左斌

【摘要】 目的：分析α-硫辛酸联合甲钴胺治疗糖尿病周围神经病变的临床效果。方法：将2018年5月1日-2019年4月30日笔者所在医院住院治疗的104例糖尿病周围神经病变患者作为研究对象，将其随机分为对照组和观察组，各52例。对照组给予前列地尔联合依帕司他治疗，观察组给予α-硫辛酸联合甲钴胺治疗。比较两组治疗效果。结果：观察组治疗总有效率为88.46%，高于对照组的71.15%，差异有统计学意义（P<0.05）。治疗后，观察组胫神经和腓总神经MNCV及SNCV均显著高于对照组，差异有统计学意义（P<0.05）。治疗后，观察组症状评分（1.6±0.2）分，反射评分（1.6±0.4）分，感觉评分（0.7±0.1）分，总分（4.1±0.6）分，均低于对照组，差异有统计学意义（P<0.05）。结论：对糖尿病周围神经病变患者应用α-硫辛酸联合甲钴胺进行治疗，效果显著，可有效改善神经传导速度，值得推广。

【关键词】 α-硫辛酸 甲钴胺 糖尿病周围神经病变

doi：10.14033/j.cnki.cfmr.2020.20.018 文献标识码 B 文章编号 1674-6805（2020）20-00-03

Clinical Effect of α-lipoic Acid Combined with Mecobalamin in the Treatment of Diabetic Peripheral Neuropathy/ZUO Bin. //Chinese and Foreign Medical Research， 2020， 18（20）： -49

[Abstract] Objective： To analyze the clinical effect of α-lipoic Acid combined with Mecobalamin in the treatment of diabetic peripheral neuropathy. Method： From May 1st， 2018 to April 30th， 2019， 104 diabetic peripheral neuropathy patients hospitalized in our hospital were selected as study subjects. They were randomly divided into the control group and the observation group， with 52 cases in each group. The control group was treated with Alprostadil combined with Epalrestat， while the observation group was treated with α-lipoic Acid combined with Mecobalamin. The therapeutic effects of the two groups were compared. Result： The total effective rate in the observation group was 88.46%， which was higher than 71.15% in the control group， the difference was statistically significant （P<0.05）. After treatment， MNCV and SNCV of tibial nerve and common peroneal nerve in the observation group were significantly higher than those of the control group， and the differences were statistically significant （P<0.05）. After treatment， symptom score （1.6±0.2） points， reflex score （1.6±0.4） points， sensory score （0.7±0.1） points and total score （4.1±0.6） points in the observation group were all lower than those in the control group， and the differences were statistically significant （P<0.05）. Conclusion： The application of α-lipoic Acid combined with Mecobalamin in the treatment of diabetic peripheral neuropathy has a significant effect and can effectively improve the nerve conduction velocity， which is worthy of promotion.

[Key words] α-lipoic Acid Mecobalamin Diabetic peripheral neuropathy

First-authors address： Wuzhou Red Cross Hospital， Wuzhou 543002， China

糖尿病是由胰島素分泌不足或胰岛素抵抗引起的代谢性疾病，糖尿病周围神经病变（DPN）是患者体内外周神经功能障碍的并发症，不包括其他疾病原因[1]。DPN作为常见的一种慢性并发症，患者会出现异常和出现对称性疼痛感。且下肢症状的发生率高于上肢。该病常有麻木、灼烧感、蚁走感等表现，和糖尿病肾病及糖尿病视网膜病变是最常见的并发症类型，如果未有效治疗，会对患者生活质量造成影响[2]。DPN的临床表现有很多种，通常根据临床病理特征分为远端型原发性感觉神经病变、自主神经病变、糖尿病足、急性或亚急性近端型运动神经病变等[3]。DPN的治疗重点是防治，健康饮食、科学运动、保持血糖平稳，预防并发症[4]。基于此，本文选取笔者所在医院住院治疗的104例糖尿病周围神经病变患者，探讨应用α-硫辛酸联合甲钴胺治疗的效果，现报告如下。

1 资料与方法

1.1 一般资料

将2018年5月1日-2019年4月30日医院住院治疗的糖尿病周围神经病变患者104例作为研究对象，纳入标准：（1）符合WHO制定的糖尿病诊断标准;（2）有肢体感觉异常，如蚁行感、麻木、针刺样疼痛、冷觉减退;（3）腱反射减退或消失;（4）肌电图异常。……