秦晓丹　屈丹

[摘要] 目的 观察前列地尔联合硫辛酸注射液和甲钴胺对2型糖尿病周围神经病变患者的疗效。 方法 选择2015年1月～2016年12月于我院內分泌科住院治疗的80例DPN患者，将所有病例按就诊先后分为两组，研究组40例和对照组40例。两组患者都在降血糖等常规治疗基础上应用甲钻胺注射液500 μg，肌肉注射，每日1次；硫辛酸注射液600 mg，避光静脉滴注，每日1次。研究组在对照组治疗的基础上同时应用前列地尔注射液10 μg，静脉注射，每日1次，两组疗程均为14 d。观察两组患者治疗前后TSS评分和神经电生理变化。 结果 两组患者在治疗后症状均明显改善（P<0.05），其中研究组更优于对照组（P<0.05）；治疗后正中神经及腓总神经感觉传导速度（SCV）及运动传导速度（MCV）均加快（P<0.05），且研究组较对照组更明显（P<0.05）。 结论 前列地尔联合硫辛酸注射液和甲钴胺在糖尿病周围神经病变临床治疗中疗效显著，值得推广应用。

[关键词] 糖尿病周围神经病变；硫辛酸；前列地尔；甲钴胺

[中图分类号] R587.2 [文献标识码] B [文章编号] 1673-9701（2018）20-0050-03

Clinical observation on alprostadil combined with lipoic acid and mecobalamin in the treatment of type 2 diabetic peripheral neuropathy

QIN Xiaodan QU Dan

Department of Endocrinology， Benxi Central Hospital in Liaoning Province， Benxi 117000， China

[Abstract] Objective To observe the efficacy of alprostadil combined with lipoic acid injection and mecobalamin in the treatment of type 2 diabetic peripheral neuropathy. Methods 80 patients with DPN who were hospitalized in the Department of Endocrinology of our hospital from January 2015 to December 2016 were divided into two groups according to their visits， including the study group（n=40） and the control group（n=40）. Both groups of patients were treated with methamamine injection 500 μg， intramuscular injection， once daily， and lipoic acid 600 mg intravenous drip in shade， once daily， based on the routine treatment such as hypoglycemia. The study group was also treated with 10 mg of alprostadil injection， intravenous injection， and once daily treatment. The treatment course of both groups was 14 days. The TSS scores and neurophysiological changes before and after treatment were observed in both groups. Results Symptoms of both groups improved significantly after treatment（P<0.05）. And the improvement of the study group was superior to the control group（P<0.05）. The median nerve and common peroneal nerve sensory conduction velocity（SCV） and motor conduction velocity（MCV） after treatment were all accelerated（P<0.05）， and the changes of the study group were more obvious than those of the control group（P<0.05）. Conclusion Alprostadil combined with lipoic acid injection and mecobalamin has significant effect in the clinical treatment of diabetic peripheral neuropathy， which is worthy of popularization and application.

[Key words] Diabetic peripheral neuropathy； Lipoic acid； Alprostadil； Methylcobalamin

糖尿病周围神经病变（DPN）是糖尿病患者最常见的慢性并发症之一和最主要的致残因素，有研究显示，30岁以上2型糖尿病（T2DM）患者DPN的发生率为61.8%[1]，患者易因为DPN导致的保护性感觉迟钝或丧失发生足部溃疡和感染，甚至导致截肢[2]。目前DPN已成为威胁糖尿病患者生活质量的公共卫生问题之一，尚无特效的治疗方法。2015年1月～2016年12月本研究采用前列地尔联合硫辛酸、甲钴胺治疗DPN，取得较为满意的效果，报道如下。

1资料与方法

1.1一般资料

研究对象选择于我院内分泌科住院治疗的80例DPN患者，纳入标准：2型糖尿病的诊断符合1999年WHO糖尿病诊断与分类标准[3]。有以下周围神经病变表现之一的患者诊断为糖尿病周围神经病变：（1）肢体有运动功能异常的症状，如肌无力、肌萎缩，行走不稳，跟、膝腱反射减弱或消失；……