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目的观察硫辛酸联合地塞米松治疗中枢神经系统脱髓鞘疾病的临床疗效。方法选取2013年1月—2016年9月广东省肇庆市高要区人民医院收治的中枢神经系统脱髓鞘疾病患者102例,根据治疗方案分为对照组和观察组,每组51例。对照组患者给予硫辛酸治疗,观察组患者给予硫辛酸联合地塞米松治疗;两组患者均连续治疗2个月。比较两组患者临床疗效及治疗前后扩展残疾状况量表(EDSS)评分、氧化应激反应指标[丙二醇(MDA)、超氧化物歧化酶(SOD)]、血清炎性因子[肿瘤坏死因子α(TNF-α)、白介素6(IL-6)]水平、生活质量评分,观察两组患者不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者EDSS评分比较,差异无统计学意义(P>0.05);治疗后观察组患者EDSS评分低于对照组(P<0.05);治疗后两组患者EDSS评分低于治疗前(P<0.05)。治疗前两组患者血清MDA、SOD、TNF-α、IL-6水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清MDA、TNF-α、IL-6水平低于对照组,血清SOD水平高于对照组(P<0.05);治疗后两组患者血清MDA、TNF-α、IL-6水平低于治疗前,血清SOD水平高于治疗前(P<0.05)。治疗前两组患者躯体功能、心理功能、社会功能、物质生活状态评分比较,差异无统计学意义(P>0.05);治疗后观察组患者躯体功能、心理功能、社会功能、物质生活状态评分高于对照组(P<0.05);治疗后两组患者躯体功能、心理功能、社会功能、物质生活状态评分高于治疗前(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论硫辛酸联合地塞米松治疗中枢神经系统脱髓鞘疾病的临床疗效确切,可有效减轻氧化应激反应及炎性反应,促进神经功能恢复,有助于改善患者生活质量且安全性较高。
Objective To observe the clinical efficacy of lipoic acid combined with dexamethasone in the treatment of central nervous system demyelinating diseases. Methods From January 2013 to September 2016, 102 patients with demyelinating diseases of the central nervous system admitted to Gaoyao District People’s Hospital of Zhaoqing City, Guangdong Province were divided into control group and observation group according to the treatment plan, with 51 cases in each group. Patients in the control group were treated with lipoic acid, and patients in the observation group were treated with lipoic acid combined with dexamethasone. Patients in both groups were treated continuously for 2 months. The clinical efficacy, EDSS score, oxidative stress index (MDA, SOD), serum inflammatory factor [tumor necrosis factor alpha TNF-α) and interleukin-6 (IL-6) levels, quality of life scores were observed in two groups of patients with adverse reactions. Results The clinical efficacy of the observation group was better than that of the control group (P <0.05). There was no significant difference in EDSS score between the two groups before treatment (P> 0.05). After treatment, the EDSS score of the observation group was lower than that of the control group (P <0.05) <0.05). The levels of serum MDA, SOD, TNF-α and IL-6 in the two groups before treatment were not significantly different (P> 0.05). The levels of serum MDA, TNF-α and IL-6 in the observation group were lower than those in the control group (P <0.05). Serum levels of MDA, TNF-α and IL-6 in the two groups were lower than those before treatment, and serum SOD level was higher than before treatment (P <0.05). There was no significant difference in body function, mental function, social function and physical status score between the two groups before treatment (P> 0.05). After treatment, the body function, mental function, social function and physical living status of the observation group were high (P <0.05). After treatment, the scores of physical function, psychological function, social function and physical status in two groups were higher than those before treatment (P <0.05). Two groups of patients with adverse reactions, the difference was not statistically significant (P> 0.05). Conclusions The combination of lipoic acid and dexamethasone is effective in demyelinating diseases of the central nervous system, which can effectively reduce the oxidative stress reaction and inflammatory reaction, promote the recovery of nerve function, and improve the quality of life of patients with high safety.