摘要
目的探讨依帕司他联合α-硫辛酸治疗老年糖尿病周围神经病变(DPN)的临床疗效及其对神经传导速度、氧化应激水平的影响。方法将123例老年DPN患者按随机数字表法分为2组:对照组61例给予α-硫辛酸治疗;观察组62例给予依帕司他联合α-硫辛酸治疗。比较2组患者的临床疗效及治疗前后神经功能、神经传导速度、氧化应激反应水平变化情况,观察2组治疗期间药物不良反应发生情况。结果观察组临床疗效明显优于对照组(Z=2.247,P=0.025)。观察组治疗后多伦多临床评分系统(TCSS)评分、神经病变自觉症状问卷(TSS)评分及丙二醛水平均显著低于对照组(P<0.05),正中神经与腓总神经的运动神经传导速度(MCV)、感觉神经传导速度(SCV)及超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平均显著高于对照组(P<0.05)。观察组不良反应发生率显著低于对照组(8.06%比21.32%,χ^(2)=4.320、P=0.038)。结论依帕司他联合α-硫辛酸可通过降低氧化应激反应,加快老年DPN患者的正中神经与腓总神经的神经传导,从而改善神经功能,提高治疗效果,且药物安全性较高。
Objective To investigate the effects of epalrestat combined with α-lipoic acid on diabetic peripheral neuropathy(DPN),nerve conduction velocity and oxidative stress in the elderly.Methods A total of 123 elderly patients with DPN were randomly treated with α-lipoic acid alone(control group,61 cases)or in combination with epalrestat(observation group,61 cases).Clinical efficacy,neurological function,nerve conduction velocity,oxidative stress response and adverse reactions were compared between the two groups.Results The clinical efficacy in the observation group was better than that in the control group(Z=2.247,P=0.025).Furthermore,compared with the control group,combined treatment with epalrestat andα-lipoic acid decreased the Toronto Clinical Scoring System(TCSS)score,Total Symptom Score(TSS)for neuropathic symptoms and malondialdehyde content,and increased the motor and sensory nerve conduction velocity of median nerve and common peroneal nerve and levels of superoxide dismutase and glutathione peroxidase(P<0.05).In addition,the incidence of adverse reactions in the observation group was lower than that in the control group(8.06%vs 21.32%,χ^(2)=4.320,P=0.038).Conclusion The combination of epalrestat andα-lipoic acid can effectively and safely improve nerve function in elderly DPN patients through reducing oxidative stress response and accelerating nerve conduction of median nerve and common peroneal nerve.
作者
李彬彬
王民
田勇
楚清锋
LI Bin-bin;WANG Min;TIAN Yong;CHU Qing-feng(Department of Endocrinology and Nephrology,Xun County People’s Hospital,Xun County 456250,China;Department of Neurology,Hebi People’s Hospital,Hebi 458030,China;Department of Endocrinology and Metabolism,Pingdingshan First People’s Hospital,Pingdingshan 467000,China)
出处
《实用临床医学（江西）》
CAS
2022年第2期16-19,共4页
Practical Clinical Medicine
