甲基維生素B12治療糖尿病周圍神經病變的系統評價_《中國循證醫學雜志》

作者：

賈海燕 ¹ , 田浩明 ¹ , 魏東 ²

1. 四川大學華西醫院內分泌科,成都6100412. 成都市第二人民醫院內分泌科,成都610017;

關鍵詞：

甲基維生素B12 糖尿病周圍神經病變隨機對照試驗半隨機對照試驗系統評價

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　了解甲基維生素B12治療糖尿病周圍神經病變的療效和安全性.
方法　按照國際Cochrane協作網的系統評價方法,檢索全世界關于甲基維生素B12治療糖尿病周圍神經病變的隨機或半隨機對照試驗,包括Cochrane 圖書館2003年第4期、臨床對照試驗資料庫、MEDLINE、EMBASE、中國生物醫學文獻光盤數據庫、中文科技期刊全文數據庫以及所有納入研究的參考文獻.由兩位評價者獨立地對符合納入標準的試驗進行質量評價和資料提取.采用下列指標對甲基維生素B12治療糖尿病周圍神經病變的療效和安全性進行評價:臨床癥狀體征的總有效率、感覺及運動神經傳導速度以及嚴重不良反應的發生率.
結果　30個試驗共納入1 949例糖尿病周圍神經病變患者.大部分試驗的方法學質量較低.甲基維生素B12與其他B族維生素比較的13個試驗的"漏斗圖"圖分析顯示基本對稱,提示發表偏倚的可能性較小,結果比較可靠,但是不一定能代表整體發表偏倚情況.Meta分析結果顯示:甲基維生素B12可明顯改善糖尿病周圍神經病變的臨床癥狀和體征,且療效優于其他B族維生素;甲基維生素B12改善某些周圍神經傳導速度的療效優于其他B族維生素;在治療期間,試驗未發現嚴重不良反應.
結論　甲基維生素B12可能是一種相對安全和有效的治療糖尿病周圍神經病變的藥物.但由于納入試驗的方法學質量低下和可能存在發表偏倚,證據強度不足,尚有待大樣本、高質量的多中心隨機雙盲對照試驗加以證實.

引用本文： 賈海燕,田浩明,魏東. 甲基維生素B12治療糖尿病周圍神經病變的系統評價. 中國循證醫學雜志, 2005, 05(8): 609-618. doi: 復制

1.	汪仁斌, 劉興洲. 糖尿病神經病的發病機制[J]. 中日友好醫院學報, 1998; 12(1): 87.
2.	于鳳玲, 徐方江, 于鳳泉, 王艷芝. 甲鈷胺治療糖尿病周圍神經病變30例[J]. 醫藥導報, 2001; 20(9): 577.
3.	龐明. 彌可保對糖尿病周圍神經病變療效觀察[J]. 海峽藥學, 1997; 9(3): 32.
4.	龐建華, 康勝群, 王燕. 彌可保治療糖尿病周圍神經病變臨床觀察[J]. 河北醫學, 1998; 4(1): 87.
5.	姜雅秋, 劉國良, 王秋月, 王玉珍. 彌可保治療糖尿病周圍神經病變的療效觀察[J]. 遼寧醫學雜志, 1998; 12(2): 100～101.
6.	孟麗琴. 彌可保對糖尿病周圍神經病變的療效. 鎮江醫學院學報, 1999; 9(1): 97～98.
7.	馬書平, 趙志剛, 劉衛紅, 文世林, 魯平. 甲鈷胺對糖尿病周圍神經病變體感誘發電位潛時的影響[J]. 中國實用內科雜志, 1999; 19(7): 425～426.
8.	杜慶萍, 張福華, 王旭光, 趙頡. 彌可保治療糖尿病周圍神經病變臨床觀[J]. 青海醫藥雜志, 1999; 29(3): 23～24.
9.	康勝群, 支忠繼. 彌可保治療糖尿病周圍神經病變療效觀察[J]. 現代中西醫結合雜志, 1999; 8(12): 2067.
10.	甘華俠, 昌玉蘭, 陳惠賢, 李雯霞. 彌可保治療糖尿病周圍神經病變的療效觀察. 江西醫學院學報, 2000; 40(4): 102, 104.
11.	楊榮禮, 李勵, 呂麗麗, 項潔, 趙向東. 甲鈷胺治療老年糖尿病周圍神經病變的臨床觀察[J]. 徐州醫學院學報, 2000; 20(6): 468～469.
12.	施克新. 彌可保治療糖尿病周圍神經病變63例. 錦州醫學院學報, 2000;21(1):39～40.
13.	李雪鋒, 胡清, 朱大菊. 甲鈷胺治療糖尿病周圍神經病變的臨床評價[J]. 中國基層醫藥, 2001; 8(5): 452～453.
14.	徐靜, 孫艷波. 彌可保治療糖尿病周圍神經病56例療效觀察[J]. 中國臨床康復, 2002; 6(7): 1031.
15.	司獻軍. 甲鈷胺治療糖尿病周圍神經病變28例觀察[J]. 河南實用神經疾病雜志, 2002; 5(3): 55～56.
16.	張蜀平, 陸菊明, 潘長玉. 彌可保治療糖尿病周圍神經病變療效觀察[J]. 天津醫藥, 1997; 25(6): 337～340.
17.	徐震. 彌可保治療糖尿病神經病變11例療效觀察[J]. 嘉興醫學, 2000; 16(2): 121～122.
18.	李光偉, 北京彌可保臨床觀察協作組. 甲鈷胺治療糖尿病神經病變的臨床觀察[J]. 中華內科雜志, 1999; 38(1): 14～17.
19.	馮來會, 馮元森, 李彩霞, 楊洪文, 史廣巍. 甲鈷胺與前列腺素E1聯合應用治療周圍神經病變療效觀察[J]. 河南實用神經疾病雜志, 1999; 2(4): 25.
20.	岑海燕, 施文瑜. 彌可保治療糖尿病周圍神經病變療效觀察[J]. 南通醫學院學報, 2000; 20(4): 396～397.
21.	沈云峰, 鄒文華, 賴曉陽. 彌可保聯用前列腺素E1治療糖尿病神經病變的療效觀察[J]. 江西醫學院學報, 2001; 41(5): 113～114.
22.	朱旭萍, 周智廣. PGE1加甲鈷胺治療糖尿病周圍神經病變[J]. 湖南醫科大學學報, 2001; 26(4): 343～344.
23.	徐錫祥, 顧峰. 彌可保治療糖尿病多發性末梢神經病變[J]. 中國臨床醫學, 2003; 10(1): 64～65.
24.	張秀菊, 張秀芬. 彌可保治療糖尿病周圍神經病變51例療效觀察[J]. 中國臨床醫藥研究雜志, 2002; (68): 5655.
25.	鐘樹妹, 劉澤洪, 王健雄, 李韶今. 彌可保聯用血栓通治療糖尿病周圍神經病變短期療效[J]. 中國臨床康復, 2002; 6(23): 3582.
26.	張蜀平, 陸菊明, 潘長玉, 尹嶺, 竇京濤. 彌可保對糖尿病周圍神經病變治療作用的實驗研究[J]. 中華內分泌代謝雜志, 1998; 14(2): 130～132.
27.	Greene DA, Sima AAF, Stevens MJ, Feldman EL, Lattimer SA. Complication: neuropathy, pathogenetic consideration[J]. Diabetes Care, 1992; 15 (12): 1902-1925.
28.	Wang RB, Liu XZ. Pathogenesis of diabetic neuropathy[J]. Journal of China-Japan Friendship Hospital, 1998; 12 (1): 87.
29.	Devathasan G, Teo WL, Mylvaganam A, Thai AC, Chin JH. Methylcobalamin in chronic diabetic neuropathy. A double-blind clinical and electrophysiological study[J]. Clin Trials J, 1986; 23(2): 130-140.
30.	Yaqub BA, Siddique A, Sulimani R. Effects of methylcobalamin on diabetic neuropathy[J]. Clin Neurol Neurosurg, 1992; 94(2): 105-111.
31.	Yu FL, Xu FJ, Yu FQ, Wang YZ. Effects of methylcobalamin on diabetic peripheral neuropathy: analysis of 32 cases[J]. Herald of Medicine, 2001; 20(9): 577.
32.	Pang M. Effects of methylcobalamin on diabetic peripheral neuropathy[J]. Strait Medicine, 1997; 9(3): 32.
33.	Pang JH, Kang SQ, Wang Y. Clinical observation of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Hebei Medicine, 1998; 4(1): 87.
34.	Wu DH, Zhao HY, Liu YH, Shi XQ. Clinical observation of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Harbing Medical Journal, 1998; 18(3): 13-14.吳東紅, 趙環宇, 劉岳鴻, 史秀琴. 彌可保治療糖尿病周圍神經病變的臨床觀察[J]. 哈爾濱醫藥, 1998; 18(3): 13～14.
35.	Jiang YQ, Liu GL, Wang QY, Wang YZ. Effects of methylcobalamin on diabetic peripheral neuropathy[J]. Liaoning Medical Journal, 1998; 12(2): 100-101.
36.	Meng LQ. Effects of methylcobalamin on diabetic peripheral neuropathy[J]. Journal of ZhenJiang Medical College, 1999; 9(1): 97-98.
37.	Ma SP, Zhao ZG, Liu WH, Wen SL, Lu P. Effects of mecobalamin on latent period of somatosensory evked potential of diabetic peripheral neuropathy[J]. Chinese Journal of practical internal medicine, 1999; 19(7): 425-426.
38.	Du QP, Zhang FH, Wang XG, Zhao J. Clinical observation of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Qinghai Medical Journal, 1999; 29(3): 23-24.
39.	Kang SQ, Zhi ZJ. Clinical observation of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 1999; 8(12): 2067.
40.	Gan HX, Chang YL, Chen HX, Li WX. Clinical observation of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Acta Academiae Medicinae Jiangxi, 2000; 40(4): 102, 104.
41.	Yang RL, Li L, Lv LL, Xiangjie, Zhaoxiangdong. Clinical observation of effects of mecobalamin on older diabetic patients with peripheral neuropathy[J]. Acta Academiae Medicinae Xuzhou, 2000; 20(6): 468-469.
42.	Shi KX. Effects of methylcobalamin on diabetic peripheral neuropathy: analysis of 63 cases[J]. Acta Academiae Medicinae Jinzhou, 2000; 21(1): 39-40.
43.	Li XF, Hu Q, Zhu DJ. Clinical trial of mecobalamin in diabetic peripheral neuropathies[J]. Chinese Journal of Primary Medicine and Pharmacy, 2001; 8(5): 452-453.
44.	Xu J, Sun YB. Effects of methylcobalamin on diabetic peripheral neuropathy: analysis of 56 cases[J]. Chinese Journal of Clinical Rehabilitation, 2002; 6(7): 1031.
45.	Si XJ. Effects of mecobalamin on diabetic peripheral neuropathy: analysis of 28 cases[J]. Henan Journal of Practical Nervous Disease, 2002; 5(3): 55-56.
46.	Zhang SP, Lu JM, Pan CY. Effects of methylcobalamin on diabetic peripheral neuropathy[J]. TianJing Medical Journal, 1997; 25(6): 337-340.
47.	Xu Z. Effects of methylcobalamin on diabetic peripheral neuropathy: analysis of 11 cases[J]. JiaXing Medicine, 2000; 16(2): 121-122.
48.	Li GW, Beijing methycobal clinical trial collaborative group. Effects of mecobalamin on diabetic neuropathies[J]. Chinese Journal of Internal Medicine, 1999; 38(1): 14-17.
49.	Feng LH, Feng YS, Li CX, Yang HW, Shi GW. Clinical observation of combined therapeutic effect of mecobalamin and prostaglandin E1 on diabetic peripheral neuropathy[J]. Henan Journal of Practical Nervous Disease, 1999: 2(4): 25.
50.	Cen HY, Shi WY. Effects of mecobalamin on diabetic neuropathies[J]. Acta Academiae Medicinae Nantong, 2000; 20(4): 396-397.
51.	Shen YF, Zhou WH, Lai XY. Clinical observation of combined therapeutic effect of prostaglandin E1 and methylcobalamin on diabetic peripheral neuropathy[J]. Acta Academiae Medicinae Jiangxi, 2001; 41(5): 113-114.
52.	Zhu XP, Zhou ZG. Combined therapeutic effect of prostaglandin E1 and mecobalamin on diabetic peripheral neuropathy[J]. Bull Hunan Medical University, 2001; 26(4): 343-344.
53.	Xu XX, Gu F. Mecobalamin treats the diabetic distal polyneuropathy[J]. Clinical Medical Journal of China, 2003;10(1): 64-65.
54.	Zhang XJ, Zhang XF. Effects of methylcobalamin on diabetic peripheral neuropathy: analysis of 51 cases[J]. Chinese Journal of Research of Clinical Medicine and Pharmacy, 2002; (68): 5655.
55.	Li FS, Guo XH, Pan HF, Liu W. Effects of combined therapy of methylcobalamin and erigeron on diabetic peripheral neuropathy[J]. Jilin Medicine, 2002; 23(4): 232-233.李逢時, 郭興華, 潘煥峰, 劉巍. 彌可保與燈盞花聯合治療糖尿病周圍神經病變[J]. 吉林醫學, 2002; 23(4): 232～233.
56.	Zhong SM, Liu ZH, Wang JX, Li SJ. Short-term effects of combined therapy of methylcobalamin and XueShuangTong on diabetic peripheral neuropathy[J]. Chinese Journal of Clinical Rehabilitation, 2002; 6(23): 3582.
57.	Watanabe T, Kaji R, Oka N, Bara W, Kimura J. Ultra-high dose methyl-cobalamin promotes nerve regeneration in experimental acrylamide neuropathy[J]. J neurol Sci, 1994; 122(2): 140-143.
58.	Zhang SP, Lu JM, Pan CY, Yin L, Dou JT. Experimental study of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Chinese Journal of Endocrinology and Metabolism, 1998; 14(2): 130-132.
59.	Dyck PJ, Obrien PC. Meaningful degrees of prevention or improvement of nerve conduction in controlled clinical trials of diabetic neuropathy[J]. Diabetes Care, 1989; 12(9): 649-652.
60.	Ziegler D, Hanefeld M, Ruhnau KJ, Hasche H, Lobish M, Schutte K, Kerum G, Malessa R. Treatment of symptomatic diabetic polyneuropathy with the antioxidantα-lipoic acid[J]. Diabetes Care, 1999; 22(8): 1296-1301.
61.	Hotta N, Toyta T, Matsuoka K, Shigeta Y, Kikkawa R, Kaneko T, Takahashi A, Sugimura K, Koike Y, Ishii J, Sakamoto N. Clinical efficacy of fidarestat, a novel aldose reductade inhibitor, for diabetic peripheral neuropathy[J]. Diabetes Care, 2001; 24(10): 1776-1782.

1. 汪仁斌, 劉興洲. 糖尿病神經病的發病機制[J]. 中日友好醫院學報, 1998; 12(1): 87.
2. 于鳳玲, 徐方江, 于鳳泉, 王艷芝. 甲鈷胺治療糖尿病周圍神經病變30例[J]. 醫藥導報, 2001; 20(9): 577.
3. 龐明. 彌可保對糖尿病周圍神經病變療效觀察[J]. 海峽藥學, 1997; 9(3): 32.
4. 龐建華, 康勝群, 王燕. 彌可保治療糖尿病周圍神經病變臨床觀察[J]. 河北醫學, 1998; 4(1): 87.
5. 姜雅秋, 劉國良, 王秋月, 王玉珍. 彌可保治療糖尿病周圍神經病變的療效觀察[J]. 遼寧醫學雜志, 1998; 12(2): 100～101.
6. 孟麗琴. 彌可保對糖尿病周圍神經病變的療效. 鎮江醫學院學報, 1999; 9(1): 97～98.
7. 馬書平, 趙志剛, 劉衛紅, 文世林, 魯平. 甲鈷胺對糖尿病周圍神經病變體感誘發電位潛時的影響[J]. 中國實用內科雜志, 1999; 19(7): 425～426.
8. 杜慶萍, 張福華, 王旭光, 趙頡. 彌可保治療糖尿病周圍神經病變臨床觀[J]. 青海醫藥雜志, 1999; 29(3): 23～24.
9. 康勝群, 支忠繼. 彌可保治療糖尿病周圍神經病變療效觀察[J]. 現代中西醫結合雜志, 1999; 8(12): 2067.
10. 甘華俠, 昌玉蘭, 陳惠賢, 李雯霞. 彌可保治療糖尿病周圍神經病變的療效觀察. 江西醫學院學報, 2000; 40(4): 102, 104.
11. 楊榮禮, 李勵, 呂麗麗, 項潔, 趙向東. 甲鈷胺治療老年糖尿病周圍神經病變的臨床觀察[J]. 徐州醫學院學報, 2000; 20(6): 468～469.
12. 施克新. 彌可保治療糖尿病周圍神經病變63例. 錦州醫學院學報, 2000;21(1):39～40.
13. 李雪鋒, 胡清, 朱大菊. 甲鈷胺治療糖尿病周圍神經病變的臨床評價[J]. 中國基層醫藥, 2001; 8(5): 452～453.
14. 徐靜, 孫艷波. 彌可保治療糖尿病周圍神經病56例療效觀察[J]. 中國臨床康復, 2002; 6(7): 1031.
15. 司獻軍. 甲鈷胺治療糖尿病周圍神經病變28例觀察[J]. 河南實用神經疾病雜志, 2002; 5(3): 55～56.
16. 張蜀平, 陸菊明, 潘長玉. 彌可保治療糖尿病周圍神經病變療效觀察[J]. 天津醫藥, 1997; 25(6): 337～340.
17. 徐震. 彌可保治療糖尿病神經病變11例療效觀察[J]. 嘉興醫學, 2000; 16(2): 121～122.
18. 李光偉, 北京彌可保臨床觀察協作組. 甲鈷胺治療糖尿病神經病變的臨床觀察[J]. 中華內科雜志, 1999; 38(1): 14～17.
19. 馮來會, 馮元森, 李彩霞, 楊洪文, 史廣巍. 甲鈷胺與前列腺素E1聯合應用治療周圍神經病變療效觀察[J]. 河南實用神經疾病雜志, 1999; 2(4): 25.
20. 岑海燕, 施文瑜. 彌可保治療糖尿病周圍神經病變療效觀察[J]. 南通醫學院學報, 2000; 20(4): 396～397.
21. 沈云峰, 鄒文華, 賴曉陽. 彌可保聯用前列腺素E1治療糖尿病神經病變的療效觀察[J]. 江西醫學院學報, 2001; 41(5): 113～114.
22. 朱旭萍, 周智廣. PGE1加甲鈷胺治療糖尿病周圍神經病變[J]. 湖南醫科大學學報, 2001; 26(4): 343～344.
23. 徐錫祥, 顧峰. 彌可保治療糖尿病多發性末梢神經病變[J]. 中國臨床醫學, 2003; 10(1): 64～65.
24. 張秀菊, 張秀芬. 彌可保治療糖尿病周圍神經病變51例療效觀察[J]. 中國臨床醫藥研究雜志, 2002; (68): 5655.
25. 鐘樹妹, 劉澤洪, 王健雄, 李韶今. 彌可保聯用血栓通治療糖尿病周圍神經病變短期療效[J]. 中國臨床康復, 2002; 6(23): 3582.
26. 張蜀平, 陸菊明, 潘長玉, 尹嶺, 竇京濤. 彌可保對糖尿病周圍神經病變治療作用的實驗研究[J]. 中華內分泌代謝雜志, 1998; 14(2): 130～132.
27. Greene DA, Sima AAF, Stevens MJ, Feldman EL, Lattimer SA. Complication: neuropathy, pathogenetic consideration[J]. Diabetes Care, 1992; 15 (12): 1902-1925.
28. Wang RB, Liu XZ. Pathogenesis of diabetic neuropathy[J]. Journal of China-Japan Friendship Hospital, 1998; 12 (1): 87.
29. Devathasan G, Teo WL, Mylvaganam A, Thai AC, Chin JH. Methylcobalamin in chronic diabetic neuropathy. A double-blind clinical and electrophysiological study[J]. Clin Trials J, 1986; 23(2): 130-140.
30. Yaqub BA, Siddique A, Sulimani R. Effects of methylcobalamin on diabetic neuropathy[J]. Clin Neurol Neurosurg, 1992; 94(2): 105-111.
31. Yu FL, Xu FJ, Yu FQ, Wang YZ. Effects of methylcobalamin on diabetic peripheral neuropathy: analysis of 32 cases[J]. Herald of Medicine, 2001; 20(9): 577.
32. Pang M. Effects of methylcobalamin on diabetic peripheral neuropathy[J]. Strait Medicine, 1997; 9(3): 32.
33. Pang JH, Kang SQ, Wang Y. Clinical observation of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Hebei Medicine, 1998; 4(1): 87.
34. Wu DH, Zhao HY, Liu YH, Shi XQ. Clinical observation of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Harbing Medical Journal, 1998; 18(3): 13-14.吳東紅, 趙環宇, 劉岳鴻, 史秀琴. 彌可保治療糖尿病周圍神經病變的臨床觀察[J]. 哈爾濱醫藥, 1998; 18(3): 13～14.
35. Jiang YQ, Liu GL, Wang QY, Wang YZ. Effects of methylcobalamin on diabetic peripheral neuropathy[J]. Liaoning Medical Journal, 1998; 12(2): 100-101.
36. Meng LQ. Effects of methylcobalamin on diabetic peripheral neuropathy[J]. Journal of ZhenJiang Medical College, 1999; 9(1): 97-98.
37. Ma SP, Zhao ZG, Liu WH, Wen SL, Lu P. Effects of mecobalamin on latent period of somatosensory evked potential of diabetic peripheral neuropathy[J]. Chinese Journal of practical internal medicine, 1999; 19(7): 425-426.
38. Du QP, Zhang FH, Wang XG, Zhao J. Clinical observation of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Qinghai Medical Journal, 1999; 29(3): 23-24.
39. Kang SQ, Zhi ZJ. Clinical observation of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 1999; 8(12): 2067.
40. Gan HX, Chang YL, Chen HX, Li WX. Clinical observation of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Acta Academiae Medicinae Jiangxi, 2000; 40(4): 102, 104.
41. Yang RL, Li L, Lv LL, Xiangjie, Zhaoxiangdong. Clinical observation of effects of mecobalamin on older diabetic patients with peripheral neuropathy[J]. Acta Academiae Medicinae Xuzhou, 2000; 20(6): 468-469.
42. Shi KX. Effects of methylcobalamin on diabetic peripheral neuropathy: analysis of 63 cases[J]. Acta Academiae Medicinae Jinzhou, 2000; 21(1): 39-40.
43. Li XF, Hu Q, Zhu DJ. Clinical trial of mecobalamin in diabetic peripheral neuropathies[J]. Chinese Journal of Primary Medicine and Pharmacy, 2001; 8(5): 452-453.
44. Xu J, Sun YB. Effects of methylcobalamin on diabetic peripheral neuropathy: analysis of 56 cases[J]. Chinese Journal of Clinical Rehabilitation, 2002; 6(7): 1031.
45. Si XJ. Effects of mecobalamin on diabetic peripheral neuropathy: analysis of 28 cases[J]. Henan Journal of Practical Nervous Disease, 2002; 5(3): 55-56.
46. Zhang SP, Lu JM, Pan CY. Effects of methylcobalamin on diabetic peripheral neuropathy[J]. TianJing Medical Journal, 1997; 25(6): 337-340.
47. Xu Z. Effects of methylcobalamin on diabetic peripheral neuropathy: analysis of 11 cases[J]. JiaXing Medicine, 2000; 16(2): 121-122.
48. Li GW, Beijing methycobal clinical trial collaborative group. Effects of mecobalamin on diabetic neuropathies[J]. Chinese Journal of Internal Medicine, 1999; 38(1): 14-17.
49. Feng LH, Feng YS, Li CX, Yang HW, Shi GW. Clinical observation of combined therapeutic effect of mecobalamin and prostaglandin E1 on diabetic peripheral neuropathy[J]. Henan Journal of Practical Nervous Disease, 1999: 2(4): 25.
50. Cen HY, Shi WY. Effects of mecobalamin on diabetic neuropathies[J]. Acta Academiae Medicinae Nantong, 2000; 20(4): 396-397.
51. Shen YF, Zhou WH, Lai XY. Clinical observation of combined therapeutic effect of prostaglandin E1 and methylcobalamin on diabetic peripheral neuropathy[J]. Acta Academiae Medicinae Jiangxi, 2001; 41(5): 113-114.
52. Zhu XP, Zhou ZG. Combined therapeutic effect of prostaglandin E1 and mecobalamin on diabetic peripheral neuropathy[J]. Bull Hunan Medical University, 2001; 26(4): 343-344.
53. Xu XX, Gu F. Mecobalamin treats the diabetic distal polyneuropathy[J]. Clinical Medical Journal of China, 2003;10(1): 64-65.
54. Zhang XJ, Zhang XF. Effects of methylcobalamin on diabetic peripheral neuropathy: analysis of 51 cases[J]. Chinese Journal of Research of Clinical Medicine and Pharmacy, 2002; (68): 5655.
55. Li FS, Guo XH, Pan HF, Liu W. Effects of combined therapy of methylcobalamin and erigeron on diabetic peripheral neuropathy[J]. Jilin Medicine, 2002; 23(4): 232-233.李逢時, 郭興華, 潘煥峰, 劉巍. 彌可保與燈盞花聯合治療糖尿病周圍神經病變[J]. 吉林醫學, 2002; 23(4): 232～233.
56. Zhong SM, Liu ZH, Wang JX, Li SJ. Short-term effects of combined therapy of methylcobalamin and XueShuangTong on diabetic peripheral neuropathy[J]. Chinese Journal of Clinical Rehabilitation, 2002; 6(23): 3582.
57. Watanabe T, Kaji R, Oka N, Bara W, Kimura J. Ultra-high dose methyl-cobalamin promotes nerve regeneration in experimental acrylamide neuropathy[J]. J neurol Sci, 1994; 122(2): 140-143.
58. Zhang SP, Lu JM, Pan CY, Yin L, Dou JT. Experimental study of effects of methylcobalamin on diabetic peripheral neuropathy[J]. Chinese Journal of Endocrinology and Metabolism, 1998; 14(2): 130-132.
59. Dyck PJ, Obrien PC. Meaningful degrees of prevention or improvement of nerve conduction in controlled clinical trials of diabetic neuropathy[J]. Diabetes Care, 1989; 12(9): 649-652.
60. Ziegler D, Hanefeld M, Ruhnau KJ, Hasche H, Lobish M, Schutte K, Kerum G, Malessa R. Treatment of symptomatic diabetic polyneuropathy with the antioxidantα-lipoic acid[J]. Diabetes Care, 1999; 22(8): 1296-1301.
61. Hotta N, Toyta T, Matsuoka K, Shigeta Y, Kikkawa R, Kaneko T, Takahashi A, Sugimura K, Koike Y, Ishii J, Sakamoto N. Clinical efficacy of fidarestat, a novel aldose reductade inhibitor, for diabetic peripheral neuropathy[J]. Diabetes Care, 2001; 24(10): 1776-1782.

《中國循證醫學雜志》

甲基維生素B12治療糖尿病周圍神經病變的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《中國循證醫學雜志》

甲基維生素B12治療糖尿病周圍神經病變的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料