Objective To review systematically whether there is enough existing evidence that methylcobalamin is effective and safe in the treatment of the patients with diabetic peripheral neuropathy.Methods A Cochrane systematic review of all relevant randomized or quasi-randomized controlled trials of methycobalamin for diabetic peripheral neuropathy was performed. Clinical trials were searched from Cochrane Controlled Trials Register (Issue 4, 2003), MEDLINE (January 1966 to January 2004), EMBASE (January 1980 to January 2004), the Chinese Biological Medicine Database (1978 to January 2004), the Chinese Science and Technology Journal Full-text Database (1989 to January 2004) and references of all included trials. The selection of studies, data extraction and assessment of methodological quality were performed independently by two reviewers. The following outcomes were assessed: effectiveness of clinical signs and symptoms, sensory nerve and motor nerve conduction velocities and serious adverse events of methylcobalamin. Results Thirty randomized clinical trials including 1 949 patients met the inclusion criteria. The quality of the most included trials was of low level. The "funnel plot" of the comparison of thirteen studies of methylcobalamin with other B Vitamins studies showed symmetry, which indicated less possible publication bias and the result was partly reliable, but it could not indicate the whole publication biases. The results of meta-analysis indicated that methylcobalamin showed significantly positive effects on the improvement of the signs and symptoms of peripheral neuropathy, and the effects were better than the other vitamin B agents. The increase of some nerves conduction velocities by methylcobalamin was better than by the other vitamin B. No serious adverse events were observed during the treatment period.Conclusions Methylcobalamin appears to be a safe and effective treatment on diabetic peripheral neuropathy. However, the evidence is not b because of the low quality of most trials. Rigorously designed, randomized, double-blinded, placebo-controlled trials of methylcobalamin for diabetic peripheral neuropathy are needed to further assess the effect.
ObjectiveTo study the effect of combined treatment using pancreatic kinionogenase enteric-coated tab and mecobalamin injection on diabetic peripheral neuropathy (DPN) patients. MethodsWe collected 84 subjects with DPN who received treatment from January 2012 to December 2012 in our hospital, and we randomly divided them into treatment group (42 subjects, using pancreatic kinionogenase enteric-coated tab and methylcobalamin injection) and control group (42 subjects, using mecobalamine only). Subjects in the treatment group were given oral pancreatic kininogenase at 120 unit/times and 3 times/day, and methylcobalamin intravenous injection at 1 mg/day for 14 days. Subjects in the control group were only given methylcobalamin intravenous injection at 1 mg/day for 14 days. ResultsIn the treatment group, 22 subjects showed excellent, 19 subjects effective and 1 subject ineffective outcome. In the control group, 8 subjects showed excellent, 22 effective and 12 ineffective outcome. The difference between the two groups is statistically significant (P<0.01). Compared with no treatment, the nerve conduction velocity in both the two groups has been improved. The improvement in the treatment group is significantly better than that of the control group (P<0.01), and all of them had no obvious adverse reaction during the treatment. ConclusionThe combined treatment using pancreatic kinionogenase enteric-coated tab and methylcobalamin injection on DPN is better than using methylcobalamin only.