α-硫辛酸对2型糖尿病周围神经病变的神经传导速度影响

The influence of α-lipoic acid on nerve conduction velocity in the treatment of type 2 diabetes with peripheral neuropathy

目的 观察α-硫辛酸对2型糖尿病周围神经病变的神经传导速度影响.方法 选择90例2型糖尿病周围神经病变患者作为观察对象,按随机数字表分为观察组45例和对照组45例,对照组给予降血糖综合干预、神经营养等常规治疗,观察组在对照组的基础上再给予α-硫辛酸治疗,600 mg/d,21 d为1个疗程,疗程结束后采用肌电图仪测定运动和感觉神经传导速,观察治疗前后外周神经病变症状（肢体疼痛、麻木、发热、发凉、感觉减退）改善情况,评价两组临床疗效.结果 观察组治疗后运动神经传导速度（正中神经、胫神经、腓总神经）及感觉神经传导速度（正中神经、腓总神经）均较治疗前明显升高（t =3.946、4.175、3.887、3.915、4.034,均P＜0.05）,但对照组正中神经感觉传导速度变化不显著（P＞0.05）,观察组治疗后运动神经传导速度（正中神经、胫神经、腓总神经）及感觉神经传导速度（正中神经、腓总神经）均明显高于对照组（=3.488、3.585、3.362、3.246、3.505,均P＜0.05.观察组肢体疼痛、麻木、发热、发凉、感觉减退总有效率分别为71.43％、78.95％、62.5％、61.54％、59.26％,对照组为36.36％、43.24％、21.4％、29.17％、28％,观察组明显高于对照组（χ^2=8.419、10.077、5.129、5.265、5.142,均P＜0.05）.观察组临床总有效率为84.44％,对照组为64.44％,观察组明显高于对照组（χ^2=6.925,P＜0.05）.结论 α-硫辛酸能够有效提高2型糖尿病周围神经病变患者的运动神经传导速度和感觉神经传导速度,显著地缓解糖尿病周围神经病变阳性症状,临床疗效明显提高,值得临床推广使用.

Objective To observe the influence of α-lipoic acid on nerve conduction velocity in the treatment of type 2 diabetes with peripheral neuropathy,to provide a theoretical basis for clinical treatment.Methods 90 type 2 diabetes patients with peripheral neuropathy were included in this study.The patients were randomly divided into the observation group and the control group,45 cases in each group.The control group was given conventional therapy,containing hypoglycemic comprehensive intervention and neurotrophic treatment.The observation group was given αt-lipoic acid treatment,600mg/d,21d for a course of treatment.The motor and sensory nerve conduction velocity were measured by EMG after a course,and the peripheral neuropathy symptoms （limb pain,numbness,fever,cold,hypoesthesia） before and after treatment were observed,the clinical efficacy was evaluated.Results The motor nerve conduction velocity （median nerve,tibial nerve,peroneal nerve） and sensory nerve conduction velocity （median nerve,peroneal nerve） of the observation group after treatment were significantly higher than before treatment （t =3.946,4.175,3.887,3.915,4.034,all P 〈 0.05）,but the median nerve sensory conduction velocity of the control group had no significant difference before and after treatment（P 〉 0.05）.The motor nerve conduction velocity （median nerve,tibial nerve,peroneal nerve） and sensory nerve conduction velocity （median nerve,peroneal nerve） of the observation group after treatment were significantly higher than the control group （t =3.488,3.585,3.362,3.246,3.505,all P 〈 0.05）.The efficacy of limb pain,numbness,fever,cold,feeling diminished of the observation group were 71.43%,78.95%,62.5%,61.54%,59.26%,which were significantly higher than 36.36%,43.24%,21.4%,29.17%,28% of the control group（all P 〈0.05）.The total effective rate of the observation group was 84.44%,which was significantly higher than 64.44% of the control group （χ^2=6.925,P 〈 0.05）.Conclusion α-lipoic acid can improve the motor nerve conduction velocity and sensory nerve conduction velocity of type 2 diabetes patients with peripheral neuropathy,significantly relieve the positive symptoms of DPN and improve clinical efticacy,which is worthy of clinical use.