Abstract: Objective　To investigate the clinical effects of thioctic acid sequential therapy combined with epalrestat in the treatment of diabetic painful neuropathy （PDN）.Methods　A total of 80 patients with PDN admitted to the Department of Endocrinology of Lu'an Second People's Hospital in 2016 were enrolled as the study subjects.The random number table was adopted to divide the patients into the observation group and the control group，each with 40 cases.The observation group was treated with thioctic acid sequential therapy combined with epalrestat for 8 weeks.The control group was treated with mecobalamin sequential therapy combined with epalrestat for 8 weeks.The clinical efficacy of the two groups of patients after treatment was recorded.The motor nerve conduction velocity （MNCV） and sensory nerve conduction velocity （SNCV） of median nerve and common peroneal nerve were measured before and after the treatment.Results　In the observation group，33 cases（82.5%） were markedly effective，6 cases（15.0%） improved，and 1 case（2.5%） failed.In the control group，9 cases （22.5%）were markedly effective，21 cases （52.5%）improved，and 10 cases（25.0%） failed.The clinical efficacy of the observation group was better than that of the control group （u=4.81，P<0.01）.Before the treatment，there was no significant difference in MNCV and SNCV of median and peroneal nerves between the two groups （P>0.05）.After the treatment，the MNCV and SNCV of median nerve and peroneal nerve in the observation group were higher than those in the control group （P<0.05）.The difference in MNCV and SNCV of median and peroneal nerves before and after the treatment in the observation group were higher than those in the control group （P<0.05）.No serious adverse reaction occurred in both two groups.Conclusion　Compared with mecobalamin，the use of thioctic acid sequential therapy combined with epalrestat for the treatment of PDN is more effective and safer，so it is worthy of clinical application.

Key words: Diabetic neuropathies, Thioctic acid, Epalrestat, Neural conduction

摘要： 目的　探讨硫辛酸序贯疗法联合依帕司他治疗糖尿病痛性神经病变（PDN）的临床效果。方法　选取2016年六安市第二人民医院内分泌科收治的PDN患者80例为研究对象，采用随机数字表法将其分为观察组和对照组，各40例。观察组采用硫辛酸序贯疗法联合依帕司他治疗8周，对照组采用甲钴胺序贯疗法联合依帕司他治疗8周，记录两组患者治疗8周后临床疗效，治疗前及治疗8周后检测正中神经、腓总神经运动神经传导速度（MNCV）和感觉神经传导速度（SNCV）。结果　治疗后观察组显效33例（82.5%），有效6例（15.0%），无效1例（2.5%）；对照组显效9例（22.5%），有效21例（52.5%），无效10例（25.0%）；观察组临床疗效优于对照组（u=4.81，P<0.01）。治疗前，两组患者正中神经和腓总神经MNCV和SNCV比较，差异均无统计学意义（P>0.05）；治疗后，观察组患者正中神经和腓总神经MNCV和SNCV较对照组升高（P<0.05）；观察组患者正中神经和腓总神经MNCV和SNCV治疗前后差值较对照组增大（P<0.05）。两组患者均未发生严重不良反应。结论　与甲钴胺相比，采用硫辛酸序贯疗法联合依帕司他治疗PDN效果更明显，可明显提高神经传导速度，且用药安全性好。

关键词: 糖尿病神经病变, 硫辛酸, 依帕司他, 神经传导