α-硫辛酸联合甲钴胺治疗周围神经病变的疗效观察

目的观察α-硫辛酸（ALA）联合甲钴胺治疗糖尿病周围神经病变的临床疗效。方法选取我院有周围神经症状的2型糖尿病患者共171例,测定入院时的身高、体重、空腹血糖、餐后血糖、糖化血红蛋白后,随机分为3组：0组（n=75）,ALA600mg与甲钴胺1.0mg加入生理盐水250ml静滴;1组（n=75）ALA600mg加入生理盐水250ml静滴;2组（n=21）,单纯降糖治疗。0组和1组均连续用药2周,每日1次。观察治疗前后症状的改善及记录FBG、PBG、TSS评分的变化,同时评价疗效的满意度。结果①治疗2周后,0组麻木、烧灼感等症状改善最明显,1组有所改善,2组无明显改善。②各组治疗前后TSS评分：0组和1组治疗后的TSS评分较治疗前降低（P〈0.05）,2组未见明显降低（P〉0.05）。③各组间TSS评分变化比较：三组间的TSS变化比较,均具有统计学差异（P〈0.05）。④满意度评价：医生和患者对0组的疗效,满意度明显高于1组和2组,0组患者总体满意度为88%,而1组仅32%,2组认为疗效不满意。结论α-硫辛酸联合甲钴胺静滴治疗糖尿病周围神经病变,2周内可见明显改善,疗效优于单独应用α-硫辛酸,单纯降糖无改善。

The superiority and curative effect of combined therapy neuropathy

Objective To observe the effect and superiority of single or combined therapy of α-lipoic acid and mecobalamin for diabetic peripheral neuropathy （DPN）. Methods 171 type 2 diabetic patients complicated with DPN were randomly divided into 3 groups： combination therapy of ALA and mecobalamin （0 组, n=75）, ALA （1 组, n=75）,or only control of blood glucose （2 组 ,n=21）.The drugs were given for 14 days.Before and 14 days after the treatment,the fasting glucose （FBG） ,postmeal blood glucose（PBG）,total symptom seore（TSS） were used to evaluate the nervous symptoms. Results （1）After 14 days , the symptoms of numbness,burning sensation of cases reduced much more in group 0 than group 1 ,but none reduce in group 2. （2）Mter 14 days,the TSS of group 0 were significantly lower than that of group 1 ,thus TSS of group 2 changed less.（3） The total satisfaction rate of group 0 was 88% （66/75）, significantly higher than that of group 1 （32%, 24/75 ）.Patients of group 2 were not satisfaction with curative effect. Conclusion The combined therapy of ALA and mecobalamin is better than single ALA for improvement of DPN symptoms, but treatment of only control blood glucose may have no significant effect.