目的 探討硫辛酸注射液聯(lián)合甲鈷胺注射液治療2型糖尿病周圍神經(jīng)病變的臨床療效。方法 選取2018年1月-2019年12月太原市第二人民醫(yī)院收治的136例糖尿病周圍神經(jīng)病變患者，使用隨機(jī)數(shù)字表法將患者分為對照組和治療組，每組各68例。對照組患者靜脈滴注甲鈷胺注射液，1 000μg加入生理鹽水100 mL中，1次/d。治療組患者在對照組治療的基礎(chǔ)上靜脈滴注硫辛酸注射液，600 mg加入生理鹽水250 mL中，1次/d。兩組患者均持續(xù)治療2周。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者血清因子水平、神經(jīng)傳導(dǎo)速度和神經(jīng)病變主覺癥狀問卷（TSS）評分。結(jié)果 治療后，治療組總有效率為83.82%，對照組則僅為55.88%，治療組總有效率明顯高于對照組（P<0.05）。治療后，治療組血清糖基化終末產(chǎn)物（AGEs）水平明顯降低（P<0.05），對照組則無明顯變化。治療后，兩組患者血清丙二醛（MDA）、晚期氧化蛋白產(chǎn)物（AOPPs）水平均明顯下降，超氧化物歧化酶（SOD）水平明顯提高（P<0.05），且治療組患者各項(xiàng)氧化應(yīng)激指標(biāo)水平改善更明顯（P<0.05）。治療后，兩組患者正中神經(jīng)運(yùn)動神經(jīng)傳導(dǎo)速度（MNCV）、感覺神經(jīng)傳導(dǎo)速度（SNCV）和腓總神經(jīng)MNCV、SNCV均較治療前上升（P<0.05），且治療組神經(jīng)傳導(dǎo)速度改善更明顯（P<0.05）。治療后，兩組TSS評分均下降（P<0.05），且治療組TSS評分下降更明顯（P<0.05）。結(jié)論 硫辛酸注射液聯(lián)合甲鈷胺注射液治療2型糖尿病周圍神經(jīng)病變具有較好的臨床療效，能夠降低患者血清氧化應(yīng)激指標(biāo)水平和AGEs水平，減輕患者的臨床癥狀，具有更高的安全性。

Objective To investigate the efficacy of Thioctic Acid Injection combined with Mecobalamin Injection in treatment of type 2 diabetic peripheral neuropathy. Methods Patients (136 cases) with type 2 diabetic peripheral neuropathy in Taiyuan Second People's Hospital from January 2018 to December 2019 were randomly divided into control and treatment groups, and each group had 68 cases. Patients in the control group were iv administered with Mecobalamin Injection, 1 000 μg added into normal saline 100 mL, once daily. Patients in the treatment group were iv administered with Thioctic Acid Injection on the basis of the control group, 600 mg added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and serum factor level, nerve conduction velocity and TSS score in two groups were compared. Results After treatment, the total effective rate of the treatment group was 83.82%, while that of the control group was only 55.88%. The total effective rate of the treatment group was significantly higher than that of the control group (P<0.05). After treatment, the level of AGEs in the treatment group was decreased significantly (P<0.05), but the level of AGEs in the control group did not change significantly. After treatment, the levels of MDA and AOPPs in two groups were significantly decreased, but the level of SOD was significantly increased (P<0.05), and the levels of oxidative stress indexes in the treatment group were better than those in the control group (P<0.05). After treatment, the MNCV and SNCV of median nerve and the MNCV and SNCV of common peroneal nerve in two groups were increased (P<0.05), and nerve conduction velocity in treatment group was better than that in the control group (P<0.05). After treatment, the TSS score of two groups were decreased (P<0.05), and the TSS score of the treatment group was better than that in the control group (P<0.05). Conclusion Thioctic Acid Injection combined with Mecobalamin Injection has clinical curative effect in treatment of type 2 diabetic peripheral neuropathy, can reduce the serum levels of oxidative stress index and AGEs, relieve the clinical symptoms of patients, with good safety.

R971