鼠神经生长因子联合维生素D、甲钴胺治疗糖尿病周围神经病变的临床观察

doi:10.6040/j.issn.1671-7554.0.2015.508

山东大学学报（医学版） ›› 2016, Vol. 54 ›› Issue (4): 64-67.doi: 10.6040/j.issn.1671-7554.0.2015.508

鼠神经生长因子联合维生素D、甲钴胺治疗糖尿病周围神经病变的临床观察

史蕊¹,孙佩²,王璐璐²,丁琳³,夏金¹,王燕³,逄曙光²

1.泰山医学院, 山东泰安 271000;2.山东大学附属济南市中心医院内分泌科, 山东济南250013;3.山东大学医学院, 山东济南 250012

收稿日期:2015-05-22 出版日期:2016-04-10 发布日期:2016-04-10
通讯作者: 逄曙光. E-mail:shuguangpang@163.com E-mail:shuguangpang@163.com
基金资助:
国家自然科学基金(81170771、81270175);山东省科技发展计划(2012GSF11803);济南市国际合作计划(201011008)

Vitamin D and mecobalamin combined with mouse nerve growth factor for diabetic peripheral neuropathy: a clinical observation

SHI Rui¹, SUN Pei², WANG Lulu², DING Lin³, XIA Jin¹, WANG Yan³, PANG Shuguang²

1. Taishan Medical College, Taian 271000, Shandong, China;
2. Department of Endocrinology, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, Shandong, China;
3. School of Medicine, Shandong University, Jinan 250012, Shandong, China

Received:2015-05-22 Online:2016-04-10 Published:2016-04-10

摘要/Abstract

摘要： 目的观察鼠神经生长因子联合维生素D、甲钴胺治疗糖尿病周围神经病变的临床疗效。方法 64例糖尿病周围神经病变患者随机分为A、B、C三组,A组(n=21)给予甲钴胺治疗,B组(n=21)给予甲钴胺联合维生素D治疗,C组(n=22)应用鼠神经生长因子联合维生素D、甲钴胺治疗。治疗4周,观察3组治疗前后的临床症状及神经传导速度的变化情况。结果 3组治疗后患者的神经病变主觉症状问卷(TSS)评分降低,神经传导速度增加,差异有统计学意义(P<0.05);C组TSS评分下降程度及神经传导速度增加的程度优于A组、B组,差异有统计学意义(P<0.05)。结论鼠神经生长因子联合维生素D、甲钴胺治疗糖尿病周围神经病变的临床疗效显著。

关键词: 鼠神经生长因子, 甲钴胺, 糖尿病周围神经病变, 临床观察, 维生素D

Abstract: Objective To observe the clinical efficacy of vitamin D, mecobalamin and mouse nerve growth factor(mNGF)used in combination for diabetic peripheral neuropathy(DPN). Methods A total of 64 DPN cases were randomly divided into 3 groups. Group A(n=21)received mecobalamin, Group B(n=21)was given mecobalamin combined with vitamin D, Group C(n=22)received vitamin D and mecobalamin combined with mNGF injection. After 4 weeks, all patients’ symptoms and changes of the nerve conduction velocity were recorded. Results The TSS score was reduced and nerve conduction velocity was improved in all 3 groups after treatment, and the difference was statistically significant(P<0.05). Group C had greater reduction in TSS score and increase in nerve conduction velocity than group A and B, and the difference was statistically significant(P<0.05). Conclusion vitamin D and mecobalamin combined with mouse nerve growth factor is effective in the treatment of diabetic peripheral neuropathy.

Key words: Mouse nerve growth factor, Vitamin D, Diabetic peripheral neuropathy, Mecobalamin, Clinical observation

中图分类号:

R587.2

史蕊,孙佩,王璐璐,丁琳,夏金,王燕,逄曙光. 鼠神经生长因子联合维生素D、甲钴胺治疗糖尿病周围神经病变的临床观察[J]. 山东大学学报（医学版）, 2016, 54(4): 64-67.

SHI Rui, SUN Pei, WANG Lulu, DING Lin, XIA Jin, WANG Yan, PANG Shuguang. Vitamin D and mecobalamin combined with mouse nerve growth factor for diabetic peripheral neuropathy: a clinical observation[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(4): 64-67.

参考文献

[1] Tesfaye S, Selvarajah D. Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy[J]. Diabetes Metab Res Rev, 2012, 28(S1): 8-14.
[2] Lu B, Yang Z, Wang M, et al. High prevalence of diabetic neuropathy in population-based patients diagnosed with type 2 diabetes in the Shanghai downtown[J]. Diabetes Res Clin Pract, 2010, 88(3): 289-294.
[3] Davies M, Brophy S, Williams R, et al. The prevalence, severity, and impact of painful diabetic peripheral neuropathy in type 2 diabetes[J]. Diabetes Care, 2006, 29(7):1518-1522.
[4] Van Acker K, Bouhassira D, De Bacquer D, et al. Prevalence and impact on quality of life of peripheral neuropathy with or without neuropathic pain in type 1 and type 2 diabetic patients attending hospital out patients clinics[J]. Diabetes Metab, 2009, 35(3): 206-213.
[5] Shehab D, Al-Jarallah K, Mojiminiyi OA, et al. Does Vitamin D deficiency play a role in peripheral neuropathy in Type 2 diabetes?[J]. Diabet Med, 2012, 29(1): 43-49.
[6] Soderstrom LH, Johnson SP, Diaz VA, et al. Association between vitamin D and diabetic neuropathy in a nationally representative sample: results from 2001-2004 NHANES[J]. Diabet Med, 2012, 29(1): 50-55.
[7] Holick MF. Vitamin D deficiency[J]. N Engl J Med, 2007, 357(3): 266-281.
[8] Dey I, Midha N, Singh G, et al. Diabetic Schwann cells suffer from nerve growth factor and neurotrophin-3 underproduction and poor associability with axons[J]. Glia, 2013, 61(12): 1990-1999.
[9] Tosaki T, Kamiya H, Yasuda Y, et al. Reduced NGF secretion by Schwann cells under the high glucose condition decreases neurite outgrowth of DRG neurons[J]. Exp Neurol, 2008, 213(2): 381-387.
[10] Hellweg R, Raivich G, Hartung HD, et al. Axonal transport of endogenous nerve growth factor(NGF)and NGF receptor in experimental diabetic neuropathy[J]. Exp Neurol, 1994, 130(1): 24-30.
[11] Rask CA. Biological actions of nerve growth factor in the peripheral nervoussystem[J]. Eur Neurol, 1999, 41(Suppl 1):14-19.
[12] 李书林, 蒋晓江, 陈曼娥. 大鼠坐骨神经损伤后髓鞘碱性蛋白与神经功能的变化及神经生长因子的影响[J]. 中国临床康复, 2002, 6(6): 798-799. LI Shulin, JIANG Xiaojiang, CHEN Mane. Effects of NGF on the changes of MBP in nervous tissue and the neurological behavior following sciatic nerves injury in rats[J]. Modern Rehabilitation, 2002, 6(6): 768-799.
[13] Kim HC, Cho YJ, Ahn CW, et al. Nerve growth factor and expression of its receptors in patients with diabetic neuropathy[J]. Diabet Med, 2009, 26(12): 1228-1234.
[14] Apfel SC, Kessler JA, Adornato BT, et al. Recombinant human nerve growth factor in the treatment of diabetic polyneuropathy. NGF Study Group[J]. Neurology, 1998, 51(3): 695-702.
[15] Pilz S, Kienreich K, Rutters F, et al. Role of vitamin D in the development of insulin resistance and type 2 diabetes[J]. Curr Diab Rep, 2013, 13(2): 261-270.
[16] Zerwekh JE. Blood biomarkers of vitamin D status[J]. Am J Clin Nutr, 2008, 87(4): S1087-S1091.
[17] Lee P, Chen R. Vitamin D as an analgesic for patients with type 2 diabetes and neuropathic pain[J]. Arch Intern Med, 2008, 168(7): 771-772.
[18] Bell DS. Reversal of the symptoms of diabetic neuropathy through correction of vitamin D deficiency in a type 1 diabetic patient[J]. Case Rep Endocrinol, 2012: 165056. doi:10.1155/2012/165056.
[19] Shehab D, Al-Jarallah K, Abdella N, et al. Prospective evaluation of the effect of short-term oral vitamin D supplementation on peripheral neuropathy in type 2 diabetes mellitus[J]. Med Princ Pract, 2015, 24(3): 250-256.
[20] Brown J, Bianco I, McGrath JJ, et al. 1,25-dihydroxyvitamin D3 induces nerve growth factor, promotes neurite outgrowth and inhibits mitosis in embryonic rat hippocampal neurons[J]. Neurosci Lett, 2003, 343(2): 139-143.
[21] Cornet A, Baudet C, Neveu I, et al. 1,25-Dihydroxyvitamin D3 regulates the expression of VDR and NGF gene in Schwann cells in vitro[J]. J Neurosci Res, 1998, 53(6): 742-746.
[22] Cheng HT, Dauch JR, Hayes JM, et al. Nerve growth factor mediates mechanical allodynia in a mouse model of type 2 diabetes[J]. Neuropathol Exp Neurol, 2009, 68(11): 1229-1243.
[23] Rukwied R, Mayer A, Kluschina O, et al. NGF induces non-inflammatory localized and lasting mechanical and thermal hypersensitivity in human skin[J]. Pain, 2010, 148(3): 407-413.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed

鼠神经生长因子联合维生素D、甲钴胺治疗糖尿病周围神经病变的临床观察

Vitamin D and mecobalamin combined with mouse nerve growth factor for diabetic peripheral neuropathy: a clinical observation

PDF (PC)

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 10

多维度评价

本文评价

推荐阅读 0

[1]	张亮,徐敏,庄向华,娄福臣,娄能俊,吕丽,郭文娟,郑凤杰,陈诗鸿. 内质网应激与凋亡在糖尿病周围神经病变中的表达变化[J]. 山东大学学报（医学版）, 2017, 55(8): 13-17.
[2]	王震,高计芳,关新媛,郭娟娟,杨笃晓,刘师莲. PC12细胞中V_d介导的SPHK1/S1P通路及其在EAE中的潜在功能[J]. 山东大学学报（医学版）, 2016, 54(10): 21-24.
[3]	李秀华, 李晓丽, 段瑞生, 朱梅佳, 曹莉莉, 李衍滨, 王思, 岳龙涛, 马庆海, 刘菲. 1,25(OH)₂D₃诱导实验性自身免疫性重症肌无力大鼠免疫耐受的机制[J]. 山东大学学报（医学版）, 2015, 53(8): 5-10.
[4]	孙卓浩, 刘妍, 周冬梅, 李伟. 阿米替林治疗痛性糖尿病周围神经病变的临床研究[J]. 山东大学学报（医学版）, 2015, 53(5): 81-84.
[5]	侯丽君1，邢鹂健2，李广红1，刘燕3,亓文波4. 维生素D受体基因ApaI多态性与糖耐量减低的相关性[J]. 山东大学学报（医学版）, 2014, 52(6): 51-54.
[6]	缪玉娥，王珏，王潍博. 胃癌及其癌旁黏膜中维生素D受体的表达[J]. 山东大学学报(医学版), 2012, 50(2): 74-.
[7]	尹晓1,阎玲2,陆勇1. 维生素D干预治疗对肥胖及相关代谢异常的影响[J]. 山东大学学报(医学版), 2011, 49(3): 1-.
[8]	尹晓1,阎玲2,陆勇1. 维生素D干预治疗对肥胖及相关代谢异常的影响[J]. 山东大学学报(医学版), 2011, 49(3): 1-.
[9]	王燕,康东红,曹维,王萍,刘智文. 血清维生素D水平与中老年人生活质量的相关性研究[J]. 山东大学学报(医学版), 2011, 49(2): 1-.
[10]	李晓红1,2，李芸1，王班琴1，刘师莲1. 山东汉族人群DBP基因多态性与多发性硬化的相关性[J]. 山东大学学报(医学版), 2010, 48(4): 67-.