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目的研究硫辛酸注射液联合小牛血清去蛋白注射液治疗II型糖尿病周围神经病变(DPN)的疗效。方法收集延安大学咸阳医院门诊及住院DPN患者90例,随机分成两组,对照组与治疗组各45例,两组均积极控制血糖、血脂、血压,在此基础上治疗组给予硫辛酸600 mg加入生理盐水250 m L静脉滴注,1次/d,以及小牛血清去蛋白注射液20 m L加入生理盐水250 m L静脉续点,1次/d。对照组单纯给予硫辛酸600 mg加入生理盐水250 m L静脉滴注,1次/d,两组均连续治疗4周。测定患者治疗前后的正中神经、尺神经、胫神经、腓总神经的运动神经传导速度(MCV)和感觉神经传导速度(SCV);测定两组治疗前后尿微量白蛋白、超敏C反应蛋白含量变化;分别对患者四肢的烧灼感、刀割样刺痛、刺痛、麻木4个阳性的感觉神经系统症状的严重程度(无、轻、中、重)及频率(偶尔、经常、持续)进行评分;分别在治疗前后做肝肾功能检查,记录腱反射、深浅感觉治疗前后变化情况。结果治疗后两组患者神经传导速度比治疗前均有所提高,差异有统计学意义(P<0.05),且治疗组比对照组提高更明显,组间差异具有统计学意义(P<0.05);治疗后两组自觉症状评分均有改善,差异有统计学意义(P<0.05、0.01),治疗组比对照组改善更明显,组间差异具有统计学意义(P<0.01);治疗后两组C反应蛋白及尿微量白蛋白均有一定程度的下降,与治疗前比较差异具有统计学意义(P<0.05);与对照组治疗后比较,治疗组下降更显著,组间差异有统计学意义(P<0.05);治疗组总有效率为93.3%,明显高于对照组总有效率68.9%,组间差异有统计学意义(P<0.05)。结论硫辛酸注射液联合小牛血清去蛋白治疗DPN疗效显著,能改善神经传导速度,减轻自觉症状,值得进一步的推广应用。
Objective To study the efficacy of lipoic acid injection plus bovine serum albumin in the treatment of type 2 diabetic peripheral neuropathy (DPN). Methods 90 outpatients and inpatients with DPN in Xianyang Hospital of Yan’an University were enrolled in this study. They were randomly divided into two groups, 45 cases in control group and 45 cases in treatment group. Both groups were active in controlling blood sugar, blood lipid and blood pressure. On the basis of this, Add normal saline 250 m L intravenous infusion, once / d, and bovine serum deproteinized injection 20 m L added saline 250 m L intravenous point, 1 / d. The control group was given only 600 mg of lipoic acid by intravenous infusion of 250 m L normal saline once a day for 4 weeks. The motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) of the median nerve, ulnar nerve, tibial nerve and common peroneal nerve before and after treatment were measured. Before and after treatment, urinary albumin and high-sensitivity C-reactive protein (No, mild, moderate, severe) and frequency (occasional, regular, continuous) of the four positive sensory nervous system symptoms of the patient, such as sensation of the burning sensation of the limbs, stabbing pain, stabbing and numbness Score; liver and kidney function tests were done before and after treatment, recording tendon reflexes, shades feel changes before and after treatment. Results After the treatment, the nerve conduction velocity in both groups was higher than that before treatment, the difference was statistically significant (P <0.05), and the treatment group than the control group increased more significantly, the difference between the groups was statistically significant (P <0.05) (P0.05,0.01). The improvement of the treatment group was more obvious than that of the control group, and the difference between the two groups was statistically significant (P0.01). After treatment, the scores of two groups were significantly improved The levels of C-reactive protein and urinary microalbumin decreased to a certain degree compared with those before treatment (P <0.05). Compared with the control group, the treatment group decreased more significantly, with statistical difference between the two groups (P <0.05). The total effective rate in the treatment group was 93.3%, which was significantly higher than that in the control group (68.9%). The difference between the two groups was statistically significant (P <0.05). Conclusions Lipoic acid injection combined with bovine serum albumin treatment of DPN has significant curative effect, which can improve the nerve conduction velocity and relieve the symptoms, which deserves further popularization and application.