硫辛酸联合小牛血清去蛋白注射液治疗老年2型糖尿病周围神经病变疗效观察

目的观察硫辛酸联合小牛血清去蛋白注射液治疗老年2型糖尿病周围神经病变的疗效。方法收集2型糖尿病合并周围神经病变患者176例,其中男性108例,女性68例,随机分为2组,治疗组89例,对照组87例,2组均积极控制血糖、血脂、血压,对照组用0.9%氯化钠注射液250 ml+硫辛酸注射液600 mg静脉滴注,每日1次,共2周;治疗组用0.9%氯化钠注射液250 ml+硫辛酸注射液600 mg静脉滴注,每日1次,5%葡萄糖250 ml+生物合成人胰岛素注射液R 4 U+小牛血清去蛋白800 mg静脉滴注,每日1次,共2周。治疗前后分别记录症状、深浅感觉、腱反射、检测神经肌电图,分别测定双侧尺神经、正中神经、腓总神经、胫神经、腓肠神经传导速度及踝臂指数ABI,记录神经主觉症状问卷(TSS)评分。结果治疗组神经传导速度的提高明显优于对照组(P<0.05);踝臂指数ABI治疗组治疗后较治疗前异常率减少(P<0.05),而对照组治疗后较治疗前异常率无明显改变(P>0.05),治疗组TSS分值治疗后较治疗前明显改善,且较同期对照组减小(P<0.05);治疗组总有效率96%,明显高于对照组总有效率67%(P<0.05)。结论硫辛酸联合小牛血清去蛋白注射液治疗老年2型糖尿病周围神经病变疗效显著,同时可改善大血管病变,改善心脑及下肢血液循环。

Effects of thioctic acid injection combined with deproteinized calf serum on elderly type 2 diabetic peripheral neuropathy

Objective To assess the effects of thioctic acid combined with deproteinized calf serum injection on the treatment of type 2 diabetic peripheral neuropathy （DPN） in elderly patients.Methods A total of 176 patients with type 2 diabetic with diabetic peripheral neuropathy （108 males,68 females） were randomly allocated to the treatment group （n=89） and control group （n=87）.The blood glucose,blood lipid and blood pressure were controlled in both groups.The control group was treated with 0.9% saline 250 ml plus thioctic acid injection 600 mg intravenous drip once daily for 2 weeks.The treatment group was treated with 0.9% saline 250 ml plus thioctic acid injection 600 mg and 5% glucose 250 ml plus Novolin R4u and deproteinized calf serum 800 mg intravenous drip once daily for 2 weeks.The symptoms,depth of feeling,tendon reflexes and nerve electromyogram were recorded.The bilateral ulnar nerve,median nerve,common peroneal nerve,tibial nerve,sural nerve conduction velocity and humerus index ABI were also detected.The neural symptoms questionnaire （TSS） score were assessed before and after the treatment.Results The nerve conduction velocity in treatment group was significantly higher as compared with control group （P〈0.05）.Following treatment,the abnormality of the humerus index ABI was significantly reduced in experimental group （P〈0.05）,but not in control group （P〉0.05）.The TSS scores in experimental group were significantly improved and remained lower than those in control group at the same time points （all P〈0.05）.The total effective rate was markedly higher in treatment group （96% vs 67%,P〈0.05）.Conclusion The combination of thioctic acid and deproteinized calf serum injection significantly improves the outcomes,in terms of alleviated vascular lesions and improved blood circulation of cardiovascular and lower limbs,and deserves further clinical application in patients with type 2 diabetic peripheral neuropathy.