硫辛酸联合空气波压力治疗对PDN患者的影响

Effect of Alpha-Lipoic Acid Combined with Intermittent Pneumatic Compression on ET,NO and TNF-α in the Treatment of Patients with Diabetic Peripheral Neuropathy

目的:观察硫辛酸联合空气波压力治疗仪治疗糖尿病周围神经病变的临床疗效,进一步探讨该联合疗法对糖尿病周围神经病变患者ET、NO、TNF-α的影响。方法:将90例患者按随机原则分为硫辛酸组、空气波压力组和联合治疗组,每组各30例。硫辛酸组单独用硫辛酸注射液静脉滴注治疗,1次/d;空气波压力组采用空气波压力治疗仪,20 min/次,2次/d;联合治疗组采用硫辛酸注射液静脉滴注治疗联合空气波压力治疗仪治疗,1次/d。治疗4周后,观察和比较3组患者治疗前及治疗后的自觉症状、运动神经与感觉神经传导速度以及ET、NO、TNF-α水平的差异。结果:联合治疗组治疗后的总有效率为93.33%,明显优于硫辛酸治疗组(73.33%)和空气波压力治疗组(66.67%),神经传导速度恢复效果最好,可以显著减少患者血浆中ET-1含量和血清中TNF-α含量,并提高机体NO水平(P<0.05)。结论:硫辛酸联合空气波压力治疗仪治疗糖尿病周围神经病变的临床疗效肯定,可有效降低患者炎症反应,改善血管内皮功能,值得临床推广。

Objective：To observe the curative effect of alpha -lipoic acid （ALA） combined with intermittent pneumatic compression （IPC） in the trearment of patients with diabetic peripheral neuropathy （ DPN ） and to investigate the changes of endothelin （ ET）, nitric oxide （ NO ） and tumor necrosis factor - α （ TNF - α ）. Methods： 90 cases with DPN were randomly divided into ALA group, IPC group and ALA ＋ IPC group, 30 cases in each group. The ALA group was intravenously injected with alpha - lipoic acid 600 mg/d plus 250 mL normal saline once a day for 4 weeks. The IPC group was treated with IPC 20 minutes at a time, twice a day for 4 weeks. The ALA ＋ IPC group was administered with the same dose of alpha - lipoic acid combined with IPC once a day for 4 weeks. Recorded and evaluated the improvement of symptoms, motor nerve conduction velocity and sensory nerve conduction velocity and the level of ET - 1, NO, TNF - α before and after treatment, respectively. Results： The total effective rates of ALA ＋ IPC group was 93.33%, which was significantly higher than ALA group （ 73.33% ） or IPC group （66. 67% ）. After treatment, the nerve conduction velocity of three groups both increased than those before treatment, and the ALA ＋ IPC group had the best efficacy compared with other groups. ET and TNF - α were decreased obviously, and NO was heighten obviously in the ALA ＋ IPC group after the treatment（ P 〈 0. 05 ）. Conclusion：The combined treatment of ALA and IPC can effectively reduce the inflammatory reaction and improve vascular endothelial function in DPN patients, and deserves to be popularized in clinic.