醛糖还原酶抑制剂治疗糖尿病周围神经病变的临床研究

Therapeutic effects of aldose reductase inhibitor on diabetic peripheral neuropathy

目的观察醛糖还原酶抑制剂治疗糖尿病周围神经病变(DPN)的疗效。方法DPN患者158例,随机分为治疗组(口服依帕司他)88例,对照组(仅控制血糖)70例,各组治疗前、后测FPG、2hPG、HbA1c、血浆内皮素(ET)并进行神经电生理检查。结果治疗前后治疗组与对照组的正中神经与腓神经的神经传导速度及ET水平的差异均有统计学意义。结论醛糖还原酶抑制剂可以提高DPN神经传导速度,具有显著疗效。

Objective To investigate the effects of aldose reductase inhibitor on diabetic peripheral neuropathy（DPN）. Methods 158 DPN patients were randomized to therapy group including 88 patients receiving Epalrestat and control group including 70 patients taking antihyperglycemic drugs only. Electromyography was taken and measurements of fasting blood glucose（FPG）, postprandial blood sugar（PPG）, glyeosylated hemoglobin（ HbAle）, endothelin（ET） were performed before and after treatment. Results The motor nerve conduction velocities（MNCV） of median nerve before and after medication were 40.8±5.6m/s and 46.5±4. 1m/s respectively in therapy group, and 40.6±5.3m/s and 40.2±4.8m/s respectively in control group. In therapy group, the sensory nerve conduction veloeities（SNCV） of median nerve before and after medication were 34.2±2.6m/s and 39.0±3.9m/s respectively,versus control group of 34. 5±2.5m/s and 35.6±2.8m/s respectively. In therapy group, the motor nerve conduction velocities of peroneal nerve before and after medication were 36.1 ±2.3m/s and 39.4±2.2m/s versus control group of 36.3±2.6m/s and 36.6±3.1m/s respectively. In therapy group, the sensory nerve conduction velocities of peroneal nerve before and after medication were 34. 1 ±1. 6m/s and 39.4±2.2m/s , versus control group of 36.2±1.9m/s and 36.5±2.1m/s respectively. In therapy group before and after treatment,the levels of endothelin were 122.41 ± 12.83pg/ml and 60.01±14.74pg/ml versus control group of 123.28± 15.64pg/ml and 116.54± 16.32pg/ml respectively. There were significant differences in the above parameters between pre-and post-treatmont and between groups of treatment and control （all P〈 0. 01 ）. Conclusion Aldose reductase inhibitor could accelerate the nerve conduction velocity, and has a significant effect on DPN therapy.