Methylcobalamin And Efficacy Of Lipoic Acid Combination Therapy In Type2Diabetes Patients With Diabetic Peripheral Neuropathy

Objective:Diabetic neuropathy(diabetic neuropathy, DN) is one of the most commonchronic complications of diabetes, the disease can be accumulated central and peripheralnerves, of which the latter is the most common, distal symmetry multiple neuropathy isdiabetic peripheral neuropathy (diabetic peripheral neuropathy, DPN), one of the mostcommon type is given priority to with feeling obstacle, with varying degrees ofautonomic nerve symptoms, usually characterized by pain, chills, pins and needles,swelling and a burning sensation. Because of the different diagnostic criteria and testmethods, the prevalence of10%~10%. In the United States, the course of the disease in15~20years of clinical symptoms of patients with diabetes peripheral neuropathyprevalence is estimated at30%~50%. In DPN is one of the reasons for the differences inprevalence of diagnostic criteria is different, and most of the detection method for nerveconduction velocity. Therefore, actively explore and looking for better treatment isparticularly important, this topic is to explore a joint lipoic acid cobalt amine treatingDPN curative effect, to further explore the possible mechanism of diabetic neuropathydevelopment, for the clinical diagnosis and prognosis judgement and treatment ofdiabetes provide new targets.Methods:1.(The World Health Organization, WHO) diagnostic criteria for diabetes,60patientswith the diagnosis of diabetic neuropathy, diabetic peripheral neuropathy symptoms1~2years or more, and ask the selected patients in stable condition, good blood sugar control, and there is no primary serious diseases such as liver and kidney hematopoietic system,nervous system diseases, no ketoacidosis, infections, nearly six months without acutecardiocerebrovascular events; No abnormal tumor, organ transplantation and we wait fora disease.2.Using the random number table method,60cases were randomly divided into twogroups, namely the control group (group a cobalt amine) and experimental group (groupa joint lipoic acid cobalt amine), of which the control group30cases,13cases of male,female17cases, aged60to79years old, average age (67.1+8.2); Treatment group30cases,16cases of male, female14cases, aged62to77years old, with an average age of(66.7+7.8). Two groups of patients in gender, occupation, age, course, glycosylatedhemoglobin, body mass index and complications were no statistical difference (P>0.05),comparable.3.Two groups of patients were given oral hypoglycemic drugs or insulin hypoglycemic,have high Blood pressure, high cholesterol, given antihypertension lipid-loweringtherapy, fasting Blood sugar control,2h Postprandial Blood Glucose (2h PostprandialBlood Glucose, PBG), glycosylated hemoglobin (HbAlc), control of Blood pressure andBlood fat, Blood pressure stable at about130/80MMHG. The control group (n=30)using a cobalt amine injection eisai co.(Japan)500ug in0.9%sodium chloride injection250ml, intravenous drip, daily1time,2weeks. Treatment group (n=30) in the controlgroup on the basis of the same drug use of alpha lipoic acid injection (yantai only chu)450mg in0.9%sodium chloride injection,250ml, intravenous drip, daily1time,2weeks. To evaluate clinical curative effect in two groups of patients before and aftertreatment, at the same time check the Nerve conduction velocity (Nerve conductionvelocity, NCV) and rating scale. Treatment process, giving education, moderate exercise,diabetes diet, hypoglycemic, step-down, lipid-lowering drugs during the same. Treatment,patients were given to improve the circulation of routine before and after treatment asblood, urine, liver and kidney function examination such as electrolytes and bloodcoagulation series. 4. The clinical curative effect judgment standard:4.1Rating scale: use of Michigan neuropathy screening scale (Michigan neuropathyscreening instrument, MNSI) and Michigan diabetic neuropathy rating scale (Michigandiabetic neuropathy score, MDNS) signs and symptoms of the patients with evaluation.4.2Nerve electrophysiology: determination of advantage of lateral movement branch ofmedian nerve and tibial nerve nerve conduction velocity (MNCV), median nerve feelingand the feeling of sural nerve conduction velocity (SNCV), and the shortest incubationperiod of F wave.:consciously symptoms improved significantly or disappeared (MNSIscore difference before and after treatment in the above three points, including3points),tendon reflex as significantly improved or returned to normal; Effective: self-conscioussymptom improvement (MNSI score difference before and after treatment in the twopoints above, including two points, three points below), tendon reflex improved; Invalid:self-conscious symptom without improvement (MNSI score difference before and aftertreatment in the following2points, not including2points), tendon reflex noimprovement.Results:Two groups of patients before treatment generally contrast has no statisticalsignificance (P>0.05), there is a good comparability. After two weeks, two groups ofpatients with significant efficiency, effective, total effective rate were significantlyimproved, have significant difference (P <0.05),2weeks later, the experimental groupthan control group in terms of efficiency, effective, total effective rate were significantlyincreased (P <0.05), the difference was statistically significant.Conclusion: A joint lipoic acid cobalt amine treatment of diabetic peripheral neuropathyeffect is remarkable.