目的 探讨穴位注射甲钴胺联合静脉滴注α-硫辛酸治疗糖尿病周围神经病变的临床疗效及安全性。方法 选取76例糖尿病周围神经病变患者将其随机分为治疗组（38例）和对照组（38例）。所有患者均给予常规降糖、降压、降脂等综合治疗，对照组给予穴位注射甲钴胺0.5 mg，1次/d，治疗组在对照组基础上给予α-硫辛酸600 mg加入0.9%的生理盐水250 mL中静脉滴注，1次/d，两组均连续治疗14 d。分别在治疗前后记录两组患者的震动感觉阈值，并观察临床症状、体征变化及有无药物不良反应。结果 治疗后两组震动感觉阈值均较治疗前明显下降（P＜0.01），治疗组下降较对照组更明显，两组比较差异有统计学意义（P＜0.05）。治疗组和对照组有效率分别为89.5%、76.3%，两组比较差异有统计学意义（P＜0.05）。治疗过程中两组均未见明显的药物不良反应。结论 甲钴胺联合α-硫辛酸治疗糖尿病周围神经病变，可在短时间内降低患者的震动感觉阈值，改善临床症状，且治疗过程中没有明显的不良反应，值得临床推广应用。

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.