• 1. 四川大學(xué)華西醫(yī)院內(nèi)分泌科,成都6100412. 成都市第二人民醫(yī)院內(nèi)分泌科,成都610017;

目的 　了解甲基維生素B12治療糖尿病周圍神經(jīng)病變的療效和安全性.
方法 　按照國際Cochrane協(xié)作網(wǎng)的系統(tǒng)評價方法,檢索全世界關(guān)于甲基維生素B12治療糖尿病周圍神經(jīng)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(yī)學(xué)文獻(xiàn)光盤數(shù)據(jù)庫、中文科技期刊全文數(shù)據(jù)庫以及所有納入研究的參考文獻(xiàn).由兩位評價者獨立地對符合納入標(biāo)準(zhǔn)的試驗進(jìn)行質(zhì)量評價和資料提取.采用下列指標(biāo)對甲基維生素B12治療糖尿病周圍神經(jīng)病變的療效和安全性進(jìn)行評價:臨床癥狀體征的總有效率、感覺及運動神經(jīng)傳導(dǎo)速度以及嚴(yán)重不良反應(yīng)的發(fā)生率.
結(jié)果 　30個試驗共納入1 949例糖尿病周圍神經(jīng)病變患者.大部分試驗的方法學(xué)質(zhì)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(fā)表偏倚的可能性較小,結(jié)果比較可靠,但是不一定能代表整體發(fā)表偏倚情況.Meta分析結(jié)果顯示:甲基維生素B12可明顯改善糖尿病周圍神經(jīng)病變的臨床癥狀和體征,且療效優(yōu)于其他B族維生素;甲基維生素B12改善某些周圍神經(jīng)傳導(dǎo)速度的療效優(yōu)于其他B族維生素;在治療期間,試驗未發(fā)現(xiàn)嚴(yán)重不良反應(yīng).
結(jié)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(jīng)病變的藥物.但由于納入試驗的方法學(xué)質(zhì)量低下和可能存在發(fā)表偏倚,證據(jù)強度不足,尚有待大樣本、高質(zhì)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(jīng)病變的系統(tǒng)評價. 中國循證醫(yī)學(xué)雜志, 2005, 05(8): 609-618. doi: 復(fù)制

1. 汪仁斌, 劉興洲. 糖尿病神經(jīng)病的發(fā)病機制[J]. 中日友好醫(yī)院學(xué)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(jīng)病變30例[J]. 醫(yī)藥導(dǎo)報, 2001; 20(9): 577.
3. 龐明. 彌可保對糖尿病周圍神經(jīng)病變療效觀察[J]. 海峽藥學(xué), 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(jīng)病變臨床觀察[J]. 河北醫(yī)學(xué), 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(jīng)病變的療效觀察[J]. 遼寧醫(yī)學(xué)雜志, 1998; 12(2): 100～101.
6. 孟麗琴. 彌可保對糖尿病周圍神經(jīng)病變的療效. 鎮(zhèn)江醫(yī)學(xué)院學(xué)報, 1999; 9(1): 97～98.
7. 馬書平, 趙志剛, 劉衛(wèi)紅, 文世林, 魯平. 甲鈷胺對糖尿病周圍神經(jīng)病變體感誘發(fā)電位潛時的影響[J]. 中國實用內(nèi)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(jīng)病變臨床觀[J]. 青海醫(yī)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(jīng)病變療效觀察[J]. 現(xiàn)代中西醫(yī)結(jié)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(jīng)病變的療效觀察. 江西醫(yī)學(xué)院學(xué)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(jīng)病變的臨床觀察[J]. 徐州醫(yī)學(xué)院學(xué)報, 2000; 20(6): 468～469.
12. 施克新. 彌可保治療糖尿病周圍神經(jīng)病變63例. 錦州醫(yī)學(xué)院學(xué)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(jīng)病變的臨床評價[J]. 中國基層醫(yī)藥, 2001; 8(5): 452～453.
14. 徐靜, 孫艷波. 彌可保治療糖尿病周圍神經(jīng)病56例療效觀察[J]. 中國臨床康復(fù), 2002; 6(7): 1031.
15. 司獻(xiàn)軍. 甲鈷胺治療糖尿病周圍神經(jīng)病變28例觀察[J]. 河南實用神經(jīng)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(jīng)病變療效觀察[J]. 天津醫(yī)藥, 1997; 25(6): 337～340.
17. 徐震. 彌可保治療糖尿病神經(jīng)病變11例療效觀察[J]. 嘉興醫(yī)學(xué), 2000; 16(2): 121～122.
18. 李光偉, 北京彌可保臨床觀察協(xié)作組. 甲鈷胺治療糖尿病神經(jīng)病變的臨床觀察[J]. 中華內(nèi)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(lián)合應(yīng)用治療周圍神經(jīng)病變療效觀察[J]. 河南實用神經(jīng)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(jīng)病變療效觀察[J]. 南通醫(yī)學(xué)院學(xué)報, 2000; 20(4): 396～397.
21. 沈云峰, 鄒文華, 賴曉陽. 彌可保聯(lián)用前列腺素E1治療糖尿病神經(jīng)病變的療效觀察[J]. 江西醫(yī)學(xué)院學(xué)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(jīng)病變[J]. 湖南醫(yī)科大學(xué)學(xué)報, 2001; 26(4): 343～344.
23. 徐錫祥, 顧峰. 彌可保治療糖尿病多發(fā)性末梢神經(jīng)病變[J]. 中國臨床醫(yī)學(xué), 2003; 10(1): 64～65.
24. 張秀菊, 張秀芬. 彌可保治療糖尿病周圍神經(jīng)病變51例療效觀察[J]. 中國臨床醫(yī)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(lián)用血栓通治療糖尿病周圍神經(jīng)病變短期療效[J]. 中國臨床康復(fù), 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(jīng)病變治療作用的實驗研究[J]. 中華內(nèi)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(huán)宇, 劉岳鴻, 史秀琴. 彌可保治療糖尿病周圍神經(jīng)病變的臨床觀察[J]. 哈爾濱醫(yī)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(lián)合治療糖尿病周圍神經(jīng)病變[J]. 吉林醫(yī)學(xué), 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. 1. 汪仁斌, 劉興洲. 糖尿病神經(jīng)病的發(fā)病機制[J]. 中日友好醫(yī)院學(xué)報, 1998; 12(1): 87.
  2. 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(jīng)病變30例[J]. 醫(yī)藥導(dǎo)報, 2001; 20(9): 577.
  3. 3. 龐明. 彌可保對糖尿病周圍神經(jīng)病變療效觀察[J]. 海峽藥學(xué), 1997; 9(3): 32.
  4. 4. 龐建華, 康勝群, 王燕. 彌可保治療糖尿病周圍神經(jīng)病變臨床觀察[J]. 河北醫(yī)學(xué), 1998; 4(1): 87.
  5. 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(jīng)病變的療效觀察[J]. 遼寧醫(yī)學(xué)雜志, 1998; 12(2): 100～101.
  6. 6. 孟麗琴. 彌可保對糖尿病周圍神經(jīng)病變的療效. 鎮(zhèn)江醫(yī)學(xué)院學(xué)報, 1999; 9(1): 97～98.
  7. 7. 馬書平, 趙志剛, 劉衛(wèi)紅, 文世林, 魯平. 甲鈷胺對糖尿病周圍神經(jīng)病變體感誘發(fā)電位潛時的影響[J]. 中國實用內(nèi)科雜志, 1999; 19(7): 425～426.
  8. 8. 杜慶萍, 張福華, 王旭光, 趙頡. 彌可保治療糖尿病周圍神經(jīng)病變臨床觀[J]. 青海醫(yī)藥雜志, 1999; 29(3): 23～24.
  9. 9. 康勝群, 支忠繼. 彌可保治療糖尿病周圍神經(jīng)病變療效觀察[J]. 現(xiàn)代中西醫(yī)結(jié)合雜志, 1999; 8(12): 2067.
  10. 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(jīng)病變的療效觀察. 江西醫(yī)學(xué)院學(xué)報, 2000; 40(4): 102, 104.
  11. 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(jīng)病變的臨床觀察[J]. 徐州醫(yī)學(xué)院學(xué)報, 2000; 20(6): 468～469.
  12. 12. 施克新. 彌可保治療糖尿病周圍神經(jīng)病變63例. 錦州醫(yī)學(xué)院學(xué)報, 2000;21(1):39～40.
  13. 13. 李雪鋒, 胡清, 朱大菊. 甲鈷胺治療糖尿病周圍神經(jīng)病變的臨床評價[J]. 中國基層醫(yī)藥, 2001; 8(5): 452～453.
  14. 14. 徐靜, 孫艷波. 彌可保治療糖尿病周圍神經(jīng)病56例療效觀察[J]. 中國臨床康復(fù), 2002; 6(7): 1031.
  15. 15. 司獻(xiàn)軍. 甲鈷胺治療糖尿病周圍神經(jīng)病變28例觀察[J]. 河南實用神經(jīng)疾病雜志, 2002; 5(3): 55～56.
  16. 16. 張蜀平, 陸菊明, 潘長玉. 彌可保治療糖尿病周圍神經(jīng)病變療效觀察[J]. 天津醫(yī)藥, 1997; 25(6): 337～340.
  17. 17. 徐震. 彌可保治療糖尿病神經(jīng)病變11例療效觀察[J]. 嘉興醫(yī)學(xué), 2000; 16(2): 121～122.
  18. 18. 李光偉, 北京彌可保臨床觀察協(xié)作組. 甲鈷胺治療糖尿病神經(jīng)病變的臨床觀察[J]. 中華內(nèi)科雜志, 1999; 38(1): 14～17.
  19. 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(lián)合應(yīng)用治療周圍神經(jīng)病變療效觀察[J]. 河南實用神經(jīng)疾病雜志, 1999; 2(4): 25.
  20. 20. 岑海燕, 施文瑜. 彌可保治療糖尿病周圍神經(jīng)病變療效觀察[J]. 南通醫(yī)學(xué)院學(xué)報, 2000; 20(4): 396～397.
  21. 21. 沈云峰, 鄒文華, 賴曉陽. 彌可保聯(lián)用前列腺素E1治療糖尿病神經(jīng)病變的療效觀察[J]. 江西醫(yī)學(xué)院學(xué)報, 2001; 41(5): 113～114.
  22. 22. 朱旭萍, 周智廣. PGE1加甲鈷胺治療糖尿病周圍神經(jīng)病變[J]. 湖南醫(yī)科大學(xué)學(xué)報, 2001; 26(4): 343～344.
  23. 23. 徐錫祥, 顧峰. 彌可保治療糖尿病多發(fā)性末梢神經(jīng)病變[J]. 中國臨床醫(yī)學(xué), 2003; 10(1): 64～65.
  24. 24. 張秀菊, 張秀芬. 彌可保治療糖尿病周圍神經(jīng)病變51例療效觀察[J]. 中國臨床醫(yī)藥研究雜志, 2002; (68): 5655.
  25. 25. 鐘樹妹, 劉澤洪, 王健雄, 李韶今. 彌可保聯(lián)用血栓通治療糖尿病周圍神經(jīng)病變短期療效[J]. 中國臨床康復(fù), 2002; 6(23): 3582.
  26. 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(jīng)病變治療作用的實驗研究[J]. 中華內(nèi)分泌代謝雜志, 1998; 14(2): 130～132.
  27. 27. Greene DA, Sima AAF, Stevens MJ, Feldman EL, Lattimer SA. Complication: neuropathy, pathogenetic consideration[J]. Diabetes Care, 1992; 15 (12): 1902-1925.
  28. 28. Wang RB, Liu XZ. Pathogenesis of diabetic neuropathy[J]. Journal of China-Japan Friendship Hospital, 1998; 12 (1): 87.
  29. 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. 30. Yaqub BA, Siddique A, Sulimani R. Effects of methylcobalamin on diabetic neuropathy[J]. Clin Neurol Neurosurg, 1992; 94(2): 105-111.
  31. 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. 32. Pang M. Effects of methylcobalamin on diabetic peripheral neuropathy[J]. Strait Medicine, 1997; 9(3): 32.
  33. 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. 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(huán)宇, 劉岳鴻, 史秀琴. 彌可保治療糖尿病周圍神經(jīng)病變的臨床觀察[J]. 哈爾濱醫(yī)藥, 1998; 18(3): 13～14.
  35. 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. 36. Meng LQ. Effects of methylcobalamin on diabetic peripheral neuropathy[J]. Journal of ZhenJiang Medical College, 1999; 9(1): 97-98.
  37. 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. 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. 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. 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. 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. 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. 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. 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. 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. 46. Zhang SP, Lu JM, Pan CY. Effects of methylcobalamin on diabetic peripheral neuropathy[J]. TianJing Medical Journal, 1997; 25(6): 337-340.
  47. 47. Xu Z. Effects of methylcobalamin on diabetic peripheral neuropathy: analysis of 11 cases[J]. JiaXing Medicine, 2000; 16(2): 121-122.
  48. 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. 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. 50. Cen HY, Shi WY. Effects of mecobalamin on diabetic neuropathies[J]. Acta Academiae Medicinae Nantong, 2000; 20(4): 396-397.
  51. 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. 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. 53. Xu XX, Gu F. Mecobalamin treats the diabetic distal polyneuropathy[J]. Clinical Medical Journal of China, 2003;10(1): 64-65.
  54. 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. 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(lián)合治療糖尿病周圍神經(jīng)病變[J]. 吉林醫(yī)學(xué), 2002; 23(4): 232～233.
  56. 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. 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. 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. 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. 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. 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.