前列地尔联合α-硫辛酸治疗糖尿病周围神经病变的临床研究

Clinical study of alprostadil combined withα-lipoic acid in treating diabetic peripheral neuropathy

目的探讨前列地尔与α-硫辛酸联合使用治疗糖尿病周围神经病变(DPN)的疗效与作用机制,为临床应用提供科学的依据。方法选择DPN患者50例,随机分为治疗组和对照组,两组均给予常规控制血糖治疗,对照组给予甲钴胺治疗,治疗组则给予前列地尔联合α-硫辛酸治疗,共14d,记录两组治疗前后的临床症状评估,下肢神经传导速度(NCV)、振动感觉阈值(VPT),并检测血清超敏C反应蛋白(hs-CRP)、丙二醛(MDA)及超氧化物歧化酶(SOD)水平。结果经过14d治疗,前列地尔联合a-硫辛酸组不仅临床疗效优于对照组,且NCV明显增加,VPT也明显降低,差异均有统计学意义(P<0.05);与对照组比较,治疗组hs-CRP和MDA水平明显降低,SOD活性明显增加,差异具有统计学意义(P<0.05)。结论前列地尔与α-硫辛酸联合使用可明显改善DPN患者治疗效果,增加NCV,降低VPT,其机制可能是通过提高抗氧化能力,减轻炎性反应而实现。

Objective To investigate the effect and action mechanism of alprostadil combined with α‐lipoic acid in the treatment of diabetic peripheral neuropathy（DPN） to provide the scientific basis for its clinical application .Methods Totally 50 patients with DPN were selected and randomly divided into the treatment group and control group .The two groups were given the conventional controlling blood sugar therapy .The control group was given methylcobalamin ,while the treatment group was treated with alpros‐tadil combinedα‐lipoic acid ,for 14 d .The clinical symptom assessment before and after treatment ,lower extremity nerve conduction velocity （NCV） and vibration perception threshold （VPT） were recorded in the two groups .Serum high‐sensitivity C‐reactive pro‐tein（hs‐CRP） ,malondialdehyde （MDA） and superoxide dismutase （SOD） levels were detected .Results After 14 d treatment ,the clinical efficacy of the treatment group not only was superior to that of the control group ,but also NCV was significantly increased and VPT was significantly decreased ,the differences were statistically significant（P〈0 .05）;compared with the control group ,hs‐CRP and MDA levels in the treatment group were significantly decreased ,while the SOD activity was significantly increased ,the differences were statistically significant （P〈0 .05） .Conclusion Alprostadil combined with α‐lipoic acid can significantly improve the clinical effect in the patients with DNP as well as increase NCV and decrease VPT ,its mechanism may realized by increasing an‐tioxidant capacity and reducing inflammatory reaction .