摘要
目的 探讨α-硫辛酸联合前列地尔治疗糖尿病周围神经病变(DPN)的临床效果.方法 将82例2型糖尿病DPN患者分为对照组和研究组,每组41例.对照组患者在常规治疗基础上加用前列地尔注射液,研究组在对照组治疗基础上联合应用α-硫辛酸注射液.疗程均为2周.采用肌电图仪测定两组患者的双侧正中神经和腓总神经的运动神经传导速度(MNCV)和感觉神经传导速度(SNCV);采用神经病变主觉症状问卷(TSS)评估两组患者的病情严重程度,采用视觉模拟评分(VAS)评估疼痛程度.比较两组患者治疗前后MNCV、SNCV、TSS和VAS评分变化以及两组患者的临床效果.结果 治疗前两组MNCV和SNCV差异均无统计学意义(P均＞0.05).治疗后两组正中神经的MNCV、SNCV,腓总神经的MNCV、SNCV均较治疗前相比明显升高,而且研究组治疗前后[正中神经MNCV (42.5±3.6)、(47.8±4.6)m/s,t=-5.752,P＜0.05;SNCV(39.6±1.6)、(46.2±4.5) m/s,t=-5.882,P＜0.05;腓总神经MNCV(39.8±3.2)、(44.5±2.5) m/s,t=-4.263,P＜0.05;SNCV(36.5±1.7)、(48.7±2.6) m/s,t=-7.526,P＜0.05]比较,升高幅度较对照组[正中神经MNCV(42.3±4.2)、(44.5±5.3) m/s,t=-4.627,P＜0.05;SNCV(39.8±2.4)、(42.4±2.5)m/s,t=-5.527,P＜0.05;腓总神经MNCV(40.3± 1.6)、(42.2±1.6) m/s,t=-4.181,P＜0.05;SNCV(36.4±2.3)、(41.2±3.5) m/s,t=-5.928,P＜0.05]更为明显.治疗前TSS对照组(11.4±2.5)分,研究组(11.6±1.6)分;VAS评分对照组[(5.3±1.6)分,研究组(5.2±1.8)分,两组比较差异均无统计学意义(P均＞0.05);治疗后TSS对照组(6.4±1.3)分,研究组(4.2±3.3)分;VAS评分对照组(3.6±1.3)分,研究组(1.7±0.9)分,治疗后较治疗前相比均明显降低,差异均有统计学意义(P均＜ 0.05),而且研究组降低较对照组更为明显,两组间差异有统计学意义(P均＜0.05).研究组患者总有效率95.1％(39/41)明显高于对照组65.9％(27/41),差异有统计学意义(x2=5.363,P=0.031).结论 α-硫辛酸联合前列地尔治疗糖尿病周围神经病变效果优于单用前列地尔.
Objective To discuss the effect of α-lipoic acid combined with alprostadil in patients with diabetic peripheral neuropathy (DPN).Methods Eighty-two patients with DPN were divided into the control group(n=41) and research group(n=41) according to the random number table method.The patients of the control group were given alprostadil based on conventional therapy, while the research group were given alpha lipoic acid based on treatment of the control group, the course was two weeks.The bilateral median nerve and sural nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) were tested by electromyograph.Disease severity were evaluated by neuropathy symptoms questionnaire (TSS) and pain degree were tested by Visual analogue scales(VAS).The MNCV, SNCV, TSS and VAS of before and after treatment and the clinical effect of the two groups were compared.Results There were no statistically significant difference about MNCV and SNCV of the two groups before treatment (P＞0.05).After treatment, the MNCV and SNCV of nervus medianus and nervus peroneus communis of research group and control group were significantly higher than before treatment, and the differences of research group before and after treatment (MNCV of nervus medianus: (42.5 ± 3.6) m/s vs (47.8± 4.6) m/s, t =-5.752, P ＜ 0.05;SNCV of ervus medianus : (39.6 ±1.6) m/s vs (46.2±4.5) m/s,t =-5.882,P＜0.05;MNCV of nervus peroneus communis: (39.8±3.2) m/s vs (44.5±2.5) m/s,t=-4.263,P＜0.05;SNCV of nervus peroneus communis: (36.5±1.7) m/s vs (48.7± 2.6) m/s, t =-7.526, P ＜ 0.05), significantly obvious than the control group (MNCV of nervus medianus: (42.3 ±4.2) m/s vs (44.5±5.3) m/s,t =-4.627,P＜0.05;SNCV of nervus medianus: (39.8 ±2.4) m/s vs (42.4±2.5) m/s,t =-5.527,P＜0.05;MNCV of nervus peroneus communis: (40.3±1.6) m/s vs (42.2± 1.6) m/s, t =-4.181, P＜ 0.05;SNCV of nervus peroneus communis: (36.4± 2.3) m/s vs (41.2±3.5) m/s,t =-5.928,P＜0.05).Before the treatment,the TSS and VAS of the control group were (11.4±2.5) sore and (5.3±1.6) sore,of the research group were (11.6±1.6) sore and (5.2±1.8) sore,and there was no significant difference between the two groups (P＞0.05).After treatment, the TSS and VAS of the control group were (6.4± 1.3) sore and (3.6± 1.3) sore, of the research group were (4.2± 3.3) sore and (1.7 ±0.9) sore, and compared to before treatment, there was significant difference (P＜0.05), and the research group was significantly lower than the control group, the difference between the two groups was statistically significant (P＜ 0.05).The total effective rate of research group was obviously higher than that of control group, the differences were statistically significant (95.1％ (39/41) vs 65.9％ (27/41), x2 =5.363, P =0.031) .Conclusion The effect of α-lipoic acid combined with alprostadil in patients with diabetic peripheral neuropathy is obviously better than that of using alprostadil only,it is worth popularization and application.
出处
《中国综合临床》
2016年第1期-,共4页
Clinical Medicine of China
