吴卫国

【摘要】 目的：探究α-硫辛酸联合甲钴胺、依帕司他治疗糖尿病周围神经病变的效果。方法：选取糖尿病周围神经病变患者160例，随机分成两组，各80例，观察组给予α-硫辛酸联合甲钴胺、依帕司他治疗，对照组给予常规治疗。治疗后比较各项指标。结果：观察组治疗总有效率高于对照组，差异有统计学意义（字2=0.017，P<0.05）。治疗前两组感觉神经传导速度、运动神经传导速度比较差异无统计学意义（P>0.05）;治疗后两组神经传导速度均高于治疗前，且观察组高于对照组，差异均有统计学意义（P<0.05）。结论：应用α-硫辛酸联合甲钴胺、依帕司他治疗糖尿病周围神经病变效果确切，具有临床推广意义。

【关键词】 α-硫辛酸 甲钴胺 依帕司他 糖尿病周围神经病变

doi：10.14033/j.cnki.cfmr.2019.28.013 文献标识码 B 文章编号 1674-6805（2019）28-00-03

Clinical Effect of Alpha-lipoic Acid Combined with Mecobalamin and Epalrestat in Treatment of Diabetic Peripheral Neuropathy/WU Weiguo. //Chinese and Foreign Medical Research， 2019， 17（28）： -34

[Abstract] Objective： To investigate the effect of Alpha-lipoic Acid combined with Mecobalamin and Epalrestat on diabetic peripheral neuropathy. Method： A total of 160 patients with diabetic peripheral neuropathy were randomly divided into two groups， 80 cases in each group. The observation group was treated with Alpha-lipoic Acid combined with Mecobalamin and Epalrestat， and the control group was given routine treatment. The indexes were compared after treatment. Result： The total effective rate of treatment in the observation group was higher than that in the control group， the difference was statistically significant （字2=0.017， P<0.05）. There were no significant differences in sensory nerve conduction velocity and motor nerve conduction velocity between the two groups before treatment （P>0.05）. The nerve conduction velocity in the two groups after treatment were higher than those before treatment， and the observation group was higher than the control group （P<0.05）. Conclusion： The application effect of Alpha-lipoic Acid combined with Mecobalamin and Epalrestat in treatment of diabetic peripheral neuropathy is effective， and it has the significance of clinical popularization.

[Key words] Alpha-lipoic Acid Mecobalamin Epalrestat Diabetic peripheral neuropathy

First-authors address： Wuxi Second Peoples Hospital， Wuxi 214002， China

糖尿病病程漫長，常常伴发多种慢性并发症，其中周围神经病变（DPN）是较为常见的一种，尤常见于2型糖尿病。DNP起病隐匿，渐进性发展，常双侧同时受到累及[1]。早期发现，及时治疗对改善甚至逆转患者临床症状、体征至关重要，近年来常用甲钴胺、依帕司他来减轻患者疼痛、麻木的周围神经症状[2]。由于研究证实的α-硫辛酸具有可清除自由基，对抗氧化物质有促进再生的作用，从而减弱发生氧化反应，α-硫辛酸是一种抗氧化剂，且作用较强[3]。依帕司他对醛糖还原酶活性具有显著的抑制作用，从而使多元醇旁路被迫中断。并且其对内皮细胞生成一氧化氮作用具有促进作用，主要通过对蛋白激酸信号通路的抑制作用来达成[4]。甲钴胺具有维生素B12活性的作用，有利于修复受损的神经髓鞘，对其形成具有刺激作用，同时还可促进轴突的再生[5]。本研究联合应用α-硫辛酸、甲钴胺、依帕司他治疗2型糖尿病患者的周围神经症状，分析其治疗效果，报道如下。……