目的 比较目前临床应用相对较多的两种维生素B12制剂对周围神经病变临床症状的疗效。方法 选取天津市第一医院临床收纳的满足试验条件的神经卡压性周围神经病变患者，随机分为甲钴胺组（41例），腺苷钴胺组（39例）和针灸组（41例），甲钴胺组患者静脉滴注弥可保，每次0.5 mg，1 次/d；腺苷钴胺组患者肌肉注射腺苷钴胺，每次0.5 mg，1 次/d；针灸组选用针灸理疗、按摩等常规治疗。3组患者均治疗两周。观测治疗后患者的主观症状、各项体征，并严密观察、记录试验期间发生的不良反应事件。结果 3组治疗患者均未见不良反应，甲钴胺组在主观症状、客观体征方面改善均优于腺苷钴胺组及针灸组。结论 甲钴胺作为最新一代的维生素B12临床应用疗效、安全性方面均优于以往维生素B12，且西医治疗周围神经病变较单纯针灸治疗有明显疗效优势。

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.