依帕司他、前列地尔联合a—硫辛酸治疗糖尿病周围神经病变临床观察依帕司他、前列地尔联合a—硫辛酸治疗糖尿病周围神经病变临床观察doi：10.3969/j.issn.1007-614x.2014.16.11摘要目的：观察依帕司他、前列地尔联合a-硫辛酸治疗糖尿病周围神经病变的疗效及安全性。方法：收治糖尿病周围神经病变患者120例，随机分为对照组和治疗组，各60例。对照组静滴前列地尔10ug,1次/日，口服依帕司他50mg,3次/日;治疗组在对照组基础上增加静滴Q-硫辛酸600mg,1次/日。两组均3周1疗程，观察治疗前后患者的临床症状及肌电图改善情况。结杲：治疗组、对照组总有效率分别为93.3%、68.3%,两者差异有统计学意义（P〈0・01）。两组治疗后正中神经和腓总神经的运动神经传导速度（MCV）和感觉神经传导速度（SCV）较治疗前均有明显改善（P<0.05）,治疗组较对照组改善更明显（P〈0.01）。两组均未见明显的不良反应。结论：依帕司他、前列地尔联合a-硫辛酸治疗糖尿病周围神经病变疗效优于依帕司他联合前列地尔，并且无明显不良反应。关键词糖尿病周围神经病变联合疗法疗效Clinicalobservationofepalrestat,al-prostadilcombinedwithalphalipoicacidinthetreatmentofdia-beticperipheralneuropathyFengCuiel,ShiZhendong2,ZhangJian-wei2DepartmentofEndocrinology,TiefaCoalIndustryGroupGeneralHospitalAffiliatedtoShenyangMedicalCollege,TielingCity,Liaoning1127001VIPWard2AbstractObjective：Toexploretheefficacyandsafetyofepalrestat,al-prostadilcombinedwithalphalipoicacidinthetreatmentofdia-beticperipheralneuropathy.Methods：120caseswithdiabeticpe-ripheralneuropathywereselected.Theywererandomlydividedintothecontrolgroupandthetreatmentgroupwith60casesineach.Thecontrolgroupweretreatedwithalprostadil10ngforintra-venousdrip,1time/day,epalrestat50mgorally,3times/day.Thetreatmentgroupaddedalphalipoicacid600mgforintravenousdrip,1time/day.Inthetwogroups,1courseoftreatmentwas3weeks・Weobservedtheclinicalsymptomsbeforeandaftertreat-mentandEMGinpatientswithimprovement.Results：Thetotalef-ficiencyofthetreatmentgroupandthecontrolgroupwere93.3%and68.3%respectively.Thedifferencewasstatisticallysignifi-cant(P<0.01).Aftertreatment,themotornerveconductionvelocity(MCV)andsensorynerveconductionvelocity(SCV)ofthemediannerveandcommonperonealnerveofthetwogroupswereimprovedsignificantly(P<0.05)・Comparedwiththecontrolgroup,thetreatmentgroupwasimprovedmoreobviously(P<0.01).Therewerenoobviousadversereactionsintwogroups.Conclusion：Curativeeffectofepalrestat,alprostadilcombinedwithalphalipoicacidinthetreatmentofdiabeticperipheralneuropathyisbetterthanthatofepalrestatcombinedwithal-prostadil,andthereisnoobviousadversereaction.KeywordsDiabeticperipheralneuropathy；Combinationtherapy；Curativeeffect糖尿病周围神经病变(Diabeticperineuropathy,DPN)发病率可达60%〜90%[l],是糖尿病最常见的慢性并发症和主要致残因素之一，可见DN的早期诊断和合理治疗意义重大。本研究观察依帕司他、前列地尔联合a-硫辛酸治疗120例DPN患者的临床疗效，现报告如下。资料与方法2012年2月-2013年2月收治糖尿病患者120例，诊断均符合WHO糖尿病诊断标准及糖尿病神经病变诊断标准[2],其中男68例，女52例，平均年龄(58.5±12.3)岁；平均病程(14・3±7.2)年，随机分为治疗组和对照组各60例。两组患者年龄、性别构成、体质量指数及每H摄取热量比较差异无统计学意义(P>0.05),具有可比性。<!―endprint--><!--startprint—>治疗方法：两组均在控制饮食的基础上，应用丨I服降糖药或胰岛素皮下注射控制血糖，对照组患者静滴前列地尔10ug,1次/日，口服依帕司他50mg,3次/山治疗组在对照组基础上增加静滴Q-硫辛酸600mg,1次/H,两组均3周1疗程，观察治疗前后患者的临床症状及肌电图改善情况。观察指标：所有患者在治疗前后进行腱反射、膝反射检...