目的 比較目前臨床應(yīng)用相對較多的兩種維生素B12制劑對周圍神經(jīng)病變臨床癥狀的療效。方法 選取天津市第一醫(yī)院臨床收納的滿足試驗條件的神經(jīng)卡壓性周圍神經(jīng)病變患者，隨機分為甲鈷胺組（41例），腺苷鈷胺組（39例）和針灸組（41例），甲鈷胺組患者靜脈滴注彌可保，每次0.5 mg，1 次/d；腺苷鈷胺組患者肌肉注射腺苷鈷胺，每次0.5 mg，1 次/d；針灸組選用針灸理療、按摩等常規(guī)治療。3組患者均治療兩周。觀測治療后患者的主觀癥狀、各項體征，并嚴密觀察、記錄試驗期間發(fā)生的不良反應(yīng)事件。結(jié)果 3組治療患者均未見不良反應(yīng)，甲鈷胺組在主觀癥狀、客觀體征方面改善均優(yōu)于腺苷鈷胺組及針灸組。結(jié)論 甲鈷胺作為最新一代的維生素B12臨床應(yīng)用療效、安全性方面均優(yōu)于以往維生素B12，且西醫(yī)治療周圍神經(jīng)病變較單純針灸治療有明顯療效優(yōu)勢。

Objective To compare the clinical efficacy of two kinds of vitamin B12 which were commonly applied in clinic for the clinical symptoms of peripheral neuropathy. Methods Nerve entrapment neuropathy patients in Tianjin First Hospital which meet the experiment condition were selected. They were randomly divided into methylcobalamin (41 cases), cobamamide (39 cases), and acupuncture (41 cases) groups. Patients in methylcobalamin group were iv administered with methylcobalamin 0.5 mg once daily. Patients in cobamamide group were im administered with cobamamide 0.5 mg once daily, and patients in acupuncture group used acupuncture treatments, massages, and other conventional treatment. Three groups were treated for two weeks. Clinical symptom and sign were observed and adverse drug reactions during experiment period were observed and recorded. Results There was no serious adverse reaction in the three groups. Changes of subjective symptoms and objective signs in methylcobalamin group were better than those in cobamamide and acupuncture groups. Conclusion Methylcobalamin as the latest generation of vitamin B12 is better than previous vitamin B12 in clinical efficacy and safety aspects. Western medicine treatment in peripheral neuropathy has the advantages on efficacy than simple acupuncture treatment.