α-硫辛酸对2型糖尿病周围神经病变的疗效：一项临床研究

[Curative effect of alpha-lipoic acid on peripheral neuropathy in type 2 diabetes: a clinical study].

作者信息

Liu Fang, Zhang Yang, Yang Ming, Liu Bo, Shen Ying-di, Jia Wei-Ping, Xiang Kun-San

机构信息

Department of Endocrinology & Metabolism, Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai Clinical Center of Diabetes, Shanghai Institute for Diabetes, Shanghai 200233, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2007 Oct 16;87(38):2706-9.

PMID:18167250

Abstract

OBJECTIVE

To evaluate the effect of alpha-lipoic acid (ALA) on diabetic peripheral neuropathy (DPN).

METHODS

95 type 2 diabetic patients complicated with DPN were randomly divided into 2 groups: treatment group (n = 52), receiving ALA 600 mg/d in normal saline 250 ml given by intravenous drip infusion once a day for 14 days; and control group (n = 43), administered with radix salviae 20 ml by intravenous drip infusion once a day for 14 days. Before and 7 and 14 days after the management fasting glucose (FPG), fasting insulin (FINS), supersensitive C reactive protein (sCRP), and HbA1c were measured, and total symptom score (TSS) and Michigan neuropathy screening instrument (MNSI) were used to evaluate the nervous symptoms.

RESULTS

50 cases of the treatment group and 43 control cases completed the study. Compared with the control group, the TSS of the treatment group reduced significantly after 1 week, but the MNSI score did not change significantly. The TSS 7d after ALA administration of the treatment group was significantly lower than that before the ALA treatment in the same group and that of the control group 7 days after the radix salviae infusion as well (both P < 0.05). The TSS and MNSI score 14 days after the management of the treatment group were significantly lower than those of the control group (both P < 0.01). The symptom scores of numbness, sting sensation, and burning sensation reduced significantly 2-weeks after ALA treatment, but there were no significant differences in these symptoms after the management in the control group. The total gratification rate of the treatment group was 90% (45/50), significantly higher than hat of the control group (13.95%, 6/43, P < 0.01). One patient of the 50 patients receiving ALA treatment felt chest distress 2 days after ALA administration, but the symptom was improved in the same day after the velocity of intravenous drip was slowed down, and no other adverse effects were found in these two groups.

CONCLUSION

ALA effectively improves the sensitive symptoms of DPN patients and is safe for most of the patients.

摘要

目的

评估α-硫辛酸（ALA）对糖尿病周围神经病变（DPN）的疗效。

方法

95例2型糖尿病合并DPN患者随机分为两组：治疗组（n = 52），给予ALA 600mg/d加入250ml生理盐水中静脉滴注，每日1次，共14天；对照组（n = 43），给予丹参20ml静脉滴注，每日1次，共14天。治疗前及治疗后7天和14天测量空腹血糖（FPG）、空腹胰岛素（FINS）、超敏C反应蛋白（sCRP）和糖化血红蛋白（HbA1c），并采用总症状评分（TSS）和密歇根神经病变筛查量表（MNSI）评估神经症状。

结果

治疗组50例、对照组43例完成研究。与对照组相比，治疗组1周后TSS显著降低，但MNSI评分无明显变化。治疗组ALA给药7天后的TSS显著低于同组ALA治疗前及对照组丹参滴注7天后的TSS（均P < 0.05）。治疗组治疗14天后的TSS和MNSI评分显著低于对照组（均P < 0.01）。ALA治疗2周后麻木、刺痛和烧灼感症状评分显著降低，但对照组治疗后这些症状无明显差异。治疗组总满意度为90%（45/50），显著高于对照组（13.95%，6/43，P < 0.01）。50例接受ALA治疗的患者中有1例在ALA给药2天后出现胸闷，减慢静脉滴注速度后当日症状改善，两组均未发现其他不良反应。