α-硫辛酸联合前列地尔治疗糖尿病周围神经病变疗效观察

摘要

目的：研究观察a-硫辛酸联合前列地尔治疗2型糖尿病周围神经病变的疗效，探讨治疗糖尿病周围神经病变的有效方法。方法：选取2011年l月-2012年12月本科住院部的2型糖尿病伴周围神经病变患者40例，全部应用胰岛素降糖治疗，同时静脉滴注0.9%氯化钠溶液250 mL+α-硫辛酸注射液（ALA）600 mg，联合生理盐水100 mL+前列地尔注射液10μg静脉滴注，1次/d，14 d为一疗程。观察治疗前后神经病变症状和体征（TSS）评分的变化，记录不良事件，并评价医生和患者的满意度。结果：所有患者治疗后TSS总分较治疗前显著降低（P=0.001）；各项神经症状（包括刺痛、烧灼感、感觉异常和麻木）治疗后的TSS评分均明显改善（P<0.05）；治疗有效率达70%（TSS评分减少≥30%）；医生和患者对疗效的满意率分别为100%和92%；治疗过程中未观察到不良事件。结论：临床使用α-硫辛酸联合前列地尔治疗2型糖尿病周围神经病变安全有效，症状改善明显，无明显副作用，可以在临床推广。%Objective:To evaluate the efficacy of alpha-lipoic acid(ALA)with alprostadil in type 2 diabetic patients complicated with peripheral neuropathy.Method:40 patients with type 2 diabetic complicated with peripheral neuropathy hospitalized in our hospital from January 2011 to December 2012 were selected. With the background therapy of diabetes mellitus unchanged,the patients were added the ALA infusions of 600 mg in the 0.9%saline 250 mL intravenously guttae slowly,and added prostaglandin E1 infusions of 10μg in the 0.9%saline 100 mL,1 time a day,for 14 days. Then the differences in total symptom score(TSS)with ALA intravenously before and after the management were compared,recorded the adverse effects occurred in the therapy,and evaluated the degree of satisfaction of both patients and doctors.Result:The average TSS after therapy decreased significantly compared with before therapy(P=0.001). The TSS of all these four symptoms (prickle,burning sensation,paresthesia and numbness)were improved significantly after therapy(P<0.05). The responder rates reached 70%. The satisfaction rates of doctors and patients were 100%and 92%respectively. And had no adverse effect in the study.Conclusion:Clinical use alpha-lipoic acid(ALA)with alprostadil to treat type 2 diabetes peripheral neuropathy is safe and effective,symptoms improved significantly,and no obvious side effects,can be popularized in clinical.