关键词: 肺疾病, 慢性阻塞性；周围神经系统疾病；生活质量；焦虑；抑郁；预后

Abstract: Objective　To investigate the clinical characteristics of peripheral neuropathy in patients with chronic obstructive pulmonary disease（COPD） and the effect of nutritional nerve intervention on patient prognosis.Methods　The study included 120 patients who were diagnosed with COPD and treated in the People's Hospital of Quzhou between June 2015 and June 2016.All patients were examined for myoelectric activity.Patients were divided into a peripheral neuropathy group（n=72） and a non-peripheral neuropathy group（n=48） based on myoelectric activity.The peripheral neuropathy group was further divided into an intervention subgroup（n=36） and a non-intervention subgroup（n=36） using the random number table method.Patients in the intervention subgroup were treated with mecobalamin combined with alpha lipoic acid for 3 weeks.All patients were followed up for 12 months after group assignment.In each follow-up visit，the number of episodes of exacerbation was recorded and the patients received a pulmonary function test，a COPD assessment test（CAT），and evaluation according to the modified British Medical Research Council Dyspnea Scale（mMRC） and Hospital Anxiety and Depression Scale（HAD）．Data were collected and analyzed.Results　The proportion of men or smokers was significantly higher in the peripheral neuropathy group than in the non-peripheral neuropathy group（P<0.05）．The number of annual exacerbation episodes，CAT score，mMRC grade，and patients with anxiety/depression also increased significantly in the peripheral neuropathy group（P<0.05）．FEV1 was lower in the peripheral neuropathy group than in the non-peripheral neuropathy group（P<0.05）．The number of annual exacerbation episodes，CAT score，mMRC grade，the proportion of the patients with anxiety/depression，and the grading of symptoms were significantly higher in symptomatic patients with peripheral neuropathy than in those without symptoms，and FEV1 decreased in symptomatic patients（P<0.05）．There were interactive effects between FEV1，CAT score，mMRC grade，HAD score and treatment，and time in both the intervention subgroup and non-intervention subgroup（P<0.05）．The main effects of treatment and time were significant（P<0.05）．There were no significant differences in baseline FEV1，CAT score，mMRC grade，and HAD score between the intervention subgroup and non-intervention subgroup（P>0.05）．At 1，3，6，9，and 12 months of follow up，FEV1 significantly increased，and CAT score，mMRC grade，and HAD score significantly decreased in the intervention subgroup compared with the non-intervention subgroup（P<0.05）；The proportion of patients with anxiety/depression in the two subgroups at different time points was also significantly different（P<0.05）．The proportion of anxiety/depression patients in the two subgroups did not differ significantly before intervention and at 1 month of follow up（P>0.05）；however，at 3，6，9，and 12 months，the proportion was significantly lower in the intervention subgroup than in the non-intervention subgroup（P<0.05）．In the intervention subgroup，the proportion of patients with anxiety/depression at 6 months was lower than that before intervention as well as at 1 and 3 months，and the proportions at 9 and 12 months were higher than that at 6 months（P<0.003）．Conclusion　Peripheral neuropathy is a common complication of COPD，and is associated with gender，smoking and severity of COPD.The condition significantly affects quality of life and patient prognosis.Most patients are asymptomatic in the early stage，and symptomatic patients often have a severe condition.Neuro-nutrient therapy can improve both prognosis and the quality of life of patients.

Key words: Pulmonary disease, chronic obstructive；Peripheral nervous system diseases；Quality of life；Anxiety；Depression；Prognosis