α-硫辛酸辅助治疗老年糖尿病周围神经病变患者神经修复及抗氧化应激能力的影响

Effects of epalrestat,mecobalamine combined withα-lipoic acid on nerve repair and antioxidant stress in elderly patients with diabetic peripheral neuropathy

目的:探讨α-硫辛酸辅助治疗糖尿病周围神经病变(Diabetic Peripheral Neuropathy,DPN)老年患者的效果及对其抗氧化应激及神经修复能力的影响。方法:选取2020年10月至2022年10月我科收治的106例DPN老年患者作为研究对象,随机数字表法将其分为研究组和对照组,各53例。对照组患者采用依帕司他和甲钴胺治疗;研究组增加α-硫辛酸辅助治疗,均持续4 w,对比两组患者神经修复效果、神经传导速度、抗氧化应激能力情况,及临床疗效和不良反应。结果:研究组总有效率明显高于对照组(P<0.05),4 w末,患者神经修复效果:桡神经、尺神经与正中神经横径和纵径均较对照组减小,神经传导速度:正中神经、腓总神经与胫后神经感觉神经传导速度和运动传导速度均快于对照组,抗氧化应激能力:总抗氧化能力、超氧化物歧化酶血清水平高于对照组,丙二醛低于对照组(P<0.05),不良反应两组无明显差异(P>0.05)。结论:α-硫辛酸辅助治疗老年DPN,可有效提升患者神经传导速度、神经修复及抗氧化应激能力,不良反应少且有效。

Objective:To explore the effects of α-lipoic acid in the treatment of Diabetic Peripheral Neuropathy(DPN)in elderly patients and its effects on the resistance to oxidative stress and neuropathy.Methods:A total of 106 elderly patients with DPN admitted to our department from October 2020 to October 2022 were selected as research objects,and randomly divided into study group and control group,with 53 cases in each group.Control group was treated with epalrestat and mecobalamine.The study group was supplemented withα-lipoic acid adjuvant therapy,all of which lasted for 4 weeks.The nerve repair effect,nerve conduction velocity,antioxidant stress ability,clinical efficacy and adverse reactions were compared between the two groups.Results:The total effective rate of the study group was significantly higher than that of the control group(P<0.05).At the end of 4w,the nerve repair effect of the patients was as follows:the transverse and longitudinal diameters of the radial nerve,ulnar nerve and median nerve were decreased compared with that of the control group.Nerve conduction velocity:median nerve,common peroneal nerve and posterior tibial nerve sensory nerve conduction velocity and motor conduction velocity were all faster than that of the control group.The total antioxidant capacity and serum level of superoxide dismutase were higher than those of control group,but malondialdehyde was lower than that of control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:α-lipoic acid adjuvant therapy can effectively improve nerve conduction velocity,nerve repair and antioxidant stress ability in elderly patients with DPN,with less and effective adverse reactions.