硫辛酸联合依帕司他治疗糖尿病周围神经病变疗效观察

Clinical observation of thioctic acid combined with epalrestat for diabetic peripheral neuropathy

目的观察硫辛酸联合依帕司他治疗糖尿病周围神经病变的临床疗效。方法选取2010年9月至2012年11月该科收治的糖尿病周围神经病变患者,共120例,将其分为四组,每组各30例,均接受糖尿病常规治疗,A组仅接受糖尿病常规治疗;B组给予硫辛酸600 mg加入生理盐水250 mL避光静脉滴注,每天1次;C组给予依帕司他5 mg口服,每天3次;D组同时采用B、C两种治疗方法。上述各组均连续用药2周。观察四组患者症状改善情况和神经传导速度的变化。结果治疗2周后,D组麻木、烧灼感等症状改善最明显,B、C组症状有所改善,A组症状无明显改善。B、C、D组肌电图显示,正中神经、腓总神经运动神经传导速度(MCV)和感觉神经传导速度(SCV)均显著高于治疗前,差异均有统计学意义(P<0.05);且B、C、D组在治疗后MCV和SCV均优于A组,差异均有统计学意义(P<0.05)。结论联合应用硫辛酸和依帕司他治疗糖尿病周围神经病变效果显著,值得临床推广。

Objective To observe the effect of combined therapy of thioctic acid and epalrestat for diabetic peripheral neuropathy （DPN）. Methods A total of 120 patients with DPN,who were enrolled in the department from September 2010 to November 2012, were selected and divided into four groups, 30 cases in each group. All groups were given traditional treatment of diabetes, and group A was only with traditional treatment of diabetes;group B was added with 600 mg thioctic acid and 250 mL normal saline （NS） for venous injection from light, once daily;group C was with 5 mg epalrestat orally, three time daily, and group D was with the treatment of group A and group B simultaneously. The above groups were continuously administrated for 2 weeks to observe the change of clinical symptom and nerve conduction velocity of the patients. Results After 2-week treatment, the symp- toms of numbness, burning sensation and so on in group B improved obviously, all symptoms in group B and C improved, but the improvements of symptoms in group A were not obvious. The electromyography in group B, C and D showed that the motor nerve conduction velocity （MCV） of nervus peroneus communis and sensory nerve conduction velocity （SCV） after treatment were remark ably better than those before treatment with statistically significant difference （P〈0.05）, meanwhile, the MCV and SCV after treatment in group B, C and D were superior to those in the group A with statistically significant difference （P〈0.05）. Conclusion Com- bination treatment of thioctic acid and epalrestat has significant effect for treating DPN in clinic, and it is worthy of clinical promotion.