目的 探討穴位注射甲鈷胺聯(lián)合靜脈滴注α-硫辛酸治療糖尿病周圍神經(jīng)病變的臨床療效及安全性。方法 選取76例糖尿病周圍神經(jīng)病變患者將其隨機(jī)分為治療組（38例）和對照組（38例）。所有患者均給予常規(guī)降糖、降壓、降脂等綜合治療，對照組給予穴位注射甲鈷胺0.5 mg，1次/d，治療組在對照組基礎(chǔ)上給予α-硫辛酸600 mg加入0.9%的生理鹽水250 mL中靜脈滴注，1次/d，兩組均連續(xù)治療14 d。分別在治療前后記錄兩組患者的震動(dòng)感覺閾值，并觀察臨床癥狀、體征變化及有無藥物不良反應(yīng)。結(jié)果 治療后兩組震動(dòng)感覺閾值均較治療前明顯下降（P＜0.01），治療組下降較對照組更明顯，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療組和對照組有效率分別為89.5%、76.3%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療過程中兩組均未見明顯的藥物不良反應(yīng)。結(jié)論 甲鈷胺聯(lián)合α-硫辛酸治療糖尿病周圍神經(jīng)病變，可在短時(shí)間內(nèi)降低患者的震動(dòng)感覺閾值，改善臨床癥狀，且治療過程中沒有明顯的不良反應(yīng)，值得臨床推廣應(yīng)用。

Objective To observe the clinical efficacy and safety of acupoint injection mecobalamin combined with iv infusion α-lipoic acid in the treatment of type 2 diabetic peripheral neuropathy (DPN). Methods Patients (76 cases) with DPN were randomly divided into treatment (38 cases) and control (38 cases) groups. All the patients were given insulin or oral hypoglycaemic agent for antihypertensive and antilipemic therapie. Meanwhile, the patients in the control group were also given acupoint injection methylcobalamin 0.5 mg, once daily. The patients in the treatment group were iv administered with α-lipoic acid 600 mg + 0.9% physiological saline 250 mL, once daily, and other treatment was the same as the control group. The two groups were treated for 14 d. The vibration perception threshold (VPT) was evaluated in the two groups before and after the treatment. The changes in their symptoms, signs, and the adverse drug reactions were also observed. Results The VPT of the two groups was significantly decreased after treatment (P < 0.01), and the VPT was lower in the treatment group than that in the control group (P < 0.05). The efficiencies for the patients in both the treatment and control groups were 89.5% and 76.3% with the significant difference (P < 0.05). No serious adverse effects were observed in the two groups during the treatment. Conclusion Mecobalamin combined with α-lipoic acid in the treatment of diabetic peripheral neuropathy could lower the VPT and improve the symptoms of DPN in a short time with no incidence of adverse drug reactions, which could be used in clinic.