α-硫辛酸联合前列地尔治疗糖尿病周围神经病变的疗效及对其神经传导速度的影响

Effect of α-lipoic acid combined with alprostadil on diabetic peripheral neuropathy and its effect on nerve conduction velocity

目的 分析α-硫辛酸联合前列地尔治疗糖尿病周围神经病变（DPN）的疗效及对其神经传导速度的影响.方法 选取2015年2月至2016年3月78例DPN患者,根据治疗方案不同分为对照组（n=39）和研究组（n=39）.对照组仅采用前列地尔治疗,研究组采用前列地尔＋α-硫辛酸治疗,两组均持续治疗14 d.对比治疗前后两组神经传导速度[运动神经传导速度（MNCV）、感觉神经传导速度（SNCV）]、病情严重程度[神经病变主觉症状问卷（TSS）及疼痛程度视觉模拟评分法（VAS）]评分、血清炎症因子[肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）]及脂联素水平变化情况,并统计两组临床疗效及不良反应发生率.结果 治疗前两组腓总神经与正中神经MNCV、SNCV、TSS与VAS评分、TNF-α、IL-6及脂联素水平比较差异未见统计学意义（P〉0.05）.治疗后,研究组各指标明显优于对照组,总有效率（94.87%）明显高于对照组（74.36%）,差异均有统计学意义（P〈 0.05）;研究组不良反应发生率（10.25%）与对照组（7.69%）比较差异未见统计学意义（P〉0.05）.结论 联合采用α-硫辛酸与前列地尔治疗糖尿病周围神经病变效果显著,可有效提高患者神经传导速度,缓解疼痛程度及病情严重程度,改善血清炎症因子及脂联素水平,提高治疗效果,且安全性较高.

Objective To analyze the curative effect of α-lipoic acid combined with alprostadil on diabetic peripheral neuropathy （DPN） and its effect on nerve conduction velocity.Methods A total of 78 cases of DPN from February 2015 to March 2016 were selected.According to different treatment options, they were divided into control group （n=39） and study group （n=39）.The control group was only treated with alprostadil, and the study group were treated with alprostadil combined with α-lipoic acid, both of the groups were treated for 14 days.Before and after treatment, the motor nerve conduction velocity （MNCV）, sensory nerve conduction velocity （SNCV） and the severity of the disease （TSS） and pain （VAS） score, serum inflammatory factor [tumor necrosis factor alpha （TNF-alpha）, interleukin （IL-6）] change and the levels of adiponectin were compared, and the clinical curative effects, adverse reaction rates were analyzed.Results Before treatment, the MNCV, SNCV, TSS and VAS scores, TNF-α, IL-6 and adiponectin levels were scored in the two groups of common anterior nerve and median nerve, there were no significant differences（P〉0.05）.After treatment, compared with the above indexes were better and the total effective rate was higher （94.87% VS.74.36%） in the study group, and the differences were significant （P〈 0.05）.The incidence of adverse reaction in the study group was 10.25%, and it was 7.69% in the control group, there was no significant difference between the two groups （P〉0.05）.Conclusions The effect of α-lipoic acid and alprostadil on diabetic peripheral neuropathy is significant, it can effectively improve the nerve conduction velocity, relieve the severity and severity of pain.