α-硫辛酸、前列腺素E1、甲钴胺治疗糖尿病周围神经病变的临床观察

Clinical Observation onα-lipoic Acid,PE1,and Mecobalamin for Treatment of Diabetic Peripheral Neuropathy

目的评价α-硫辛酸联合前列腺素E1、甲钴胺治疗糖尿病周围神经病变(DPN)的临床疗效。方法选择60例2型糖尿病合并DPN患者,随机分成两组,每组30例。对照组予前列腺素E1 10μg静脉输注,甲钴胺1mg静脉输注,每日1次;硫辛酸组在对照组基础上加用α-硫辛酸600mg静脉输注,每日1次,连续2周。观察治疗前后临床症状、神经传导速度、8-羟基脱氧鸟苷(8-OHdG)的变化情况。结果硫辛酸组总有效率(90.0%)显著高于对照组(63.3%);两组治疗后神经病变主觉症状问卷(TSS)评分均显著降低,神经传导速度增加,且硫辛酸组TSS评分下降及神经传导速度增加较对照组明显,差异有统计学意义(P<0.05);对照组8-OHdG变化无明显差异,但硫辛酸组8-OHdG与治疗前和对照组比较差异有统计学意义(P<0.05)。两组均未见明显药物不良反应。结论α-硫辛酸和前列腺素E1、甲钴胺联合用药可显著改善糖尿病周围神经病变的症状和神经传导速度,减轻氧化应激。

Objective To observe the effect of α- lipoic acid （ALA）, prostaglandin E1, and mecobalamin for treatment of diabetic peripheral neuropathy（DPN）. Methods Sixty patients with DPN were randomized into two groups with 30 cases in each group. The control group was administered prostaglandin E1 10 9g and mecobalamin 1 mg once a day. ALA group was additionally given ALA 600mg a day. The clinical symptoms, nerve conduction velocity, total symptoms score（TSS） and 8 - OHdG were compared before and after treatment. Results The total effective rate was 90. 0% in ALA group,which was higher than that in control group（63. 3%）. The TSS score was significantly reduced and the nerve conduction velocity was obviously increased in both groups after treatment, and there were significant differences on the levels in TSS score and the nerve conduction velocity between two groups. In ALA group,8 - OHdG was significantly decreased compared with that before treatment and that in control group. The side effects were not found in both groups. Conclusion ALA combined with prostaglandin E1 and mecobalamin could significantly improve the symptoms and the oxidative stress in DPN.