| Objective: Neuromyelitis optic and NMO spectrum disorders are characterized by repeating attacks,protracted courses,chronic progress,high recurrence rate and high morbidity.The corticostero-ids,intravenous immunoglobulin,immunosuppressants and rituxan drug used in the clinical have some disadvantages,such as big side effects,expense,inconvenient applications.This study research the efficacy of lipoic acid through the observation of the patients with Neuromyelitis optic and NMO spectrum disorders.We can use MMSE,HAMD and EDSS score to compare the changes of intell-igence,psychological and neurological status before and after the application of lipoic acid.This can Provide meaningful experimental basis for clinical application.Methods: Forty five cases who come from the second hospital of hebei medical university from January to September 2015 complying with the standard set were randomly assigned into the standard treatment group,the lipoic acid group and the azathioprine group.The standard treatment group:Give the patients corticosteroids 500 mg everyday for three days in the acute phase,halve to 250 mg for three days,and halve to 125 mg for three days;In the remission we use oral prednisone acetate tablets 75 mg everyday for sever days,40 mg for fourteen days,20 mg for fourteen days,10 mg for fourteen days and 5mg for fourteen days.The lipoic acid group:beside the standard treatment we give the patients lipoic acid for injection 0.6 g/day 1 x 14 days in the acute phase,and we give the patients oral lipoic acid capsule 0.6 g/day In the remission for three months.The azathioprine group: beside the standard treatment we give the patients azathioprine 50 mg every day In the remission,and let them review routine blood and liver function.If the indicators are normal we increase azathioprine 50 mg to 100 mg for three months.The patients must review routine blood and liver function on a regular basis.We use MMSE、HAMD and EDSS score to measure intelligence,psychological and clinical nerve function defect degree at the time of admitting to hospital fourteen days after treatment、thirty days after treatment and ninety days after treatment.Results:1 The general information : The 45 Neuromyelitis optic and NMO spectrum disorders patients meeting the standard set were distributed into the standard treatment group,the lipoic acid group and the azathioprine group for each group 15 patients.There was no difference in the general situation such as age,gender before healing.(P>0.05).After ninety days of the treatment,we lose one patient and two patients relapse in the standard treatment group.After ninety days of the treatment,we lose one patient in the lipoic acid group and three patients stop the experiment in the azathioprine group.2 The comparison of MMSE scores:There was no difference between 0day and 14days、30days and 90 days after the treatment for three groups(P>0.05).3 The comparison of HAMD scores:The comparison between before and after the treatment: There was no difference between 0day and 14days、30days and 90 days after the treatment for standard treatment group(P>0.05).There was difference between 0day and 14days、30days and 90 days after the treatment for the lipoic acid group and the azathioprine group(P<0.05).The comparison among the group:The improvement of HAMD score in the lipoic acid group was greater than the standard treatment group after 14days、30days and 90 days of the treatment(P<0.05).There was no difference between the standard treatment and the azathioprine group after 14 days of the treatment(P>0.05),and the improvement of HAMD score in the azathioprine group was greater than the standard treatment group after 30 days and 90 days of the treatment(P<0.05).The improvement of HAMD score in the lipoic acid group was greater than the azathioprine group after 14 days and 30 days of the treatment(P<0.05),and There was no difference after 90 days of the treatment(P<0.05).4 The comparison of EDSS scores:The comparison between before and after the treatment:There was no difference between 0day and 14 days after the treatment for standard treatment group(P>0.05),and There was difference between 0day and 30 days and 90 days after the treatment for standard treatment group(P<0.05).There was difference between 0day and 14days、30days and 90 days after the treatment for the lipoic acid group and the azathioprine group(P<0.05).The comparison among the group:The improvement of EDSS score in the lipoic acid group was greater than the standard treatment group after 14 days 、 30 days and 90 days of the treatment(P<0.05).There was no difference between the standard treatment and the azathioprine group after 14 days of the treatment(P>0.05),and the improvement of EDSS score in the azathioprine group was greater than the standard treatment group after 30 days and 90 days of the treatment(P<0.05).The improvement of HAMD score in the lipoic acid group was greater than the azathioprine group after 90 days of the treatment(P<0.05),and There was no difference after 14 days and 30 days of the treatment(P<0.05).5 Observation of drug side effects: There was no patient quit the experiment because of the drug side effects in the standard treatment group;There was no patient quit the experiment because of the drug side effects in the lipoic acid group;There was three patients quit the experiment.One patient quit the experiment because of herpes in the azathioprine group after twenty-five days of the treatment,one patient quit the experiment because of the decrease of whole blood cells in the azathioprine group after thirty-two days of the treatment,,and one patient quit the experiment because of the injury of the liver function in the azathioprine group after sixty-four days of the treatment.Conclusions:1 The patients with neuromyelitis optic and NMO spectrum disorders have no obvious obstacle at the beginning of the illness.2 Lipoic acid can improve psychological status of the patients with neuromyelitis optic and NMO spectrum disorders sooner and earlier than azathioprine.3 lipoic acid can improve neurological status better than azathioprine in the forward for the patients with neuromyelitis optic and NMO spectrum disorders.4 Lipoic acid and azathioprine can reduce relapse but the side effect of the lipoic acid is less than azathioprine,and the security of the lipoic acid maybe is better than azathioprine. |
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