Metabolic therapy in the treatment of occupational polyneuropathy in coal workers

Introduction. Harmful production factors in most industrial enterprises cause widespread occupational polyneuropathy, manifested by polymorphic sensory and autonomic disorders. The severity of the labor process in the form of stereotypical movements and forced postures can lead to local demyelination of nerves in the tunnels, more often in the area of the carpal canal, which in some cases requires a special approach to treatment with the need for surgery. Therefore, the search for effective methods of treating neuropathies, including those of professional origin, is an urgent clinical task.

The study aims to evaluate the effectiveness of metabolic therapy and B vitamins in the treatment of occupational polyneuropathy in workers in the main professions of the coal industry.

Materials and methods. The authors have examined 22 men aged 45–55 years with a diagnosis of "vibration disease from exposure to local vibration", as well as "polyneuropathy of the upper extremities from exposure to a complex of harmful industrial factors". The clinical study included an assessment of the severity of pain, sensory disturbances and vibration sensitivity, temperature of the upper extremities and strength in the hands. An ENMG study was conducted to determine the average amplitude of sensory responses, the average rate of propagation of arousal along the motor and sensory fibers of the median and ulnar nerves, and the terminal latency of the median nerves. The specialists performed an assessment of autonomic regulation using the analysis of heart rate variability with the determination of spectral and nonlinear parameters. As metabolic therapy, the researchers used the Cocarnite complex, which included 10 mg of disodium adenosine triphosphate trihydrate, 50 mg of cocarboxylase, 0.5 mg of cyanocobalamin and 20 mg of nicotinamide, which they administered intramuscularly 3 times a week for 2 weeks.

Results. After the treatment, there was a statistically significant decrease in the terminal latency of the median nerves, an increase in the average rate of propagation of excitation along the sensory fibers of the median nerves. There was a decrease in the subjective perception of pain by patients, an improvement in vibration sensitivity and an increase in the temperature of the skin of the fingers.The vegetative imbalance in occupational polyneuropathy in the form of increased sympathetic influence is stable, promotes angiospasm and disruption of trophic processes in tissues. The tendency to increase the power of very high frequency oscillations and the nonlinear entropy index of heart rate variability after treatment indicates an improvement in tissue metabolism, increased autonomic control and increased adaptive capabilities of the body.

Limitations. The study is limited to the number of interned workers in the main professions of the coal industry with an established diagnosis of occupational polyneuropathy who underwent in-depth medical examination and treatment at the clinic of the Scientific Research Institute of Complex Problems of Hygiene and Occupational Diseases.

Conclusion. The administration of disodium adenosine triphosphate trihydrate, cocarboxylase, cyanocobalamin and nicotinamide, which are part of the Cocarnit preparation, makes it possible to improve the conduction of impulses along motor and sensory nerve fibers in miners with occupational polyneuropathy, normalize autonomic regulation and reduce the severity of symptoms of polyneuropathy.

Ethics. The study complies with the ethical standards of the Bioethical Committee of the Scientific Research Institute of Complex Problems of Hygiene and Occupational Diseases (Minutes of meeting No. 4, § 2 dated November 18, 2021), developed in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of conducting medical Research involving humans as subjects" as amended in 2013. The choice of therapy is in accordance with the Decree of the Government of the Russian Federation dated May 16, 2022, No. 1180-R.

Contributions:
Martynov I.D. — data collection, text writing;
Yamshchikova A.V. — data collection and processing, writing text;
Gestikova M.G. — concept and design of research, editing;
Panev N.I. — concept and design of research, editing.

Funding. The study had no funding.

Conflict of interest. The authors declare no conflict of interest.

Received: 22.05.2026 / Accepted: 01.06.2026 / Published: 11.09.2026

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