Efficacy And Safety Of Alpha-lipoic Acid Combined With Intermittent Pneumatic Compression System On Aged Patients With Type2Diabetic Peripheral Neuropath

ObjectivesTo evaluate the efficacy and safety of alpha-lipoic acid(ALA) combined with intermittent pneumatic compression(IPC) system on the treatment of elderly patients with type2diabetic peripheral neuropath(DPN).Methods66type2diabetic elderly patients with DPN hospitalized in Hunan Province Mawangdui Hospital from January2012to January2013were randomized into2groups by the method of random digits table: combined therapy group(n=24), ALA therapy group(n=22) and IPC therapy group(n=20). The management fasting blood glucose (FBG), body mass index (BMI), HbA1c and supersensitive C reactive protein(CRP) were measured before the grouping. The combined therapy group was intravenously injected with alpha-lipoic acid600mg/d plus250ml normal saline once a day for3weeks and combined with IPC,45minutes at a time, twice a day for3weeks. The ALA therapy group was intravenously injected the same dose of alpha-lipoic acid plus250ml normal saline once a day for3weeks. The IPC therapy group was treated with IPC,45minutes at a time, twice a day for3weeks. The total symptom score (TSS) was evaluated among three groups before and after treatment. Motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity(SNCV) were also measured among three groups before and after treatment. Each group was evaluated about the efficacy and safety.Results1.23cases of the combined therapy group and21cases of the ALA therapy group were completed the study. All case of the IPC therapy group were completed the study.2.After treatment, the symptom scores of burning sensation, numbness, sting pain and cutting pain and TSS scores were significantly lower than before in each group(P<0.01).The drop difference of TSS scores in combined therapy group before and after treatment obviously higher than those of others(P<0.01). The drop difference of TSS scores in IPC therapy group before and after treatment obviously higher than those of ALA therapy group (P<0.01).3.The MNCV and SNCV in combined therapy group after treatment were significantly faster than before.In ALA therapy group, the MNCV of median nerve after treatment were faster visibly than before(P<0.01), the MNCV of common peroneal nerve and SNCV of superficial peroneal nerve after treatment were quicker remarkably than before(P<0.05), but there were no obvious differences in the SNCV of median nerve and SNCV of superficial peroneal nerve before and after treatment(P>0.05).In IPC therapy group, the MNCV and SNCV of median nerve after treatment were faster visibly than before(P<0.01), but there were no obvious differences in the MNCV of common peroneal nerve and before and after treatment(P>0.05).The increase rates of every nerve conduction velocity in combined therapy group before and after treatment were significantly higher than those of others (P<0.01).4. The efficacy was evaluated among three groups before and after treatment. The total of effective rate in combined therapy group was95.7%. however, the total of effective rate in ALA therapy group and IPC therapy group were71.4%and65.0%which were lower visibly than that of the combined therapy group(P<0.05).5.One patient of combined therapy group receiving treatment with alpha-lipoic acid flet headache after3days and quit the experiment without special treatment. No other symptom was found in these three groups.ConclusionCompared with the treatment of alpha-lipoic acid alone, combined treatment of alpha-lipoic acid and IPC on elderly type2diabetic patients with DPN is much more effective. It is less adverse reaction and safe proved for most of the aged patients.