目的 观察α-硫辛酸注射液联合甲钴胺和前列地尔对2型糖尿病周围神经病变患者的疗效和安全性.方法 2011年1月至2012年12月于我院内分泌科住院治疗的160例DPN患者,将所有病例按就诊先后分为两组,试验组80例和对照组80例.研究中试验组有3例、对照组5例由于自身原因提前出院退出研究.研究实际完成试验组77例、对照组75例.两组均在降糖治疗基础上联合应用甲钴胺500 μg,肌肉注射,隔日1次;前列地尔10μg,静脉注射,1次/d.试验组同时加用α-硫辛酸600 mg,静脉滴注,1次/d.两组治疗均持续10～ 14 d.观察治疗前后症状的改善、神经病变总症状(TSS)评分和神经传导速度的变化、满意度和不良反应.结果 α-硫辛酸静脉滴注10 d后,试验组与对照组相比,TSS总积分[(3.5±2.5)分与(4.3±2.1)分,t=2.11,P＜0.05]、刺痛积分[(1.1±0.4)分与(1.5±0.5)分,t=1.86,P＜0.05]、烧灼感积分[(0.9±0.7)分与(1.3±0.5)分,t=1.83,P＜0.05]、感觉减退积分[(1.3±0.4)分与(1.7±0.5)分,t =1.87,P＜0.05]、麻木积分[(1.3±0.9)分与(1.9±0.4)分,t=1.91,P＜0.05]明显降低;正中神经运动传导速度[(53.6±1.4) m/s与(48.5±2.7) m/s,t=-4.94,P＜0.05]、腓总神经运动传导速度[(49.6±1.1) m/s与(43.9±2.1) m/s,t=-5.36,P＜0.05]、正中神经感觉传导速度[(47.3±1.1) m/s与(41.6±1.8) m/s,t=-5.09,P＜0.05]、腓总神经感觉传导速度[(48.2±1.9) m/s与(43.2±2.5) m/s,t=-4.27,P＜0.05]明显提高.试验组97.4％(75/77)的医师和92.2％ (71/77)的患者对治疗效果满意,对照组84.0％(63/75)的医师和78.7％(59/75)的患者对治疗效果满意.研究过程中试验组颜面潮红3例、头晕1例,对照组颜面潮红2例、头晕1例,未经特殊处理自行缓解.结论 α-硫辛酸静脉滴注治疗DPN疗效显著,同时具有良好的安全性.
目的 觀察α-硫辛痠註射液聯閤甲鈷胺和前列地爾對2型糖尿病週圍神經病變患者的療效和安全性.方法 2011年1月至2012年12月于我院內分泌科住院治療的160例DPN患者,將所有病例按就診先後分為兩組,試驗組80例和對照組80例.研究中試驗組有3例、對照組5例由于自身原因提前齣院退齣研究.研究實際完成試驗組77例、對照組75例.兩組均在降糖治療基礎上聯閤應用甲鈷胺500 μg,肌肉註射,隔日1次;前列地爾10μg,靜脈註射,1次/d.試驗組同時加用α-硫辛痠600 mg,靜脈滴註,1次/d.兩組治療均持續10～ 14 d.觀察治療前後癥狀的改善、神經病變總癥狀(TSS)評分和神經傳導速度的變化、滿意度和不良反應.結果 α-硫辛痠靜脈滴註10 d後,試驗組與對照組相比,TSS總積分[(3.5±2.5)分與(4.3±2.1)分,t=2.11,P＜0.05]、刺痛積分[(1.1±0.4)分與(1.5±0.5)分,t=1.86,P＜0.05]、燒灼感積分[(0.9±0.7)分與(1.3±0.5)分,t=1.83,P＜0.05]、感覺減退積分[(1.3±0.4)分與(1.7±0.5)分,t =1.87,P＜0.05]、痳木積分[(1.3±0.9)分與(1.9±0.4)分,t=1.91,P＜0.05]明顯降低;正中神經運動傳導速度[(53.6±1.4) m/s與(48.5±2.7) m/s,t=-4.94,P＜0.05]、腓總神經運動傳導速度[(49.6±1.1) m/s與(43.9±2.1) m/s,t=-5.36,P＜0.05]、正中神經感覺傳導速度[(47.3±1.1) m/s與(41.6±1.8) m/s,t=-5.09,P＜0.05]、腓總神經感覺傳導速度[(48.2±1.9) m/s與(43.2±2.5) m/s,t=-4.27,P＜0.05]明顯提高.試驗組97.4％(75/77)的醫師和92.2％ (71/77)的患者對治療效果滿意,對照組84.0％(63/75)的醫師和78.7％(59/75)的患者對治療效果滿意.研究過程中試驗組顏麵潮紅3例、頭暈1例,對照組顏麵潮紅2例、頭暈1例,未經特殊處理自行緩解.結論 α-硫辛痠靜脈滴註治療DPN療效顯著,同時具有良好的安全性.
목적 관찰α-류신산주사액연합갑고알화전렬지이대2형당뇨병주위신경병변환자적료효화안전성.방법 2011년1월지2012년12월우아원내분비과주원치료적160례DPN환자,장소유병례안취진선후분위량조,시험조80례화대조조80례.연구중시험조유3례、대조조5례유우자신원인제전출원퇴출연구.연구실제완성시험조77례、대조조75례.량조균재강당치료기출상연합응용갑고알500 μg,기육주사,격일1차;전렬지이10μg,정맥주사,1차/d.시험조동시가용α-류신산600 mg,정맥적주,1차/d.량조치료균지속10～ 14 d.관찰치료전후증상적개선、신경병변총증상(TSS)평분화신경전도속도적변화、만의도화불량반응.결과 α-류신산정맥적주10 d후,시험조여대조조상비,TSS총적분[(3.5±2.5)분여(4.3±2.1)분,t=2.11,P＜0.05]、자통적분[(1.1±0.4)분여(1.5±0.5)분,t=1.86,P＜0.05]、소작감적분[(0.9±0.7)분여(1.3±0.5)분,t=1.83,P＜0.05]、감각감퇴적분[(1.3±0.4)분여(1.7±0.5)분,t =1.87,P＜0.05]、마목적분[(1.3±0.9)분여(1.9±0.4)분,t=1.91,P＜0.05]명현강저;정중신경운동전도속도[(53.6±1.4) m/s여(48.5±2.7) m/s,t=-4.94,P＜0.05]、비총신경운동전도속도[(49.6±1.1) m/s여(43.9±2.1) m/s,t=-5.36,P＜0.05]、정중신경감각전도속도[(47.3±1.1) m/s여(41.6±1.8) m/s,t=-5.09,P＜0.05]、비총신경감각전도속도[(48.2±1.9) m/s여(43.2±2.5) m/s,t=-4.27,P＜0.05]명현제고.시험조97.4％(75/77)적의사화92.2％ (71/77)적환자대치료효과만의,대조조84.0％(63/75)적의사화78.7％(59/75)적환자대치료효과만의.연구과정중시험조안면조홍3례、두훈1례,대조조안면조홍2례、두훈1례,미경특수처리자행완해.결론 α-류신산정맥적주치료DPN료효현저,동시구유량호적안전성.
Objective To investigate the clinical effect and safety of alpha lipoic acid injection combined mecobalamin and prostaglandin E on type 2 diabetic patients complicated with diabetic peripheral neuropathy(DPN).Methods One hundred and sixty type 2 diabetic patients complicated with DPN in the General Hospital of Benxi Iron and Steel Group Corporation from Jan.2011 to Dec.2012 were randomly divided into the treatment group(n =80) and the control group (n =80).Three cases of the treatment group and 5 cases of the control group discharged early from the study because of their own reasons.There were 77 cases in the treatment group and 75 cases in the control group.On the basis of controlling blood glucose,patients in the two groups were given 500 μg mecobalamin combined with intramuscular injection once two days,as well as prostaglandinE 10 μg injection once a day.Patients in treatment group were added with 600 mg alpha lipoic acid for intravenous injection once a day for 10-14 days.Total symptom score (TSS),nerve conduction velocity,satisfaction and adverse reactions were evaluated before and after treatment.Results TSS score,tingling score,burning sensation score and hypoesthesia score,numb score in treatment group were (3.5 ± 2.5),(1.1 ± 0.4),(0.9 ± 0.7),(1.3 ± 0.4),(1.3 ± 0.9),significantly lower than those in control group (4.3 ± 2.1,t =2.11,P ＜0.05;1.5 ±0.5,t =1.86,P＜0.05;1.3 ±0.5,t =1.83,P ＜0.05;1.7 ±0.5,t =1.87,P ＜0.05; 1.9 ± 0.4,t =1.91,P ＜ 0.05).The median nerve conduction velocity,peroneal nerve motor conduction velocity,median nerve sensory conduction velocity,common peroneal nerve sensory conduction velocity of patients in treatment group were (53.6 ± 1.4) m/s,(49.6 ± 1.1) m/s,(47.3 ± 1.1) m/s,(48.2 ± 1.9) m/s,lower than those in control group((48.5 ±2.7) m/s,t =-4.94,P ＜0.05;(43.9 ±2.1) m/s,t =-5.36,P ＜0.05; (41.6 ± 1.8) m/s,t =-5.09,P ＜0.05;(43.2 ±2.5) m/s,t =-4.27,P ＜ 0.05,P ＜0.05).In the treatment group,97.4％ (75/77) physicians and 92.2％ (71/77) patients were satisfied with treatment effect,while in the control group,84.0％ (63/75) physicians and 78.7％ (59/75) patients were satisfied with treatment effect.During the study periods,there were 3 cases with facial flushing and 1 cases of dizziness in the treatment group,and 2 cases of facial flushing and 1 cases of dizziness in the control group.All adverse reactions were spontaneous remission without any special treatment.Conclusion Alpha lipoic acid intravenous drip is effective in term of treating type 2 diabetic peripheral neuropathy,and with high safety.
