硫辛酸联合甲钴胺治疗糖尿病周围神经变的疗效观察及对C肽影响

Effect of lipoic acid combined with mecobalamin in the treatment of type 2 diabetic peripheral neuropathy

目的探讨硫辛酸联合甲钴胺治疗2型糖尿病周围神经病变的疗效及对C肽的影响。方法选取2018年3月至2019年5月于济南市第五人民医院内分泌科入院的2型糖尿病周围神经病变患者88例,采用随机数字表法分为对照组和治疗组,各44例。在降糖、调脂等基础上,对照组给予甲钴胺治疗,治疗组给予硫辛酸联合甲钴胺治疗,观察治疗前后两组临床症状和腓总神经、正中神经运动传导速度(Motor conduction velocity,MCV)和感觉传导速度(Sensory conduction velocity,SCV)及血糖、C肽变化。结果治疗后,治疗组总有效率显著高于对照组,差异有统计学意义(P<0.05);两组腓总神经MCV及SCV较治疗前均显著提高,且治疗组显著高于对照组,差异均有统计学意义(P<0.05);治疗组正中神经MCV、SCV及C肽较治疗前比较显著提高,差异有统计学意义(P<0.05),对照组治疗前后比较差异无统计学意义;治疗后,两组空腹及餐后2 h血糖均较治疗前显著降低,差异均有统计学意义(P<0.05)。结论硫辛酸联合甲钴胺治疗能明显减轻糖尿病周围神经病变症状,提高神经传导速度,提高C肽水平,预测治疗效果。

Objective To investigate the efficacy of lipoic acid combined with mecobalamin on type 2 diabetic peripheral neuropathy and its influence on C peptide.Methods 88 patients with type 2 diabetic peripheral neuropathy admitted to Department of endocrinology of Jinan Fifth People's Hospital from March 2018 to May 2019 were randomly divided into control group and treatment group,with 44 cases in each group.Based on controlling blood sugar and lipid regulation,control group was treated with mecobalamin,and treatment group was treated with lipoic acid combined with mecobalamin.The clinical sensory symptoms,motor and sensory nerve conduction velocity of the common peroneal nerve and the median nerve,as well as changes in blood glucose and C-peptide were compared pre-and post-treatment between the two groups.Results After treatment,the total efficacy in the treatment group was higher than the control group,the difference was statistically significant(P<0.05).The motor and sensory conduction velocity of peroneal nerve significantly improved in the two groups,and the treatment group was significantly higher than that control group,and the difference was statistically significant(P<0.05).The motor and sensory conduction velocity of median nerve and the C-peptide level in the treatment group increased significantly than before treatment,the difference was statistically significant(P<0.05).There was no significant difference in the control group before and after treatment.After treatment,fasting and 2 h postprandial blood glucose of the two groups were significantly lower than those before treatment(P<0.05).Conclusion The clinical symptoms and nerve conduction velocity were improved significantly when patients with type 2 diabetic peripheral neuropathy were treated with lipoic acid and mecobalamin.It also raised C-peptide level significantly and reflect the effect of treatment.