普瑞巴林联合硫辛酸在痛性糖尿病神经病变中的临床应用

Therapeutic effect of pregabalin and alpha lipoic acid on diabetes mellitus with painful neuropathy

目的观察普瑞巴林联合硫辛酸治疗痛性糖尿病神经病变的疗效和安全性。方法痛性糖尿病神经病变患者88例随机分为普瑞巴林组28例(A组)、硫辛酸组30例(B组)以及普瑞巴林联合硫辛酸组30例(C组)。3组基础治疗相同,A组给予普瑞巴林口服,B组给予硫辛酸静脉滴注,2周后改为口服,C组给予普瑞巴林联合硫辛酸治疗。观察治疗前及治疗2周、4周后疼痛视觉模拟评分(VAS)变化、神经传导速度改变以及不良反应。结果与治疗前比较,3组患者治疗2周及4周后VAS评分均明显下降(P<0.05),且C组<A组<B组(P<0.05),治疗4周后,总有效率C组(86.7%)>A组(71.4%)>B组(46.7%)(P<0.05)。与治疗前比较,B、C组神经传导速度均增加,且B、C组的神经传导速度较A组均增加,差异均有统计学意义(P<0.05)。3组比较,总不良反应发生率差异无统计学意义(P>0.05)。结论普瑞巴林联合硫辛酸治疗糖尿病神经病理性疼痛疗效显著,值得临床推广。

Objective To observe the efficacy and safety of pregabalin combined lipoic acid in the treatment of pain- ful diabetic neuropathy. Methods Eighty-eight cases of painful diabetic neuropathy were randomly divided into the pregabalin group with 28 cases （group A）, lipoic acid group of 30 patients （group B） and pregabalin combined lipoic acid group of 30 patients （group C）. Three groups of patients received the same basic treatment, group A received oral pregabalin, group B was treated with lipoic acid infusion, 2 weeks later changed to oral, group C was treated with pregabalin and lipoic acid treat- ment. The pain visual analog scale （VAS）, changes of nerve conduction velocity and adverse reaction were observed before and after treatment and 2 week, 4 weeks after treatment. Results Compared with before treatment, after treated for 2 weeks and g weeks, 3 groups of patients＇VAS were significantly decreased （ P 〈0.05）, and group C 〈 group A 〈 group B （ P 〈 0.05）, and 4 weeks after treatment, the total efficiency were in the order of group C （86.7%） 〉 group A （71.4%） 〉 group B （46.7%） （ P 〈0.05）. Compared with before treatment, nerve conduction velocity was increased in group B and C, the nerve conduction velocity in group B and C better than in group A, the differences were statistically significant （ P 〈 0.05）. The total adverse reaction rate had no significant difference among the 3 groups （ P 〉 0.05）. Conclusion Pregabalin com- bined lipoic acid revealed good effect in the treatment of diabetic neuropathic pain.