西洛他唑聯合α-硫辛酸治療糖尿病周圍神經病變的療效觀察

周 立 曾 勇 楊 俐

[摘要]目的 評價α-硫辛酸聯合西洛他唑對2型糖尿病合并周圍神經病變的治療效果。方法 將80例糖尿病性周圍神經病變患者隨機分為2組,治療組給予α-硫辛酸600 mg、西洛他唑100mg治療3周,對照組每日給予西洛他唑100mg治療3周。治療前后分別進行神經病變癥狀TSS評分及神經傳導速度比較。結果 經過3周治療后,兩組患者的TSS評分及神經傳導速度明顯改善(P<0.05) ,無嚴重藥物不良反應。與對照組相比,治療組改善更明顯(P <0.05)。結論 α-硫辛酸聯合西洛他唑治療糖尿病合并周圍神經病變安全有效。

[關鍵詞] 糖尿病神經病變;硫辛酸;西洛他唑

[中圖分類號] R781.6+4[文獻標識碼] A[文章編號] 1004-8650(2009)06-010-02

The effect of thioctic acid andcilostazol on diabetic peripheral neuropathy

ZHOU Li ,ZEN Yong , YANG Li

(Department of neurology, The First Hospital of Neijiang, Sichuan 641000, China)

[Abstract] ObjectiveTo evaluate the effect of thioctic acid and cilostazol on diabetic peripheral neuropathy. MethodsEighty patients with diabetic peripheral neuropathy were randomly divided into three groups. The treatment group were treated with thioctic acid 600mg and cilostazol 100mg twice daily for three weeks. The control group were treated with cilostazol 100mg daily for three weeks. All patients were evaluated with TSS score and the peripheral nerve conduction velocity before and after the treatment. ResultsCompared with the control group, the treatment group had more significant improvement of TSS score and the peripheral nerve conduction velocity after the treatment for three weeks( P<0.05).No patients had severe drug adverse effect. ConclusionTreatment of thioctic acid and cilostazol on patients with diabetic peripheral neuropathy is safe and effective.

[Key words] Diabetic neuropathies;Thioctic acid;cilostazol

糖尿病性周圍神經病變( diabetic peripheral neuropathy, DPN)是糖尿病常見的慢性并發癥之一, DPN也是糖尿病致殘的重要原因,但該并發癥在臨床治療中非常棘手。目前DPN的治療包括應用醛糖還原酶抑制劑阻斷多元醇通路、用氨基胍抑制非酶糖化、用神經生長因子促進神經組織再生等,但往往因作用有限、副作用大而難以在臨床上推廣應用。我們對2型糖尿病合并周圍神經病變患者采用α-硫辛酸聯合西洛他唑聯合治療,效果較好,現報告如下。

1資料與方法

1.1一般資料

選擇2004-2007年我院神經科住院2型糖尿病合并神經病變患者80例(WHO1999年糖尿病診斷分型標準),同時伴有四肢感覺異常:刀割樣痛、燒灼感、麻木及針刺樣疼痛,并排除其他疾病所致的周圍神經病變。將患者隨機分為兩組,其中治療組40例:男19例,女21例,年齡40-70(52.3±7.4)歲,病程5-20(中位數9.4)年,體重指數(BMI)23-29(25.2±3.2),糖化血紅蛋白6.4-13.2(8.3±2.2);對照組30例:男17例,女23例,年齡38-70(53.4±8.2)歲, 病程6-21(中位數10.1)年,體重指數(BMI)22-30(25.3±4.0),糖化血紅蛋白6.5-12.0(7.9±1.3)。上述指標兩組差異無統計學意義(P >0.05)。

1.2方法

所……