CAJ | 학술논문

目的观察比较应用α-硫辛酸、依帕司他和甲钴胺单独或联合治疗糖尿病神经源性膀胱(DNB)的效果.方法将DNB患者110例随机分为4组,α-硫辛酸联合依帕司他及甲钴胺治疗组(A组,n =25),α-硫辛酸联合甲钴胺治疗组(B组,n=35),依帕司他联合甲钴胺治疗组(C组,n=32),甲钴胺治疗对照组(D组,n=18),疗程为3周,3周后A、C组继续应用依帕司他至12周.治疗前及治疗后3周、12周B超测定膀胱残余尿量(RUV)及进行尿流动力学检查.结果 4组治疗后RUV较前均减少,差异有统计学意义(P＜0.05);A、B、C组治疗3周后膀胱初尿意容量(BS)均较治疗前减少,最大尿流率(MFR)、最大尿流率时逼尿肌压力(Pdet)增加,差异均有统计学意义(P均＜0.05),其中A组RUV、BS改善程度较B组明显,B组较C组明显,其组间差异有统计学意义(P＜0.05),治疗后3组间MFR、Pdet差异无统计学意义(P均＞0.05),D组以上指标除RUV外治疗前、后变化无统计学意义(P均＞0.05);12周后4组RUV较治疗前差异仍有统计学意义(P＜0.05),A组BS改善程度较B、C组明显,B组与C组比较差异无统计学意义(P均＞0.05);治疗3周后A组总有效率88.0％,B组85.7％,C组62.5％,D组50％,A、B两组之间疗效比较无统计学意义(P均＞0.05),与C、D组疗效比较差异均有统计学意义(P＜0.05).结论 α-硫辛酸联合依帕司他、甲钴胺治疗DNB效果较好.
목적 관찰비교응용α-류신산、의파사타화갑고알단독혹연합치료당뇨병신경원성방광(DNB)적효과.방법 장DNB환자110례수궤분위4조,α-류신산연합의파사타급갑고알치료조(A조,n =25),α-류신산연합갑고알치료조(B조,n=35),의파사타연합갑고알치료조(C조,n=32),갑고알치료대조조(D조,n=18),료정위3주,3주후A、C조계속응용의파사타지12주.치료전급치료후3주、12주B초측정방광잔여뇨량(RUV)급진행뇨류동역학검사.결과 4조치료후RUV교전균감소,차이유통계학의의(P＜0.05);A、B、C조치료3주후방광초뇨의용량(BS)균교치료전감소,최대뇨류솔(MFR)、최대뇨류솔시핍뇨기압력(Pdet)증가,차이균유통계학의의(P균＜0.05),기중A조RUV、BS개선정도교B조명현,B조교C조명현,기조간차이유통계학의의(P＜0.05),치료후3조간MFR、Pdet차이무통계학의의(P균＞0.05),D조이상지표제RUV외치료전、후변화무통계학의의(P균＞0.05);12주후4조RUV교치료전차이잉유통계학의의(P＜0.05),A조BS개선정도교B、C조명현,B조여C조비교차이무통계학의의(P균＞0.05);치료3주후A조총유효솔88.0％,B조85.7％,C조62.5％,D조50％,A、B량조지간료효비교무통계학의의(P균＞0.05),여C、D조료효비교차이균유통계학의의(P＜0.05).결론 α-류신산연합의파사타、갑고알치료DNB효과교호.
Objective To observe the effects of alpha-lipoic acid alone or in combined with epalrestat and mecobalamin on diabetic neurogenic bladder.Methods 110 patients with diabetic neurogenic bladder were randomly divided into four groups,alpha-lipoic acid combined with epalrestat and mecobalamin group (group A,n =25),alpha-lipoic acid combined with mecobalamin group(group B,n =35),epalrestat combined with mecobalamin group (group C,n =32) and mecobalamin group (group D,u =18).After 3 weeks,group A and C were treated with epalrestat for another 9 weeks,and the other two groups discontinued the treatmeat.The residual urine volume of bladder (RUV) using B-ultralsound and urodynamic indices were tested at 0th,3th and 12th week.Results After treatment,RUV of four groups decreased significantly (P ＜0.05).The beginning of a sense of capacity (BS) in group A,B and C decreased significantly,pressure at maximum flow rate(Pdet) and the maximum flow rate(MFR) increased significantly (all P ＜0.05).Compared with group B,RUV and BS decreased significantly in group A (all P ＜0.05).Compared with group C,RUV and BS decreased significantly in B group (all P ＜0.05).There were no significant change of MFR and Pdet among group A,B and C (all P ＞0.05).There were no significant change of the urodynamic indices in group D before and after treatment (all P ＞0.05).At the end of 12 weeks,RU V in all of groups were still improved compared with that before treatment.RUV and BS of group A were superior to group B and C.The effective rate in group A,B,C and D was 88.0％,85.7％,62.5％ and 50.0％,respectively.The effectiveness of group A and B were superior to group C and D,and there were no significant changes between A and B (all P ＞0.05).Conclusion Alphalipoic acid combined with epalrestat and mecobalamin has a better therapeutic effects on diabetic neurogenic bladder.