ABSTRACT
Objective To investigate the curative effect and mechanism of α lipoic acid combined with epalrestat and methylcobalamin in patients with type 2 diabetes mellitus (T2DM) complicated with pe-ripheral neuropathy ( DPN) . Methods A total of 160 cases of patients with DPN were randomly divided into the control group ( treated with methylcobalamin and epalrestat) and the observation group ( treated with methylcobalamin, epalrestat and α lipoic acid) , and all patients were treated for 4 weeks. The therapeutic effect, nerve conduction velocity, oxidative stress index and related proteins expression in serum were ob-served in two groups. Results The effective rate of treatment in the observation group was higher than that in the control group (87. 50％ vs 75. 0％) (χ2 = 4. 103,P<0. 05). After treatment, the sensory nerve conduction velocity ( SNCV) and motor nerve conduction velocity ( MNCV) of median nerve and common peroneal nerve were significantly better in the observation group than the control group ( P<0. 05 ) . After treatment, the level of superoxide dismutase ( SOD) was significantly higher in the observation group than the control group, while the level of malondialdehyde ( MDA ) was significantly lower the control group (P<0. 05). After treatment, the level of Bcl-2 protein was significantly higher in observation group than the control group, while the levels of Bax and Caspase-3 proteins were significantly lower than the control group (P<0. 05). Conclusions The application ofαlipoic acid combined to epalrestat and methylcobal-amin in the treatment of DPN can significantly improve the sensory and motor nerve conduction.
ABSTRACT
Objective To study the effect of mecobalamine treatment on acute cerebral infarction combined with high homocysteine (Hcy) and post-stroke depression.Methods A total of 160 cerebral infarction patients with high Hcy were collected from January 2010 to December 2011 in our hospital.Patients were randomly divided into two groups:the control group (n=80,with routine therapy) and the treatment group (n=80,with routine therapy plus intramuscular injection with folic acid 500μg for 8 weeks).The plasma concentration of Hcy was determined by fluoresene polarization immunoassay.The improvement of depression,anxiety and life skills in patients were assessed by selfmade questionnaires and self-reporting inventory (SLC 90).Results There were no significant differences in plasma Hcy level in control group before versus after treatment [(21.86±4.76) μmol/L vs.(18.67±3.81) μmol/L,t=0.40,P＞0.05].Compared with before treatment,plasma Hcy level in treatment group was significantly reduced 4 weeks after treatment [(11.66 ± 3.28) μmol/L vs.(22.68±5.16) μmol/L,t=2.55,P＜0.01].There was a significant difference in plasma Hcy level between the treatment group and the control group after treatment [(11.66 ±3.28) μmol/L vs.(18.67±3.81) μmol/L,t=7.40,P＜0.01].TheSCL-90 total score,positive symptom items score,the total score and the average score of positive symptom items were significantly lower in treatment group after treatment than in treatment group before treatment (t=2.04,2.97,5.45,4.21,all P＜0.05) and in control group after treatment (t 7.40,7.58,12.78,4.15,all P＜0.05).The improvement on symptomatic patterns including somatization,obsessive-compulsive problems,interpersonal sensitivity,depression,anxiety and fear were better in treatment group after treatment than in treatment group before treatment (t 2.34,2.28,2.51,2.19,3.40,2.35,allP＜0.05) and in control group after treatment (t=4.10,5.04,5.12,4.18,5.48,5.20,all P＜0.05).There were no significant differences in the improvement in paranoid ideation between the treatment group before and after treatment (t=1.40,P＞0.05),between the treatment group and the control group after treatment (t=1.48,P＞0.05),and between the control group before and after treatment (P＞0.05).Conclusions Mecobalamine can effectively reduce plasma Hcy level in cerebral infarction patients with high plasma Hcy,and alleviate the symptoms of anxiety,depression,nervousness and other emotions.