硫辛酸治疗糖尿病神经源性膀胱疗效观察

目的观察硫辛酸治疗糖尿病神经源性膀胱(DNB)的临床疗效,并探讨其对氧化应激的影响。方法将80例DNB患者随机分为观察组和对照组,每组40例,2组患者均采用降血糖等基础治疗,观察组患者在基础治疗上加用硫辛酸,2组疗程均为21 d,比较2组患者的膀胱残余尿量、尿动力学改变、治疗效果及血清超氧化物歧化酶(SOD)水平。结果 2组患者治疗后膀胱残余尿量较治疗前均显著减少(P<0.05),各项尿动力学指标较治疗前显著改善(P<0.05)。观察组患者治疗后的膀胱残余尿量、最大尿流率(MFR)、膀胱最大测压容积(VMBC)、最大尿流率时逼尿肌压力(PQmax)改善均显著优于对照组(P<0.05)。治疗后观察组总有效率显著高于对照组(P<0.01)。治疗后观察组血清SOD水平高于治疗前(P<0.05);治疗后观察组SOD水平高于对照组,差异有统计学意义(P<0.05)。结论硫辛酸可明显改善DNB患者的膀胱残余尿量及尿动力学指标,缓解症状。硫辛酸可提高DNB患者抗氧化应激功能,从而为硫辛酸治疗DNB提供理论依据。

Therapy effect of lipoic acid on diabetic neurogenic bladder

Objective To observe the clinical effect of lipoic acid on treating diabetic neurogenic bladder（ DNB）, and to explore the influence of it on oxidative stress. Methods Eighty patients with DNB were randomly divided into observation group and control group, with 40 patients in each group. All the patients were given hypoglycemic and other common treatment. Patients in observation group were given lipoic acid on the basic treatment for 21 days. The postvoiding residue of bladder, the urodynamic parameters and clinical effect of the two groups were compared, and the superoxide dismutase （SOD） level was measured before and after the treatment. Results The postvoiding residue of bladder after therapy were both decreased signifi- cantly than those before treatment in the two groups （ P 〈 0. 05 ）, all the urodynamic parameters of the two groups after treatment were better than before （P 〈 0.05 ）. After treatment, the postvoiding residue of bladder, maximum flow rate （MFR）, maximum bladder pressure volume（ VMBC）, maximum urinary flow rate when detrusor pressure（PQmax） in observation group were sig- nificantly better than those of control group（P 〈 0.05 ）. The total efficiency of observation group was significantly better than that of control group（ P 〈 0. 01 ）. The SOD level in observation group after treatment was higher than before treatment（ P 〈 0. 05 ） ;after treatment the SOD level in observation group was significantly higher than that in control group（P 〈 0.05 ） . Conclusion Lipoic acid can significantly improve the postvoiding residue of bladder, urodynamic parameters and the symptoms in patients with DNB. Lipoic acid can improve the capability of anti-oxidative stress, which provides a theoretical basis for lipoic acid treatment on DNB.