硫辛酸联合加巴喷丁或普瑞巴林治疗痛性糖尿病周围神经病变的疗效比较

Gabapentin vs pregabalin in combination with alpha-lipoic acid for treatment of painful diabetic peripheral neuropathy: a comparison of therapeutic efficacy

目的观察硫辛酸联合加巴喷丁或普瑞巴林治疗糖尿病痛性周围神经病变(PDPN)的效果以及安全性。方法 48例PDPN患者按随机数字表法分为2组,住院期间予硫辛酸(0.6 g/d)静脉滴注,加巴喷丁组予加巴喷丁(0.9 g/d)口服;普瑞巴林组予普瑞巴林(0.15 g/d)口服,出院后改硫辛酸口服,总疗程均为45 d。用视觉模拟量表(VAS)评分进行临床疗效判定,同时观察药物不良反应。结果治疗后2组VAS评分均较治疗前下降(P<0.05);普瑞巴林组治疗前为(7.6±1.6)分,治疗后为(4.9±1.3)分;加巴喷丁组治疗前为(7.6±1.3)分,治疗后为(6.2±1.6)分,且2组比较差异有统计学意义(P<0.05),均未出现严重药物不良反应。结论硫辛酸联合普瑞巴林较硫辛酸联合加巴喷丁治疗PDPN更有效。

Objective To investigate the efficacy and safety of gabapentin vs pregabalin in combination with alpha-lipoic acid for treatment of painful diabetic peripheral neuropathy(PDPN). Methods Forty-eight PDPN patients were randomly divided into two groups. Throughout the hospital stay, the patients received intravenous alpha lipoic acid(0.6 g/d) plus oral gabapentin 0.9 g/d(study group) or oral pregabalin 0.15 g/d(pregabalin group).After dis-charge,the patients remained on the previous treatments except that lipoic acid were given orally, until atotal course of45-day therapy was completed.The clinical efficacy was assessed by visual analogue scale(VAS) score, and the ad-verse reactions were recorded. Results After treatment, the VAS scores of the two groups were lower than baseline(P<0.05). In the pregabalin group, the VAS score was(7.4±1.6) at baseline and(4.9±1.3) after treatment, compared with(7.6±1.3) and(6.2±1.6) in the study group, respectively, with statistically significant differences between the two groups(P<0.05). There were no severe adverse reactions in the two groups. Conclusion Lipoic acid combined with pregabalin is more effective than with gabapentin in the treatment of PDPN.