甲钴胺联合硫辛酸治疗糖尿病周围神经病变的疗效观察

Observation on curative effect of mecobalamine combined with lipoic acid in treating diabetic peripheral neuropathy

目的观察甲钴胺联合硫辛酸治疗糖尿病周围神经病变的临床疗效。方法收集2012—2017年该院住院治疗的糖尿病周围神经病变患者112例,根据治疗方式的不同分为试验组(62例)和对照组(50例),试验组选用甲钴胺联合硫辛酸进行治疗,对照组选用甲钴胺单药进行治疗,观察2组治疗前后运动神经传导速度和感觉神经传导速度,应用多伦多临床评分系统(TCSS)评估临床疗效。结果 2组治疗后正中神经及腓总神经的运动神经传导速度和感觉神经传导速度均较治疗前明显改善,差异均有统计学意义(P<0.05);但治疗后,试验组正中神经和腓总神经的运动神经传导速度和感觉神经传导速度与对照组比较,差异均无统计学意义(P>0.05);2组治疗后TCSS评分较治疗前明显降低,差异有统计学意义(P<0.05);治疗后,试验组TCSS评分与对照组比较,差异无统计学意义(P>0.05);治疗后,2组治疗疗效比较,差异无统计学意义(P>0.05)。结论甲钴胺联合硫辛酸治疗糖尿病可明显改善糖尿病周围神经病变,但短期的联合用药并不能明显提高临床治疗效果。

Objective To observe the clinical efficacy of mecobalamine combined with lipoic acid in treating diabetic peripheral neuropathy （DPN）.Methods 112 inpatients with DPN in this hospital from 2012 to 2017 were collected and randomly divided into the experiment group （62 cases） and control group （50 cases） according to the different treatment methods. The experiment group selected the therapy of mecobalamine combined with lipoic acid, while the control group was treated by mecobalamine alone. The motor nerve conduction velocity （MNCV） and sensol3/nerve conduction velocity （SNCV） were observed before and after treatment.The TCSS was used to evaluate the clinical efficacy.Results MNCV and SNCV of the median nerve and common peroneal nerve after treatment in the two groups were significantly improved compared with before treatment, and the difference was statistically significant （P〈0.05） ; but after treatment, MNCV and SNCV of the median nerve and common peroneal nerve in the experiment group had no statistical difference compared with those in the control group （P〉 0.05） ; the TCSS score after treatment in the two groups were significantly decreased compared with those before treatment, and the difference was statistically significant （P〈0.05）, which after treatment had no difference between the two groups （P〉0.05）; the curative eftbct after treatment had no statistical difference between the two groups （P〉0.05）. Conclusion Meeobalamine combined with lipoic acid can significantly alleviate diabetic peripheral neuropathy, but short term combined medication can not improve the clinical curative effect obviously.