Lee Y, Robinson M, Wong N, Chan E, Charles M A
Diabetes Research Program, University of California, Irvine 92717-4065, USA.
J Diabetes Complications. 1997 Sep-Oct;11(5):274-8. doi: 10.1016/s1056-8727(96)00077-3.
Diabetic peripheral neuropathy is a common, painful, and disabling condition that is known to occur by two mechanisms: hyperglycemia and arterial blood flow occlusion. Pentoxifylline (Trental) functions by improving erythrocyte flexibility in blood vessels, which could increase the delivery of oxygen to occluded nerve vessels. This 1-year clinical trial was aimed at ascertaining the effects of pentoxifylline on diabetic sensory neuropathy. Fifty patients with type I or II diabetes were evaluated in a randomized, double-blind, parallel group and placebo-controlled study. Pentoxifylline effectiveness was evaluated by measuring glycated hemoglobin, blood pressure and current perception threshold (CPT). The CPT results showed no statistically significant effect of pentoxifylline on mean nerve sensory perception thresholds in ankle and toe at 5, 250 and 2000 Hz. There were no significant changes in glycated hemoglobin or in systolic and diastolic blood pressure during the trial. Thus, glycated hemoglobin and blood pressure did not explain the lack of pentoxifylline effect on diabetic neuropathy. In conclusion, pentoxifylline appears not to add benefits to the clinical treatment of diabetic sensory neuropathy of the lower extremity.
糖尿病周围神经病变是一种常见、疼痛且致残的病症，已知其通过两种机制发生：高血糖和动脉血流阻塞。己酮可可碱（曲克芦丁）通过改善血管中红细胞的柔韧性发挥作用，这可能会增加向阻塞的神经血管输送氧气。这项为期1年的临床试验旨在确定己酮可可碱对糖尿病性感觉神经病变的影响。在一项随机、双盲、平行组和安慰剂对照研究中对50例I型或II型糖尿病患者进行了评估。通过测量糖化血红蛋白、血压和电流感觉阈值（CPT）来评估己酮可可碱的有效性。CPT结果显示，己酮可可碱在5、250和2000Hz时对踝部和脚趾的平均神经感觉阈值没有统计学上的显著影响。在试验期间，糖化血红蛋白以及收缩压和舒张压均无显著变化。因此，糖化血红蛋白和血压并不能解释己酮可可碱对糖尿病神经病变缺乏疗效的原因。总之，己酮可可碱似乎并未给下肢糖尿病性感觉神经病变的临床治疗带来益处。
