目的 观察α-硫辛酸联合甲钴胺治疗2型糖尿病患者糖尿病周围神经病变(DPN)的疗效.方法 符合入选条件的DPN患者68例,随机分为观察组与对照组,每组各34例.观察组给予α-硫辛酸600 mg/d静脉滴注及甲钴胺500μg/d静脉滴注,对照组给予甲钴胺500μg/d静脉滴注,共治疗3周.在治疗前、治疗后分别进行神经病变主觉症状问卷(TSS)评分及神经传导速度测定并观察有无药物不良反应.结果 组内比较:与治疗前相比,两组患者治疗后TSS评分均有下降(P＜0.01),神经传导速度均有加快(P＜0.01);组间比较:治疗后观察组患者TSS评分下降比对照组显著,两组比较差异有统计学意义(P＜0.05),治疗后两组患者神经传导速度比较差异无统计学意义(P＞0.05).两组均未见严重药物不良反应.结论 α-硫辛酸与甲钴胺联合治疗能有效且安全地治疗2型糖尿病患者DPN,联合治疗对DPN阳性症状的改善作用优于甲钴胺单药治疗.%Objective To observe the efficacy of α-lipoic acid in combination with mecobalamin for diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus.Methods 68 patients with DPN were randomly divided into observation group and control group with each group of 34 cases.The observation group received α-lipoic acid 600 mg/d and mecobalamin 500 μ g/d by intravenous drip for 3 weeks,and the control group received mecobalamin 500 μ g/d by intravenous drip for 3 weeks.Before treatment and after treatment,their total symptoms score (TSS) and nerve conductive velocity were measured and compared,and the side effects of drugs were observed.Results Compared with that before treatment,the TSS was decreased and nerve conductive velocity was accelerated significantly after 3 weeks of treatment in both groups (all P ＜ 0.01).Compared with the control group,the TSS decrease of the observation group was more obvious after treatment and the difference was significant in statistics (P ＜ 0.05).There was no significant difference in nerve conductive velocity between the two groups after the treatment (P ＞ 0.05).The serious side effects were not found in both groups.Conclusion α-lipoic acid in combination with mecobalamin is effective and safe in the treatment of DPN in patients with type 2 diabetes mellitus.The combined therapy of α-lipoic acid and mecobalamin is better than single mecobalamin for the improvement of DPN symptoms.
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