Objective:To analyze the effect of cinepazide combined with mecobalamine on nerve conduction velocity, vibration perception threshold and serum indexes in patients with diabetic peripheral neuropathy. Methods:90 patie...Objective:To analyze the effect of cinepazide combined with mecobalamine on nerve conduction velocity, vibration perception threshold and serum indexes in patients with diabetic peripheral neuropathy. Methods:90 patients with diabetic peripheral neuropathy treated in our hospital between March 2013 and March 2016 were selected and divided into observation group and control group (n=45) according to random number table, control group received mecobalamine treatment alone and observation group accepted the cinepazide combined with mecobalamine therapy. Differences in nerve conduction velocity, vibration perception threshold as well as serum oxidative stress indexes and nerve injury marker molecules were compared between two groups of patients 2 weeks after treatment. Results:2 weeks after treatment, median nerve, ulnar nerve and peroneal nerve sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) levels of observation group were higher than those of control group (P<0.05) while both lower extremities vibration perception threshold (VPT) levels were lower than those of control group (P<0.05). Serum homocysteine (HCY), advanced glycosylation end products (AGEs), malondialdehyde (MDA), neuron-specific enolase (NSE), high mobility group B1 (HMGB1) and S100βcontent of observation group were lower than those of control group (P<0.05) while reduced glutathione (GSH), superoxide dismutase (SOD), myelin basic protein (MBP) and brain-derived neurotrophic factor (BDNF) content were higher than those of control group (P<0.05). Conclusions:Cinepazide combined with mecobalamine can reduce the nerve injury degree, improve nerve conduction and vibration perception and alleviate the oxidative stress degree in patients with diabetic peripheral neuropathy.展开更多
Objective To observe the therapeutic efficacy of moxibustion combined with mecobalamin on diabetic perineuropathy and the effects on blood homocysteine in pa ents with diabe c perineuropathy. Methods One hundred and f...Objective To observe the therapeutic efficacy of moxibustion combined with mecobalamin on diabetic perineuropathy and the effects on blood homocysteine in pa ents with diabe c perineuropathy. Methods One hundred and fifty patients with diabetic perineuropathy meeting with the inclusive criteria were randomized into a moxibus on group,a mecobalamin group and a therapeutic alliance group by using random digits table. Moxibustion was carried out on Tàixī（太溪 KI 3）,Sānyīnjiāo（三阴交 SP 6）,Zúsānl？（足三里 ST 36）,Hég？（合谷 LI 4） and Qūchí（曲池 LI 11） for the patients in the moxibustion group,the treatments were carried out once every other day,treatments for ten mes were considered as a treatment course,and totally three treatment courses were carried out. The pa ents in the mecobalamin group were orally administered with mecobalamin tablet 500 μg once,three times a day,20 days were considered as a treatment course,and totally three treatment courses were carried out. Moxibustion was carried out on the basis of oral administration with mecobalamin tablet in the therapeutic alliance group. The clinical symptoms,nerve conductive velocities and changes in blood homocysteine were observed before and after the treatments in the three groups. Results The total eff ec ve rate in the moxibus on group was 74.0%（37/50）,82.0%（41/50） in the mecobalamin group,94.0%（47/50） in the therapeutic alliance group,and the total effective rate in the therapeutic alliance group was significantly be er than the other two groups（P0.01）. The nerve conductive velocities in the mecobalamin group and the therapeutic alliance group after the treatments were significantly increased and the blood homocysteine level decreased in comparison to those before the treatments（P0.01）,while the nerve conductive velocity increased and the blood homocysteine level decreased in the therapeutic alliance group after the treatments in comparison to those in the other two groups（P0.01）. Conclusion Treatments on diabe c perineuropathy by therapeu c alliance of moxibustion and mecobalamin can not only improve symptoms of patients,increase nerve conduc ve velocity in aff ected limbs,but also decrease blood homocysteine level. The method is simple,economical and safe,and it deserves being generalized in clinical prac ces.展开更多
OBJECTIVE：This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction（HGWWD） for treating diabetic peripheral neuropathy.DATA SOUR...OBJECTIVE：This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction（HGWWD） for treating diabetic peripheral neuropathy.DATA SOURCES：Six electronic databases,including the Cochrane Library,MEDLINE database,Chinese Biomedical Database,Chinese National Knowledge Infrastructure Database,Chinese Science and Technique Journals Database,and the Wanfang Database,were search ed on the internet for randomized controlled trials published up until 1 December 2015.The search terms included ＂Chinese herbal medicine＂,＂diabetic peripheral neuropathy＂ and ＂randomized controlled trials＂ in Chinese and in English.DATA SELECTION：We included randomized controlled trials using HGWWD/modified HGWWD for the treatment group,without restriction for the control group.We assessed literature quality in accordance with the Cochrane Review Handbook.A random or a fixed effects model was used to analyze outcomes using Rev Man 5.2 software.OUTCOME MEASURES：The primary outcomes were changes in symptoms and nerve conduction velocities.The secondary outcomeswere fasting blood glucose and hemorheological indexes.RESULTS：Sixteen randomized controlled trials,with a total of 1,173 patients,were included.Meta-analysis revealed that the efficacy of HGWWD for diabetic peripheral neuropathy was significantly superior compared with the control treatment（i.e.,control group）（risk ratio = 0.36,95% confidence interval（CI）：0.29–0.46,Z =8.33,P 〈 0.00001） Compared with the control group,there was an increase in median motor nerve conduction velocity（mean difference（MD） = 3.46,95%CI：1.88–5.04,Z = 4.30,P 〈 0.01） and median sensory nerve conduction velocity（MD = 3.30,95%CI：2.04–4.56,Z = 5.14,P 〈 0.01）.There was also an increase in peroneal motor nerve conduction velocity（MD = 3.22,95%CI：2.45–3.98,Z = 8.21,P 〈 0.01） and peroneal sensory nerve conduction velocity（MD = 3.05,95%CI：2.01–4.09,Z = 5.75,P 〈 0.01） in the treatment groups.No significant difference in fasting blood glucose was found between the treatment groups and the control groups（MD =-0.12,95%CI：-0.42–0.19,Z = 0.76,P = 0.45）.Plasma viscosity was significantly decreased after treatment（MD =-0.11,95%CI：-0.21 to-0.02,Z = 2.30,P = 0.02）.No significant difference in fibrinogen was detectable（MD =-0.53,95%CI：-1.28–0.22,Z = 1.38,P = 0.17）.Four trials reported that treatment groups experienced no adverse reactions.Adverse events were not mentioned in the other 12 trials.No trial reported the incidence of complications,quality of life outcomes,or health economics.CONCLUSION：HGWWD treatment improves diabetic neurologic symptoms and ameliorates nerve conduction velocities.Our study suggests that HGWWD may have significant therapeutic efficacy for the treatment of diabetic peripheral neuropathy.However,the methodological quality of the randomized controlled trials was generally low.Larger and better-designed randomized controlled trials are required to more reliably assess the clinical effectiveness of HGWWD.展开更多
Mecobalamin, a form of vitamin B12 containing a central metal element （cobalt）, is one of the most important mediators of nervous system function. In the clinic, it is often used to accelerate recovery of peripheral...Mecobalamin, a form of vitamin B12 containing a central metal element （cobalt）, is one of the most important mediators of nervous system function. In the clinic, it is often used to accelerate recovery of peripheral nerves, but its molecular mechanism remains unclear. In the present study, we performed sciatic nerve crush injury in mice, followed by daily intraperitoneal administra-tion of mecobalamin （65 μg/kg or 130 μg/kg） or saline （negative control）. Walking track analysis, histomorphological examination, and quantitative real-time PCR showed that mecobalamin signiifcantly improved functional recovery of the sciatic nerve, thickened the myelin sheath in myelinated nerve ifbers, and increased the cross-sectional area of target muscle cells. Further-more, mecobalamin upregulated mRNA expression of growth associated protein 43 in nerve tissue ipsilateral to the injury, and of neurotrophic factors （nerve growth factor, brain-derived nerve growth factor and ciliary neurotrophic factor） in the L4–6 dorsal root ganglia. Our ifndings indicate that the molecular mechanism underlying the therapeutic effect of mecobalamin after sciatic nerve injury involves the upregulation of multiple neurotrophic factor genes.展开更多
Objective:To compare the clinical effect differences between western medication,acupuncture,and acupuncture combine with western medication in the treatment of diabetic peripheral neuropathy.Methods:Ninety-three patie...Objective:To compare the clinical effect differences between western medication,acupuncture,and acupuncture combine with western medication in the treatment of diabetic peripheral neuropathy.Methods:Ninety-three patients were randomized into western medication group,acupuncture group,and combination group,with 31 cases in each.The patients in western medication group were treated with lipoic acid injection and mecobalamin injection/tablets.The patients in acupuncture group were treated with acupuncture,and the acupoints were selected according to the symptoms.The needles were retained for 30 min,once a day.The patients in combination group were treated with both western medication and acupuncture,specific methods as the above.The treatments were for 18 days in succession in all of three group.The motor nerve conduction velocity(MNCV) and sensory nerve conduction velocity(SNCV) of median nerve and common peroneal nerve,as well as the changes of symptoms and signs of patients were observed before and after treatment.The clinical effect was evaluated.Results:After treatment,the median nerve MNCV in the three groups,the median nerve SNCV and common peroneal nerve MNCV in acupuncture group and combination groups,and the common peroneal nerve SNCV in acupuncture group were all higher than those of before treatment,with significantly statistical differences(all P<0.05).After treatment,the MNCV and SNCV of median nerve and common peroneal nerve in combination group were higher than those in western medication group and acupuncture group,with significantly statistical differences(all P<0.05).After treatment,the number of patients in the three groups with the symptoms and signs was lower than that of before treatment.The effective rate in combination group was 96.8%(30/31),higher than those of western medication group,74.2%(23/31),and acupuncture group,83.8%(26/31),with significantly statistical differences(both P<0.05).Conclusion:Acupuncture combined with western medication in the treatment of diabetic peripheral neuropathy can improve the nerve conduction velocity and improve the symptoms and signs of diabetic patients,with a better effect than those of western medication and simple acupuncture.展开更多
Objective: This research aims to explore the clinical curative effect for the treatment peripheral nerve injury growth factor of Mecobalamin combined with nerve. Methods: 150 cases of patients with peripheral nerve in...Objective: This research aims to explore the clinical curative effect for the treatment peripheral nerve injury growth factor of Mecobalamin combined with nerve. Methods: 150 cases of patients with peripheral nerve injury treated in the hospital in July were selected from 2011 to 2013. Those patients were randomly divided into three groups according to the types of injured nerve and the undergoing treatment order. 50 cases are for each group. Patients in group A were injected with 0.5 mg Mecobalamin by intravenous injection. It lasted for once a day, for 10 days. Later, 0.5 mg Mecobalamin was changed to be taken orally, three times a day, a course of treatment. And a course is 3 to 6 weeks. 50 patients in group B were injected with nerve growth factor for 30 micrograms by intramuscular injection, once a day, a course of treatment. And a course is 3 to 6 weeks. While in group C, 50 patients were treated with Mecobalamin (0.5 mg, intravenous injection, once a day) combined with nerve growth factor (30 mg, intramuscular injection, once a day). A course lasted 3 to 6 weeks. The purpose is to observe the therapeutic effect of two different drugs on patients with peripheral nerve injury. Results: The curative effect of Mecobalamin combined with nerve growth factors for the treatment of peripheral nerve injury in group C is more significant than the single drug treatment in group A and group B. Peripheral nerve injury after sensorimotor function rating evaluation of curative effect made by The British Medical Research Institute of Neurotrauma Society was applied in this research. The comparison of the results of 3 groups after treatment is showed as follows. As to the sensory recovery above level II, the curative effect in C group is generally better than in group A and group B, the approximate chi square test H = 13.6573, P = 0.0011. About motion recovery situation, there is a statistical significance in group A and group C which recovered V level X<sup>2</sup> = 3.8431, P = 0.0499, while there is no obvious difference in group B (P > 0.05). Conclusion: Some certain curative effect is presented of Mecobalamin combined with nerve growth factor in the treatment of peripheral nerve injury, which has an important clinical significance. Therefore, it is worth taking into application.展开更多
文摘Objective:To analyze the effect of cinepazide combined with mecobalamine on nerve conduction velocity, vibration perception threshold and serum indexes in patients with diabetic peripheral neuropathy. Methods:90 patients with diabetic peripheral neuropathy treated in our hospital between March 2013 and March 2016 were selected and divided into observation group and control group (n=45) according to random number table, control group received mecobalamine treatment alone and observation group accepted the cinepazide combined with mecobalamine therapy. Differences in nerve conduction velocity, vibration perception threshold as well as serum oxidative stress indexes and nerve injury marker molecules were compared between two groups of patients 2 weeks after treatment. Results:2 weeks after treatment, median nerve, ulnar nerve and peroneal nerve sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) levels of observation group were higher than those of control group (P<0.05) while both lower extremities vibration perception threshold (VPT) levels were lower than those of control group (P<0.05). Serum homocysteine (HCY), advanced glycosylation end products (AGEs), malondialdehyde (MDA), neuron-specific enolase (NSE), high mobility group B1 (HMGB1) and S100βcontent of observation group were lower than those of control group (P<0.05) while reduced glutathione (GSH), superoxide dismutase (SOD), myelin basic protein (MBP) and brain-derived neurotrophic factor (BDNF) content were higher than those of control group (P<0.05). Conclusions:Cinepazide combined with mecobalamine can reduce the nerve injury degree, improve nerve conduction and vibration perception and alleviate the oxidative stress degree in patients with diabetic peripheral neuropathy.
文摘Objective To observe the therapeutic efficacy of moxibustion combined with mecobalamin on diabetic perineuropathy and the effects on blood homocysteine in pa ents with diabe c perineuropathy. Methods One hundred and fifty patients with diabetic perineuropathy meeting with the inclusive criteria were randomized into a moxibus on group,a mecobalamin group and a therapeutic alliance group by using random digits table. Moxibustion was carried out on Tàixī（太溪 KI 3）,Sānyīnjiāo（三阴交 SP 6）,Zúsānl？（足三里 ST 36）,Hég？（合谷 LI 4） and Qūchí（曲池 LI 11） for the patients in the moxibustion group,the treatments were carried out once every other day,treatments for ten mes were considered as a treatment course,and totally three treatment courses were carried out. The pa ents in the mecobalamin group were orally administered with mecobalamin tablet 500 μg once,three times a day,20 days were considered as a treatment course,and totally three treatment courses were carried out. Moxibustion was carried out on the basis of oral administration with mecobalamin tablet in the therapeutic alliance group. The clinical symptoms,nerve conductive velocities and changes in blood homocysteine were observed before and after the treatments in the three groups. Results The total eff ec ve rate in the moxibus on group was 74.0%（37/50）,82.0%（41/50） in the mecobalamin group,94.0%（47/50） in the therapeutic alliance group,and the total effective rate in the therapeutic alliance group was significantly be er than the other two groups（P0.01）. The nerve conductive velocities in the mecobalamin group and the therapeutic alliance group after the treatments were significantly increased and the blood homocysteine level decreased in comparison to those before the treatments（P0.01）,while the nerve conductive velocity increased and the blood homocysteine level decreased in the therapeutic alliance group after the treatments in comparison to those in the other two groups（P0.01）. Conclusion Treatments on diabe c perineuropathy by therapeu c alliance of moxibustion and mecobalamin can not only improve symptoms of patients,increase nerve conduc ve velocity in aff ected limbs,but also decrease blood homocysteine level. The method is simple,economical and safe,and it deserves being generalized in clinical prac ces.
基金supported by a grant from the National Basic Research Program of China(973 Program),No.2010CB530600Institutes Project from Guang’anmen Hospital of China Academy of Chinese Medical Sciences,No.2011261
文摘OBJECTIVE：This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction（HGWWD） for treating diabetic peripheral neuropathy.DATA SOURCES：Six electronic databases,including the Cochrane Library,MEDLINE database,Chinese Biomedical Database,Chinese National Knowledge Infrastructure Database,Chinese Science and Technique Journals Database,and the Wanfang Database,were search ed on the internet for randomized controlled trials published up until 1 December 2015.The search terms included ＂Chinese herbal medicine＂,＂diabetic peripheral neuropathy＂ and ＂randomized controlled trials＂ in Chinese and in English.DATA SELECTION：We included randomized controlled trials using HGWWD/modified HGWWD for the treatment group,without restriction for the control group.We assessed literature quality in accordance with the Cochrane Review Handbook.A random or a fixed effects model was used to analyze outcomes using Rev Man 5.2 software.OUTCOME MEASURES：The primary outcomes were changes in symptoms and nerve conduction velocities.The secondary outcomeswere fasting blood glucose and hemorheological indexes.RESULTS：Sixteen randomized controlled trials,with a total of 1,173 patients,were included.Meta-analysis revealed that the efficacy of HGWWD for diabetic peripheral neuropathy was significantly superior compared with the control treatment（i.e.,control group）（risk ratio = 0.36,95% confidence interval（CI）：0.29–0.46,Z =8.33,P 〈 0.00001） Compared with the control group,there was an increase in median motor nerve conduction velocity（mean difference（MD） = 3.46,95%CI：1.88–5.04,Z = 4.30,P 〈 0.01） and median sensory nerve conduction velocity（MD = 3.30,95%CI：2.04–4.56,Z = 5.14,P 〈 0.01）.There was also an increase in peroneal motor nerve conduction velocity（MD = 3.22,95%CI：2.45–3.98,Z = 8.21,P 〈 0.01） and peroneal sensory nerve conduction velocity（MD = 3.05,95%CI：2.01–4.09,Z = 5.75,P 〈 0.01） in the treatment groups.No significant difference in fasting blood glucose was found between the treatment groups and the control groups（MD =-0.12,95%CI：-0.42–0.19,Z = 0.76,P = 0.45）.Plasma viscosity was significantly decreased after treatment（MD =-0.11,95%CI：-0.21 to-0.02,Z = 2.30,P = 0.02）.No significant difference in fibrinogen was detectable（MD =-0.53,95%CI：-1.28–0.22,Z = 1.38,P = 0.17）.Four trials reported that treatment groups experienced no adverse reactions.Adverse events were not mentioned in the other 12 trials.No trial reported the incidence of complications,quality of life outcomes,or health economics.CONCLUSION：HGWWD treatment improves diabetic neurologic symptoms and ameliorates nerve conduction velocities.Our study suggests that HGWWD may have significant therapeutic efficacy for the treatment of diabetic peripheral neuropathy.However,the methodological quality of the randomized controlled trials was generally low.Larger and better-designed randomized controlled trials are required to more reliably assess the clinical effectiveness of HGWWD.
基金supported by Nanjing Medical University Technology Development Fund of China(General Program),No.2013NJMU182
文摘Mecobalamin, a form of vitamin B12 containing a central metal element （cobalt）, is one of the most important mediators of nervous system function. In the clinic, it is often used to accelerate recovery of peripheral nerves, but its molecular mechanism remains unclear. In the present study, we performed sciatic nerve crush injury in mice, followed by daily intraperitoneal administra-tion of mecobalamin （65 μg/kg or 130 μg/kg） or saline （negative control）. Walking track analysis, histomorphological examination, and quantitative real-time PCR showed that mecobalamin signiifcantly improved functional recovery of the sciatic nerve, thickened the myelin sheath in myelinated nerve ifbers, and increased the cross-sectional area of target muscle cells. Further-more, mecobalamin upregulated mRNA expression of growth associated protein 43 in nerve tissue ipsilateral to the injury, and of neurotrophic factors （nerve growth factor, brain-derived nerve growth factor and ciliary neurotrophic factor） in the L4–6 dorsal root ganglia. Our ifndings indicate that the molecular mechanism underlying the therapeutic effect of mecobalamin after sciatic nerve injury involves the upregulation of multiple neurotrophic factor genes.
基金Zhangjiakou Science and Technology Research Plan:1321111D。
文摘Objective:To compare the clinical effect differences between western medication,acupuncture,and acupuncture combine with western medication in the treatment of diabetic peripheral neuropathy.Methods:Ninety-three patients were randomized into western medication group,acupuncture group,and combination group,with 31 cases in each.The patients in western medication group were treated with lipoic acid injection and mecobalamin injection/tablets.The patients in acupuncture group were treated with acupuncture,and the acupoints were selected according to the symptoms.The needles were retained for 30 min,once a day.The patients in combination group were treated with both western medication and acupuncture,specific methods as the above.The treatments were for 18 days in succession in all of three group.The motor nerve conduction velocity(MNCV) and sensory nerve conduction velocity(SNCV) of median nerve and common peroneal nerve,as well as the changes of symptoms and signs of patients were observed before and after treatment.The clinical effect was evaluated.Results:After treatment,the median nerve MNCV in the three groups,the median nerve SNCV and common peroneal nerve MNCV in acupuncture group and combination groups,and the common peroneal nerve SNCV in acupuncture group were all higher than those of before treatment,with significantly statistical differences(all P<0.05).After treatment,the MNCV and SNCV of median nerve and common peroneal nerve in combination group were higher than those in western medication group and acupuncture group,with significantly statistical differences(all P<0.05).After treatment,the number of patients in the three groups with the symptoms and signs was lower than that of before treatment.The effective rate in combination group was 96.8%(30/31),higher than those of western medication group,74.2%(23/31),and acupuncture group,83.8%(26/31),with significantly statistical differences(both P<0.05).Conclusion:Acupuncture combined with western medication in the treatment of diabetic peripheral neuropathy can improve the nerve conduction velocity and improve the symptoms and signs of diabetic patients,with a better effect than those of western medication and simple acupuncture.
文摘Objective: This research aims to explore the clinical curative effect for the treatment peripheral nerve injury growth factor of Mecobalamin combined with nerve. Methods: 150 cases of patients with peripheral nerve injury treated in the hospital in July were selected from 2011 to 2013. Those patients were randomly divided into three groups according to the types of injured nerve and the undergoing treatment order. 50 cases are for each group. Patients in group A were injected with 0.5 mg Mecobalamin by intravenous injection. It lasted for once a day, for 10 days. Later, 0.5 mg Mecobalamin was changed to be taken orally, three times a day, a course of treatment. And a course is 3 to 6 weeks. 50 patients in group B were injected with nerve growth factor for 30 micrograms by intramuscular injection, once a day, a course of treatment. And a course is 3 to 6 weeks. While in group C, 50 patients were treated with Mecobalamin (0.5 mg, intravenous injection, once a day) combined with nerve growth factor (30 mg, intramuscular injection, once a day). A course lasted 3 to 6 weeks. The purpose is to observe the therapeutic effect of two different drugs on patients with peripheral nerve injury. Results: The curative effect of Mecobalamin combined with nerve growth factors for the treatment of peripheral nerve injury in group C is more significant than the single drug treatment in group A and group B. Peripheral nerve injury after sensorimotor function rating evaluation of curative effect made by The British Medical Research Institute of Neurotrauma Society was applied in this research. The comparison of the results of 3 groups after treatment is showed as follows. As to the sensory recovery above level II, the curative effect in C group is generally better than in group A and group B, the approximate chi square test H = 13.6573, P = 0.0011. About motion recovery situation, there is a statistical significance in group A and group C which recovered V level X<sup>2</sup> = 3.8431, P = 0.0499, while there is no obvious difference in group B (P > 0.05). Conclusion: Some certain curative effect is presented of Mecobalamin combined with nerve growth factor in the treatment of peripheral nerve injury, which has an important clinical significance. Therefore, it is worth taking into application.
