硫辛酸联用甲钴胺对糖尿病周围神经病变患者神经传导速度的改善作用

目的探讨硫辛酸联合甲钴胺对糖尿病周围神经病变（DPN）患者的疗效及神经传导速度的改善作用。方法将医院2010年5月至2012年5月收治的101例DPN患者随机分为对照组49例和治疗组52例,对照组患者肌肉注射甲钴胺500μg,每日1次;治疗组肌肉注射甲钴胺500μg,每日1次,并静脉滴注硫辛酸600 mg/d。疗程结束后评价疗效,对两组患者的运动、感觉神经传导速度进行比较,并通过症状总评分（TSS）和疼痛视觉模拟评分（VAS）对病情进行评估。结果治疗组总有效率为90.38%,明显高于对照组的75.5l%（P〈0.05）;两组患者治疗后神经传导速度较治疗前均有所提高,治疗组提高更明显（P〈0.05）;治疗后对照组和治疗组TSS评分分别为（6.37±1.21）分和（4.33±0.96）分,VAS评分为（5.43±0.67）分和（4.35±0.51）分,与治疗前相比均有降低,且治疗组明显低于对照组（P〈0.05）。结论硫辛酸联合甲钴胺可明显改善糖尿病患者的周围神经病变,疗效显著,值得临床推广。

Improvement Effect of Alpha Lipoic Acid Combined with Methycobal on Nerve Conduction Velocity in Diabetic Peripheral Neuropathy

Objective To observe the effect and the improvement of the nerve conduction velocity of alpha lipoic acid and methycobal in treating diabetic peripheral neuropathy（DPN）. Methods 101 patients with DPN admitted to our hospital from May 2010 to May 2012 were randomly divided into the observation group（49 cases） and the control group（52 cases）. The control group was given methycobal 500 μg by intramuscular injection, once per day, while the observation group was given methycobal 500 μg by intramuscular injection, once per day, and alpha lipoic acid 600 mg by intravenous drip. After treatment, the curative effects were evaluated. The movement and sensory nerve conduction velocities in the two groups were detected and compared. The disease condition was evaluated by the symptom TSS score and the pain VAS score. Results The total effective rate of treatment group was 90. 38%, which was significantly higher than 75.51% in the control group（ P 〈 0.05）; the nerve conduction velocities after therapy in the two groups patients were increased than before therapy, in which the treatment group had statistically significant difference（ P 〈 0. 05）; the symptom TSS scores of control group and treatment group were （6.37±1.21） and （4.33 ±0.96） respectively, the VAS scores were （5.43 ±0.67） and （4. 35 ±0. 51） respectively, which were decreased than before therapy, moreover, the treatment group were significantly lower than the control group（ P 〈 0. 05）. Conclusion Alpha lipoic acid combined with methycobal can obviously improve DPN with significant effect, which is worthy of clinical promotion.