【摘要】：目的:考察依帕司他聯(lián)合硫辛酸對(duì)糖尿病周圍神經(jīng)病變(DPN)患者神經(jīng)功能、氧化應(yīng)激及炎癥反應(yīng)等的影響。方法:選取2013年1月-2016年1月我院收治的150例DPN患者,按隨機(jī)數(shù)字表法分為A、B、C組,各50例。A組患者給予硫辛酸注射液600 mg,ivgtt,qd;B組患者給予依帕司他片50 mg,po,tid;C組患者給予硫辛酸+依帕司他聯(lián)合治療,用法用量同上。比較3組患者治療前后的總癥狀評(píng)分系統(tǒng)(TSS)評(píng)分、運(yùn)動(dòng)神經(jīng)傳導(dǎo)速度(MNCV)、感覺神經(jīng)傳導(dǎo)速度(SNCV)、氧化應(yīng)激指標(biāo)[血清超氧化物歧化酶(SOD)和丙二醛(MDA)]、炎癥指標(biāo)[腫瘤壞死因子α(TNF-α)和白細(xì)胞介素6(IL-6)],以及血壓、血脂和血糖指標(biāo),并觀察不良反應(yīng)發(fā)生情況。結(jié)果:治療前,3組患者的上述各項(xiàng)觀察指標(biāo)比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。與治療前比較,3組患者治療后的TSS評(píng)分和MDA、TNF-α、IL-6水平明顯降低,MNCV和SNCV明顯加快,SOD水平明顯升高;且C組的各項(xiàng)指標(biāo)優(yōu)于A、B組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),但A、B組間的差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3組患者治療后的收縮壓、空腹血糖較治療前明顯降低,高密度脂蛋白膽固醇明顯升高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),但各組間比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3組患者均未見明顯的不良反應(yīng)發(fā)生。結(jié)論:依帕司他和硫辛酸通過抑制氧化應(yīng)激及炎癥反應(yīng)可以有效改善DPN患者的神經(jīng)功能,且安全性較高;聯(lián)合用藥的效果優(yōu)于單獨(dú)用藥。
[Abstract]:Aim: to investigate the effects of epalrestat combined with lipoic acid on nerve function, oxidative stress and inflammatory response in patients with diabetic peripheral neuropathy (DPN). Methods: 150 patients with DPN from January 2013 to January 2016 were randomly divided into two groups: group A (n = 50) and group A (n = 50). Group A received lipoic acid injection for 600 mg,ivgtt,qd;. The patients in group B were given epalrestat 50 mg,po,tid;C with the same dosage. The total symptom scoring system (TSS), motor nerve conduction velocity (MNCV), sensory nerve conduction velocity (SNCV),) oxidative stress index [serum superoxide dismutase (SOD) and malondialdehyde (MDA)] were compared between the three groups before and after treatment. Inflammatory markers (tumor necrosis factor 偽 (TNF- 偽) and interleukin 6 (IL-6), blood pressure, blood lipid and blood glucose were also measured. Results: before treatment, there was no significant difference in the above indexes between the three groups (P0.05). Compared with before treatment, the TSS scores and MDA,TNF- 偽, IL-6 levels in the three groups were significantly decreased, MNCV and SNCV were significantly accelerated, and SOD levels were significantly increased after treatment. The indexes of group C were better than that of group A (P0.05), but there was no significant difference between group A and B (P0.05). The systolic blood pressure and fasting blood glucose in group C were significantly lower than those before treatment. High density lipoprotein cholesterol (HDL-C) increased significantly (P0.05), but there was no significant difference between the three groups (P0.05). Conclusion: epalrestat and lipoic acid can effectively improve the neurological function of patients with DPN by inhibiting oxidative stress and inflammatory reaction, and the efficacy of combined therapy is better than that of single drug.
【作者單位】： 哈勵(lì)遜國(guó)際和平醫(yī)院內(nèi)分泌科;
【基金】：衡水市科技計(jì)劃項(xiàng)目(No.15024)
【分類號(hào)】：R587.2

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