α-硫辛酸联合依帕司他治疗糖尿病周围神经病变的疗效观察及对神经传导功能的影响
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蔡小彪
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雷州市人民医院，广东雷州，524200
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摘要：目的? 评估α-硫辛酸（α-LA}联合依帕司他治疗糖尿病患者并发周围神经病变（DPN）临床症状及神经电生理指标的改善效果。方法? 纳入2023年1月至2024年9月本院收治的94例DPN患者，采用随机数字表法分成2组。对照组（n=47）单用α-LA治疗；联合组（n=47）在α-LA基础上加用依帕司他。对比两组的临床总有效率、运动神经传导速度（MNCV）与感觉神经传导速度（SNCV）变化，并记录并发症。结果? 联合组显效率（46.82%）与总有效率（95.75%）都比对照组（38.29%，80.86%）明显增高，两组之间的差异具备统计学意义（P＜0.05，?χ2=5.0449）。治疗后联合组MNCV?[（45.17±3.75）m/s]?和?SNCV?[（45.05±3.51）m/s]?提升幅度显著优于对照组?[MNCV：（42.43±3.16）m/s；?SNCV：（42.32±3.22）m/s]（P＜0.05，?t值分别为3.8305，?3.9292）。两组间高血压、压疮、低血压等并发症发生率无显著差异（P＞0.05，?χ2=0.0000）。结论? α-硫辛酸与依帕司他联合用药方案能更有效地提升DPN患者的神经传导功能，显著改善临床疗效，且安全性良好，具有临床应用价值。
关健词：α-硫辛酸；依帕司他；糖尿病周围神经病变；治疗结局；神经电生理
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The inffuence of alpha-lipoic acid combined with epalustat on the clinical efffcacy and nerve conduction velocity of patients with diabetic peripheral neuropathy
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Xiaobiao Cai
Leizhou People’s Hospital, Leizhou Guangdong 524200，China
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Abstract：Objective To evaluate the efffcacy of combined alpha-lipoic acid (α-LA) and epalrestat therapy on clinical symptoms and nerve conduction parameters in diabetic peripheral neuropathy (DPN) patients.Methods 94 DPN patients admitted between January 2023 and September 2024,divided into two groups using the random number table method. The control group (n=47) received α-LA monotherapy. The combination group (n=47) received α-LA plus epalrestat. Clinical efficacy, motor nerve conduction velocity (MNCV), sensory nerve conduction velocity (SNCV), and complications were compared. Results The combination group demonstrated signiffcantly higher marked improvement rate (46.82%) and total effective rate (95.75%) compared to the control group (38.29%, 80.85%) (P<0.05, χ2=5.0449).Post-treatment MNCV [(45.17±3.75) m/s] and SNCV [(45.05±3.51) m/s] in the combination group were signiffcantly superior to the control group [MNCV: (42.43±3.16) m/ s; SNCV:(42.32±3.22) m/s] (P<0.05, t=3.8305,3.9292 respectively).No signiffcant difference was observed in the incidence of complications (hypertension, pressure sore, hypotension) between groups (P>0.05, χ2=0.0000).Conclusion The combination of alpha-lipoic acid and epalrestat signiffcantly enhances nerve conduction function and clinical outcomes in DPN patients with a favorable safety proffle, supporting its clinical application.
Keywords : Alpha-lipoic acid; Epalrestat; Diabetic peripheral neuropathy; Therapeutic outcome; Nerve conduction studies
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