A Randomized Controlled Study Of Epalrestat Combined With Methylcobalamin In Treatment Of Elderly Type 2 Diabetic Peripheral Neuropathy

Objective: To investigate the curative effect of epalrestat combination with mecobalamin for treatment elderly type 2 diabetic peripheral neuropathy(DPN).Methods: A total of 158 cases of elderly type 2 DPN patients who hospitalization and admitted to outpatient dept.of the Second Hospital Affiliated to Xinjiang Medical University from April 2015 to April 2016 were selected as objects,and than divided into combination group(80 cases)and mecobalamin group(78 cases)by random digitstable.Before treatment,all the patients were controlled the blood glucose and pressure.Patients in mecobalamin group were merely given mecobalamin(0.5 mg every time,three times a day,oral administration before meals),the combination group were given epalrestat(50 mg every time,three times a day,oral administration before meals)and mecobalamin.All the patients treatment for three months.Compared the neurological total symptoms scores(TSS),the sensory and motor nerve conduction velocity of median nerve and common peroneal nerve and the levels of homocysteine(Hcy)of the patients before and after treatment,compared the adverse reaction of the two groups too.Results: After treatment,the TSS scores of the patients were declined(P<0.05),and combination group was lower than mecobalamin group[(0.9±0.3)scores vs.(1.4±0.5)scores](P<0.05),the sensory and motor nerve conduction velocity of median nerve and common peroneal nerve were faster than before(P<0.05),and combination group were faster than mecobalamin group [ common peroneal nerve(47.2±0.9)m/s vs.(39.9±1.2)m/s,(44.2±1.5)m/s vs.(34.8±0.9)m/s,median nerve(51.3±1.0)m/s vs.(45.0±0.9)m/s,(45.0±1.9)m/s vs.(39.5±1.0)m/s](P<0.05).The Hcy levels of combination group were decreasedcompared with before treatment(P<0.05),the levels of Hcy of combination group were lower than mecobalamin group [(20.9±8.6)?mol/l vs.(28.0±11.6)?mol/l](P<0.05).During the treatment process,2 patients with nausea,vomiting in combination group,without stopped,symptomatic relief after 2 days,mecobalamin group without adverse reactions.Conclusion: Epalrestat combination with mecobalamin for treating elderly type 2 DPN can improvement the peripheral nerves symptom,signs and the nerve conduction velocity,enhanced the body's antioxidative stress ability,reduceing the level of Hcy,without obvious untoward effect.