족부의 말초 신경 병변으로 인한 통증에서 피리독신의 사용 = Pyridoxine in the Treatment of Peripheral Nerve Related Foot Pain

다국어 초록 (Multilingual Abstract)

Purpose: We analyzed retrospectively the effect of pyridoxine in the treatment of peripheral nerve related foot pain because we have seen favorable clinical results from it as a monotherapy. Materials and Methods: We analyzed the clinical results of 200 cases of peripheral nerve related foot pain, treated with pyridoxine from March 2009 to February 2012. We devided them into three groups, peripheral neuritis, Morton's neuroma and posttraumatic neuralgia and recorded percentage of improvement of pain, compared to initial pain level at 2 weeks and 6 weeks. Results: There were 127 peripheral neuritis cases, 22 Morton's neuroma and 51 posttraumatic neuralgia. At 2 weeks after treatment, 135 cases(67.5%) showed pain relief. At 6 weeks, 36 cases(21%) showed complete improvement of pain, 81 cases(47%) showed more than 50 % of improvement, 22 cases(13%) showed less than 50% of improvement and 33 cases(19%) showed no improvement. There are 4 cases of gastrointestinal discomfort and 2 cases of aggravation of nervy pain. Conclusion: Pyridoxine was effective drug in the treatment of peripheral neuropathic pain in terms of pain relief, safety and cost effectiveness. So it can be an available first line drug before adding other drugs.

참고문헌 (Reference)

1 정국진, "신경병증성 통증의 치료 지침에 대한 고찰" 대한척추외과학회 18 (18): 246-253, 2011

2 Tandan R, "Topical capsaicin in painful diabetic neuropathy. Effect on sensory function" 15 : 15-18, 1992

3 Ametov AS, "The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid : the SYDNEY trial" 26 : 770-776, 2003

4 Tutuncu NB, "Reversal of defective nerve conduction with vitamin E supplementation in type 2 diabetes : a preliminary study" 21 : 1915-1918, 1998

5 Boyle J, "Randomized, Placebo-Controlled Comparison of Amitriptyline, Duloxetine, and Pregabalin in Patients With Chronic Diabetic Peripheral Neuropathic Pain: Impact on pain, polysomnographic sleep, daytime functioning, and quality of life" 35 : 2451-2458, 2012

6 Major P, "Pyridoxine supplementation for the treatment of levetiracetam-induced behavior side effects in children : preliminary results" 13 (13): 557-559, 2008

7 Gregg EW, "Prevalence of lower-extremity disease in the US adult population ≥ 40 years of age with and without diabete. 1999-2000 National Health and Nutrition Examination Survey" 27 : 1591-1597, 2004

8 van der Watt JJ, "Polyneuropathy, anti-tuberculosis treatment and the role of pyridoxine in the HIV/AIDS era : a systematic review" 15 (15): 722-728, 2011

9 Kathleen A. Head, "Peripheral Neuropathy : Pathogenic Mechanisms and Alternative Therapies" 11 : 294-329, 2006

10 Bender DA, "Non-nutritional uses of vitamin B6" 81 : 7-20, 1999

11 van Dam PS, "Glutathione and alpha-lipoate in diabetic rats : nerve function, blood flow and oxidative state" 31 : 417-424, 2001

12 Yukawa M, "Folic acid-responsive neurological diseases in Japan" 47 : 181-187, 2001

13 Abbas ZG, "Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy" 74 : 803-808, 1997

14 Love A, "Effects of the sulphydryl donor N-acetyl-L-cysteine on nerve conduction, perfusion, maturation and regeneration following freeze damage in diabetic rats" 26 : 698-706, 1996

15 Yaqub BA, "Effects of methylcobalamin on diabetic neuropathy" 94 : 105-111, 1992

16 Ellis JM, "Clinical aspects of treatment of carpal tunnel syndrome with B6" 585 : 302-320, 1990

17 Haupt E, "Benfotiamine in the treatment of diabetic polyneuropathy-a three-week randomized, controlled pilot study(BEDIP study)" 43 : 71-77, 2005

18 Clayton PT, "B6 -responsive disorders: a model of vitamin dependency" 29 : 317-326, 2006

19 Sima AA, "A Acetyl-Lcarnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy : an analysis of two randomized placebo-controlled trials" 28 : 89-94, 2005