依帕司他联合硫辛酸治疗糖尿病周围神经病变的临床观察  

Clinical Observation of Epalrestat Combined with Lipoic Acid in the Treatment of Diabetic Peripheral Neuropathy

作　　者：孙殿静[1] 谷巍[1] 刘晴晴[1] 

机构地区：[1]哈励逊国际和平医院内分泌科,河北衡水053000

出　　处：《中国药房》2017年第23期3226-3229,共4页China Pharmacy

基　　金：衡水市科技计划项目(No.15024)

摘　　要：目的:考察依帕司他联合硫辛酸对糖尿病周围神经病变(DPN)患者神经功能、氧化应激及炎症反应等的影响。方法:选取2013年1月-2016年1月我院收治的150例DPN患者,按随机数字表法分为A、B、C组,各50例。A组患者给予硫辛酸注射液600 mg,ivgtt,qd;B组患者给予依帕司他片50 mg,po,tid;C组患者给予硫辛酸+依帕司他联合治疗,用法用量同上。比较3组患者治疗前后的总症状评分系统(TSS)评分、运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)、氧化应激指标[血清超氧化物歧化酶(SOD)和丙二醛(MDA)]、炎症指标[肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)],以及血压、血脂和血糖指标,并观察不良反应发生情况。结果:治疗前,3组患者的上述各项观察指标比较,差异均无统计学意义(P>0.05)。与治疗前比较,3组患者治疗后的TSS评分和MDA、TNF-α、IL-6水平明显降低,MNCV和SNCV明显加快,SOD水平明显升高;且C组的各项指标优于A、B组,差异均有统计学意义(P<0.05),但A、B组间的差异无统计学意义(P>0.05)。3组患者治疗后的收缩压、空腹血糖较治疗前明显降低,高密度脂蛋白胆固醇明显升高,差异均有统计学意义(P<0.05),但各组间比较,差异均无统计学意义(P>0.05)。3组患者均未见明显的不良反应发生。结论:依帕司他和硫辛酸通过抑制氧化应激及炎症反应可以有效改善DPN患者的神经功能,且安全性较高;联合用药的效果优于单独用药。OBJECTIVE：To observe the effects of epalrestat combined with lipoic acid on nerve function,oxidative stress and inflammatory reaction in patients with diabetic peripheral neuropathy（DPN）. METHODS：From Jan. 2013 to Jan. 2016,150 patients were selected from our hospital and then divided into group A,B,C according to random number table,with 50 cases in each group. Group A was given Lipoic acid injection 600 mg,ivgtt,qd;group B was given Epalrestat tablet 50 mg,po,tid;group C was given lipoic acid＋epalrestat,same usage and dosage as above. TSS score,MNCV,SNCV,oxidative stress indexes（SOD and MDA）and inflammatory indexes（TNF-α and IL-6）,as well as blood pressure,blood lipid and blood glucose indexes were compared among 3 groups before and after treatment. The occurrence of ADR were observed. RESULTS：Before treatment,there was no statistical significance in above indexes among 3 groups（P〈0.05）. Compared to before treatment,TSS score,MDA,TNF-α and IL-6 levels of 3 groups were decreased significantly after treatment;MNCV and SNCV were speeded up significantly,and SOD level was increased significantly;each index of group C was better than that of group A and B,with statistical significance（P〈0.05）,but there was no statistical significance between group A and B（P〈0.05）. SBP and FPG after treatment of 3 groups were decreased significantly than before treatment,while HDL-C was increased significantly,with statistical signifi-cance（P〈0.05）;there was no statistical significance among 3 groups（P〈0.05）. No obvious ADR was found in 3 groups. CONCLUSIONS：Epalrestat combined with lipoic acid can effectively improve nerve function in DPN patients by inhibiting oxidant stress and inflammatory reaction with good safety. The effect of drug combination is better than single drug.

关 键 词：依帕司他 硫辛酸 糖尿病周围神经病变 氧化应激 炎症反应 神经功能 

分 类 号：R587.1[医药卫生—内分泌]