α-硫辛酸联合空气波压力治疗仪治疗糖尿病周围神经病变合并下肢血管病变的有效性

Effect of Alpha-Lipoic Acid Combined with Intermittent Pneumatic Compression in the Treatment of Diabetic Peripheral Neuropathy and Peripheral Arteria Disease

目的:观察α-硫辛酸(ALA)联合空气波压力治疗仪(IPC)治疗糖尿病周围神经病变合并糖尿病下肢血管病变的临床疗效。方法:选取已诊断糖尿病周围神经病变(DPN)合并糖尿病下肢血管病变(PAD)的2型糖尿病患者200例,随机分为4组,每组各50例。A组为常规治疗组,在A组基础上,B组给予α-硫辛酸注射液0.6静滴1次/d,C组给予空气波压力治疗仪治疗患肢,治疗时间30min/次,2次/d,D组同时给予IPC+ALA治疗,疗程均共4周。观察和比较各组治疗前、后患者临床症状的改善、神经传导速度、踝肱指数(ABI)、足背动脉血流量的差异。结果:A、B、C、D组总有效率分别为8%,44%,60%,96%。治疗后,A组患者的各项指标改善不明显(P>0.05),B、C、D组患者的神经传导速度、ABI、足背动脉血流量较前有显著改善(P<0.05),ALA联合IPC组改善更明显。疗效优于A、B、C组(P<0.01)。结论:ALA联合IPC可显著改善DPN合并PAD患者的临床症状及明显增加患者的神经传导速度,同时下肢血管缺血状态得到显著的改善,疗效更优于单独应用ALA和IPC。

Objective： To explore the clinical effect of α-lipoie acid plus intermittent pneumatic compression in the treatment of diabetic peripheral neuropathy （DPN） and peripheral arterial disease （PAD）. Methods： A total of 200 diabetic patients with DPN and PAD were randomly divided into four groups with 50 cases in each group. The patients in group A were given the basic treatment, beside the basic treatment, the patients in group B were treated with α-lipoic acid （ALA, intrave- nous injection of α-lipoic acid 0.6 g, once a day）, the patients in group C were treated with intermittent pneumatic compression （IPC, 30 minutes at a time, twice a day） to their affected limbs, and the patients in group D were treated with ALA and IPC, all the treatment lasted for 4 weeks. The improvement of symptoms, nerve conduction velocity, ankle brachial index （ABI） and dorsal artery blood flow were compared among the four groups before and after treatment. Results： Thetotal effective rates of groups A, B, C, and D were respectively 8%, 44%, 60%, and 96%. Significant changes of nerve conduction velocity, ABI, and dorsal artery blood flow were found in groups B, C, and D after treatment （P〈0.05）. ALA and IPC showed the best effect than the other three groups （P〈0.01）. Conclusion. The combined treatment of ALA and IPC could significantly improve the clinical symptoms and significantly increase the nerve conduction velocity, improve ischemia condition of the lower extremity, and the effect is better than the single use of ALA or IPC. Key Words