标题：甲钴胺联合α-硫辛酸治疗糖尿病周围神经病变效果观察

      作者：陈思睿，韩亚娟，蒋慧荣    广州医科大学附属市八医院内分泌科，广东 广州 510080

      卷次： 2021年32卷16期

      【摘要】 目的 观察甲钴胺联合α-硫辛酸治疗糖尿病周围神经病变的临床效果。方法 选择2018年6月至2020年3月广州医科大学附属市八医院内分泌科收治的138例糖尿病并周围神经病变患者为研究对象，根据随机数表法将患者分为对照组和观察组各69例。对照组患者给予甲钴胺治疗，观察组患者在对照组治疗基础上联合α-硫辛酸治疗，疗程均为28 d。比较两组患者的治疗效果、治疗前后的神经传导速度、生活质量[采用生活质量量表(QLQ-C30)评分]、自理能力[采用日常生活能力(ADL)量表评分]以及不良反应发生情况。结果 治疗后，观察组患者的治疗总有效率为95.65%，明显高于对照组的85.51%，差异有统计学意义(P<0.05)；观察组患者运动神经中的正中神经、腓总神经的传导速度分别为(52.41±5.12) m/s、(49.78±5.16) m/s，明显高于对照组的(50.39±4.78) m/s、(47.56±4.22) m/s，差异均有统计学意义(P<0.05)；观察组患者感觉神经中的正中神经、腓总神经及腓肠神经的传导速度分别为(48.33±5.14) m/s、(44.87±4.92) m/s、(48.11±5.40) m/s，明显高于对照组的(46.35±4.78) m/s、(43.15±3.49) m/s、(46.37±4.66) m/s，差异均有统计学意义(P<0.05)；观察组患者的躯体、认知、情绪、角色、社会功能及整体生活质量评分明显高于对照组，差异均有统计学意义(P<0.05)；观察组患者的穿衣、吃饭、上下楼梯、活动及洗澡评分明显高于对照组，差异均有统计学意义(P<0.05)；观察组患者的不良反应总发生率为13.04%，与对照组的8.70%比较差异无统计学意义(P>0.05)。结论 甲钴胺联合α-硫辛酸对糖尿病周围神经病变疗效显著，对改善患者生活质量及日常生活能力积极作用明确，且用药安全性好，临床应用价值高。
      【关键词】 甲钴胺；α-硫辛酸；糖尿病；周围神经病变；疗效；不良反应
      【中图分类号】 R587.2 【文献标识码】 A 【文章编号】 1003—6350（2021）16—2073—04

Application effect of mecobalamin combined with α-lipoic acid in patients with diabetic peripheral neuropathy.CHEN Si-rui, HAN Ya-juan, JIANG Hui-rong.
Department of Endocrinology, No.8 Hospital Affiliated to GuangzhouMedical University, Guangzhou 510080, Guangdong, CHINA
【Abstract】 Objective To investigate the therapeutic effect of mecobalamin combined with α-lipoic acid on di-abetic peripheral neuropathy. Methods From June 2018 to March 2020, 138 patients with diabetes mellitus and periph-eral neuropathy treated in Department of Endocrinology, No.8 Hospital Affiliated to Guangzhou Medical Universitywere selected and divided into control group and study group according to the random number table, with 69 patients ineach group. The control group was given mecobalamin, and the study group was given mecobalamin combined with α -lipoic acid. The course of treatment was 28 days. The efficacy, nerve conduction velocity, quality of life (QLQ-C30score), self-care ability (ADL score), and incidence of adverse reactions were compared. Results The effective rate ofthe study group was 95.65%, significantly higher than 85.51% of the control group (P<0.05). The conduction velocity ofmedian nerve and common peroneal nerve in the study group were (52.41±5.12) m/s, (49.78±5.16) m/s, significantlyhigher than (50.39±4.78) m/s, (47.56±4.22) m/s in the control group (P<0.05). The conduction velocity of median nerve,common peroneal nerve, and sural nerve in the study group were (48.33±5.14) m/s, (44.87±4.92) m/s, (48.11±5.40) m/s,respectively, significantly higher than (46.35±4.78) m/s, (43.15±3.49) m/s, (46.37±4.66) m/s in the control group (P<0.05). The scores of body, cognition, emotion, role, social function and overall quality of life in the study group were sig-nificantly higher than those in the control group (P<0.05). The scores of dressing, eating, going up and down stairs, activ-ities, and bathing in the study group were significantly higher than those in the control group (P<0.05). The total inci-dence of adverse reactions in the study group was 13.04%, which was not significantly different from 8.70% in the con-trol group (P>0.05). Conclusion The application of mecobalamin combined with α-lipoic acid in patients with diabet-ic peripheral neuropathy has significant curative effect, and has a positive effect on improving the quality of life and ac-tivities of daily living of patients, with good safety.
      【Key words】 Mecobalamin; α-lipoic acid; Diabetes; Peripheral neuropathy; Curative effect; Adverse reactions