale (VAS) scores, nerve conduction velocity, and adverse reactions were compared between the two groups. 【Results】There were no significant differences in gender, age, disease duration, or smoking history between the two groups (P>0.05), and no significant differences in body mass index before treatment or after 12 and 24 weeks of treatment (P>0.05). After 12 and 24 weeks of treatment, fasting plasma glucose (FPG), 2-hour postprandial blood glucose, glycosylated hemoglobin (HbA1c) levels, and VAS scores were lower than those before treatment in both groups, with the observation group showing more significant reductions. Fasting C-peptide (FCP) and 2-hour postprandial C-peptide levels were higher than those before treatment in both groups, with the observation group showing higher levels (P<0.05). The motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) of the tibial and peroneal nerves were higher than those before treatment in both groups after 12 and 24 weeks of treatment, with the observation group showing faster velocities (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】Metformin combined with mecobalamin can significantly reduce blood glucose levels, alleviate pain, and improve nerve conduction velocity in DPNP patients, with safe and controllable medication.
周元亭. 二甲双胍联合甲钴胺治疗DPNP患者的临床疗效及对患者神经传导速度的影响[J]. 医学临床研究, 2025, 42(5): 784-787.
ZHOU Yuanting. Clinical Efficacy of Metformin Combined with Mecobalamin in Treating DPNP Patients and its Impact on Nerve Conduction Velocity. JOURNAL OF CLINICAL RESEARCH, 2025, 42(5): 784-787.
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2025, Vol. 42 
