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目的观察α-硫辛酸(ALA)联合甲钴胺治疗糖尿病周围神经病变的临床疗效。方法选取我院有周围神经症状的2型糖尿病患者共171例,测定入院时的身高、体重、空腹血糖、餐后血糖、糖化血红蛋白后,随机分为3组:0组(n=75),ALA600mg与甲钴胺1.0mg加入生理盐水250ml静滴;1组(n=75)ALA600mg加入生理盐水250ml静滴;2组(n=21),单纯降糖治疗。0组和1组均连续用药2周,每日1次。观察治疗前后症状的改善及记录FBG、PBG、TSS评分的变化,同时评价疗效的满意度。结果①治疗2周后,0组麻木、烧灼感等症状改善最明显,1组有所改善,2组无明显改善。②各组治疗前后TSS评分:0组和1组治疗后的TSS评分较治疗前降低(P<0.05),2组未见明显降低(P>0.05)。③各组间TSS评分变化比较:三组间的TSS变化比较,均具有统计学差异(P<0.05)。④满意度评价:医生和患者对0组的疗效,满意度明显高于1组和2组,0组患者总体满意度为88%,而1组仅32%,2组认为疗效不满意。结论α-硫辛酸联合甲钴胺静滴治疗糖尿病周围神经病变,2周内可见明显改善,疗效优于单独应用α-硫辛酸,单纯降糖无改善。
Objective To observe the clinical efficacy of α-lipoic acid (ALA) combined with mecobalamin in the treatment of diabetic peripheral neuropathy. Methods A total of 171 type 2 diabetic patients with peripheral neurological symptoms in our hospital were enrolled in this study. Height, weight, fasting blood glucose, postprandial blood glucose and glycosylated hemoglobin at admission were measured and randomly divided into 3 groups: group 0 (n = 75) ALA600mg and methylcobalamin 1.0mg added saline 250ml intravenous drip; 1 group (n = 75) ALA600mg added saline 250ml intravenous drip; 2 groups (n = 21), simple hypoglycemic therapy. Group 0 and group 1 were treated continuously for 2 weeks, once daily. Observed before and after treatment to improve the symptoms and record FBG, PBG, TSS score changes, while evaluating the efficacy of satisfaction. Results ① After 2 weeks of treatment, the symptoms such as numbness and burning sensation in group 0 were most obviously improved, while group 1 improved with no significant improvement in group 2. ② The TSS score of each group before and after treatment: The TSS scores of the 0 and 1 groups were lower than those before treatment (P <0.05), but no significant difference was found between the two groups (P> 0.05). ③Comparison of TSS scores between groups: The TSS changes between the three groups were statistically significant (P <0.05). ④ Satisfaction evaluation: The doctors and patients were significantly more satisfied with the efficacy and satisfaction of group 0 than those of group 1 and group 2. The overall satisfaction of group 0 was 88%, while that of group 1 was only 32%. The two groups were not satisfied with the efficacy. Conclusion Intravenous alpha-lipoic acid combined with mecobalamin treatment of diabetic peripheral neuropathy, visible improvement within 2 weeks, the effect is better than the single application of a-lipoic acid, no improvement in simple hypoglycemic.