Curative Effect Of α-Lipoic Acid On Automatic Neuropathy In Type 2 Diabetes

Objective To evaluate the efficiency of α-lipoic acid( ALA) on diabetic cardiac automatic neuropathy( DCAN). Methods 76 patients were investigated by Ewing methodology and stepping stairs exercise. Then they were divided into two groups at random: treatment group(n =38),receiving ALA 600 mg /d in normal saline 250 ml given by intravenous drip infusion; and control group(n=368),administered with vitamin C 500mg/d in normal saline 250 ml by intravenous drip infusion once a day; the course was 2 weeks. The efficiency was measured by the change of, before and after treatment, value of FBG(fasting blood glucose), 2hPBG(2 hour postprandial blood glucose), total cholesterol(TC), triglyceride(TG), Fructosamine(FMN), systolic blood pressure(SBP), malondialdehyde(MDA), uncoupling protein-2(UCP-2). The heart rate variability(HRV) was observed, compared before and after therapy, in terms of time domain such as SDNN(the standard deviation of all N-N intervals), SDANN(the standard deviation of the average of N-N intervals for each 5-min period over 24 h), RMSSD(the root mean square values of the standard deviation between adjacent normal number of intervals), PNN50(percentage of N-N50 ms in the total number of N-N intervals) and in the field of frequency domain such as HF(high frequency), LF(low frequency), LF/HF ratio, heart rate turbulence(HRT) including turbulence onset(TO) and turbulence slope(TS) and corrected QT interval. In the experiment, we found a high ratio of patients were diagnosed as CAN with DPN. We measured the scores of TSS in two groups, according their syndrome. And conduction velocity of nervous system of the two groups were compared before and after the treatment. Result In the aspects of biochemical indexes, FBG, 2hPBG, TC and FMN in treatment group were refined, compared before and after therapy(P<0.05). The differences were not statistical different in control group; the MDA and UCP-2 were lower than before in treatment group, and MDA was decreased in control group as well(P<0.05); Heart rate variabilities were elevated after therapy in treatment group in time domain and frequency domain except for LF(P<0.05). HF and LF/HF were improved in control goup(P<0.05). QTc interval was also decreased than before. Results The TSS score of the treatment group was dramaticly cut down than that of the control group(P<0.05).The symptom scores of numbness,painful sensation and thermal hyperalgesia reduced significantly after ALA treatment.But there were no significant differences in these symptoms after the management in the control group except for painful sensation.Neural response improved and conduction velocity increased in the treatment group, by contrast no significant differences were observed in the control group. Conclusion Vagus nerve is destroyed earlier than sympathetic nerve. α-Lipoic Acid is brought into full play in the improvement of the regeneration and restoration of demyelination, which would control a better balance between vagus and sympathetic nerve.