α-硫辛酸联合前列地尔治疗糖尿病周围神经病变35例  

Clinical Observation on alpha-Lipoic Acid Combined with Alprostadil in Treating 35 Cases of Diabetic Peripheral Neuropathy

作　　者：孙国香[1] 

机构地区：[1]浙江省绍兴上虞市中医院,浙江绍兴312300

出　　处：《中国药业》2012年第15期74-75,共2页China Pharmaceuticals

摘　　要：目的观察α-硫辛酸联合前列地尔治疗糖尿病周围神经病变的近期疗效。方法采用随机数字表法,将105例糖尿病周围神经病变患者均分为联合治疗组、对照Ⅰ组、对照Ⅱ组,每组35例,3组均严格控制饮食,给予降血糖、控制血压、调血脂、必需氨基酸及维生素B1、维生素B6,低盐、优质低蛋白饮食(蛋白质0.8 g/d)等常规综合治疗。联合治疗组加用α-硫辛酸和前列地尔,对照Ⅰ组单用α-硫辛酸,对照Ⅱ组单用前列地尔,3组均连续治疗2周。治疗期间监测空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1C),血电解质、肝肾功能。采用肌电图仪测定双侧肢体运动神经传导速度(MNCV)和感觉神经传导速度(SNCV);病情严重程度采用国际通用的神经病变主觉症状问卷(TSS)进行评估;疼痛以视觉模拟评分(VAS)10分法评分;观察不良反应发生情况。结果联合治疗组总有效率为91.43%,对照Ⅰ和Ⅱ组分别为71.43%和68.57%,3组总有效率比较,差异有统计学意义(P<0.05)。治疗后3组的神经传导速度(NCV)均显著改善(P<0.05或P<0.01),TSS评分、VAS评分明显降低(P<0.01),但以联合治疗组的改善程度最显著(P<0.01)。结论α-硫辛酸联合前列腺地尔治疗的疗效明显优于单用α-硫辛酸或前列腺地尔治疗,且耐受性好,未见明显不良反应,值得临床推广。Objective To observe the short term effects of alpha-lipoic acid combined with alprostadil in the treatment of diabetic peripheral neuropathy（DPN）.Methods By using the random number table method,105 cases of DPN were equally divided into the combined treatment group,the control group Ⅰand Ⅱ,35 cases in each group.Three groups were strictly controlled diet and given hypoglycemic,controlling blood pressure,regulating blood fat,essential amino acid and vitamin B1,B6,as well as low salt,high quality low protein diet（protein 0.8 g/d） and other routine comprehensive treatment.At the same time,the combined treatment group was added alpha-lipoic acid and alprostadil,the control group Ⅰwas given single alpha-lipoic acid and the control group Ⅱreceived only alprostadil.The three groups were treated for continuous 2 weeks.During the treatment process,fasting blood glucose（FPG）,2 h postprandial plasma glucose（2 h PBG）,glycosylated hemoglobin（HbA1C）,as well as blood electrolytes,liver and kidney function were monitored.The electromyography instrument was adopted to determine the bilateral limb motor nerve conduction velocity（MNCV） and the sensory nerve conduction velocity（SNCV）.The DPN severity was assessed by the international general neuropathy main sleep symptoms questionnaire（TSS） and the 10 points scoring of the visual analogue scale（VAS） was used to evaluate pain.The occurrence of adverse reactions was observed.Results The total effective rate was 91.43%in the treatment group,71.43%and 68.57%in the control group Ⅰand Ⅱ,respectively,difference among 3 groups showing statistical significance（P〈0.05）.After the treatment,the nerve conduction velocity（NCV） in 3 groups were improved significantly（P〈0.05 or P〈0.01）,the TSS and VAS scores were significantly reduced（P〈0.01）,but the improvement degrees in the combined treatment group was most significant（P〈0.01）.Conclusion The effect of alpha-lipoic acid combined with alprostadil in the treatment of DNP

关 键 词：糖尿病 周围神经病变 Α-硫辛酸 前列地尔 

分 类 号：R969.4[医药卫生—药理学] R977.3[医药卫生—药学]