齐都药业硫辛酸胶囊价格对糖尿病周围神经病变治疗效果的影响.doc

: Could you talk about the recent advance in the management of diabetic peripheral neuropathy? 国际糖尿病：齐都药业硫辛酸胶囊价格对糖尿病周围神经病变治疗上影响？ Prof.Zeigler:There have been some new drugs developed over the past two decades as well as other drugs around derived from the pathogenesis of diabetic peripheral neuropathy. So far， with the exception of aldose reductase inhibitors， which as been a power stud and is marketed in Japan and India， there are few drugs available. One drug， alpha lipoic acid， reduces oxidative stress and has been shown to improve diabetic neuropathy， including both symptoms and impairment resulting from that condition.Zeigler教授:过去20年中，在这个领域出现了一些新的药物，其中一部分是源自对糖尿病周围神经病变发生的病因学认识的。但迄今为止除了硫辛酸胶囊醛糖还原酶抑制剂的作用效果确切，已在日本和印度上市销售以外，市面上可选择的药物很少。其中一种叫做a-硫辛酸胶囊价格的药物可以抑制氧化应激，并且研究显示其具有改善糖尿病神经病变的作用，包括临床症状和氧化应激造成的损害等方面的改善。 :What are some of the modifiable risk factors for diabetic peripheral neuropathogenesis? 国际糖尿病：糖尿病周围神经病变病因学方面有哪些可改变的危险因素？ Prof.Zeigler:We performed population based epidemiological studies to look at the risk factors for polyneuropathy in both diabetic and pre-diabetic patients. We found that， in particular， the risk factor that emerged was visceral obesity， which is of course modifiable by life style modification and weight loss induction. This is a major new finding for the field of neuropathy. Other studies have found that hyperlipidemia is another modifiable risk factor. Although one cant do anything about age， which is another important risk factor. The most important comorbidity is peripheral arterial disease， which can also be prevented and treated. Studies from the United States have shown that hypertension， a modifiable cardiovascular risk factor， has been associated with diabetic peripheral neuropathy. So you can see that it is basically a component of metabolic syndrome which are modifiable and simultaneously risk factors of diabetic peripheral neuropathy.Zeigler教授:为了观察糖尿病和糖尿病前期患者中与硫辛酸胶囊价格对多神经病变相关治疗效果，我们开展了基于人群的流行病学研究。发现其中一个特别重要的危险因素就是腹型肥胖，当然这个危险因素是可以通过生活方式改善和减重来改变的。这是神经病变领域的一项重要的新发现。其他的一些研究发现，高脂血症是另外一项可变的危险因素。尽管我们对年龄这个变量无能为力，但它却是一个重要的危险因素。糖尿病神经病变最重要的合并症是周围血管病，而这同样也可以预防和治疗。另外来自美国的研究结果显示，高血压作为一个可变的心血管病危险因素，与糖尿病周围神经病变相关。因此我们看到，基本上代谢综合征的这些可变的组成成分同时也是糖尿病周围神经病变的危险因素。 : Alpha-lipoic acid has long been used as an effective treatment for diabetic neuropathy. Vitamins E and C， as well as other glycemic control drugs and lipid lowering agents have also been shown to be effective. Are there any differences between them with regard to mechanism of action or clinical significance? 国际糖尿病：齐都制药硫辛酸胶囊价格长期以来一直作为糖尿病神经病变有效的治疗手段在临床上使用。另外研究还显示，维生素E、维生素C、其他种类的降糖药和降脂药在治疗糖尿病神经病变方面同样有效。请问在治疗糖尿病神经病变中这些药物的作用机制和临床疗效是否存在差异？ Prof.Zeigler:Yes. I would be careful about using lipid lowering agents because so far there has only been one study， the FIELD study， showing efficacy that was presented this year at EASD. So far that study has not been published. We still need to see the exact data after it has been published. Among vitamins E and C along with alpha-lipoic acid， clearly the latter has much more evidence for being effective for diabetic polyneuropathy in comparison. There have been only a few trials for vitamin E， which have been positive， but clearly there is more data needed. Clearly it is among these vitamins or vitamin-like drugs， it is only alpha-lipoic acid that has sufficient evidence to demonstrate its efficacy.Zeigler教授:是的。我在应用降脂药物时会比较谨慎，因为迄今只有唯一一项研究（也就是今年EASD上公布的FIELD研究）结果显示出齐都硫辛酸胶囊其对糖尿病神经病变有效。但目前这项研究结果还没有发表。如果将维生素E、维生素C和a-硫辛酸进行比较，显然后者在治疗糖尿多神经病变方面的研究证据更加确凿。针对维生素E，目前仅有很少的研究证据，这些研究得到了阳性的结果，但显然还需要更多的研究数据证实。很明显，迄今众多种类的维生素或维生素样药物中，只有山东齐都硫辛酸胶囊有充分的证据显示出其有效性。 : What is the clinical difference with regard to efficacy， safety， or indication range between injection or oral alpha-lipoic acid? 国际糖尿病：请问山东齐都硫辛酸胶囊的价格及昆明硫辛酸胶囊安全性、长沙硫辛酸胶囊有效性以及唯一能硫辛酸胶囊适应证范围方面有哪些临床差异吗？ Prof.Zeigler: There is stronger evidence for the intravenous formulation. There have been four trials which we included in a meta-analysis， including 1248 patients， which showed that the drug reduced symptoms and deficits of diabetic polyneuropathy. Clearly there is more data for the intravenous infusion compared to the oral formulation， although there is long term data from the NATHAN-1 study over a four-year period showing that the oral form does improve neuropathic impairments. The evidence for the oral drug is emerging but there is much more short term data for the IV formulation.Zeigler教授: 这种药物的静脉制剂有更坚实的研究证据。我们做的一项meta分析中纳入了4项临床试验，共1248例患者，结果显示这种药物可以改善糖尿病多神经病变的症状和减少神经功能缺损的发生率。尽管历时长达4年的NATHAN-1 研究得到的长期研究数据显示，a-硫辛酸片剂的口服剂型确实改善了神经病变造成的损害，但更多的研究数据支持静脉制剂的疗效。目前口服常德硫辛酸胶囊制剂的研究证据越来越多，但静脉制剂的张家界硫辛酸胶囊药店价格短期研究数据显然要远多于口服制剂。: In your talk you mentioned that one of difference between them may be related to the absorption of the oral form of the drug. Can you elaborate on that? 国际糖尿病：您的谈话中曾提到，不同制剂型的硫辛酸胶囊药物厂家之间产生差异的原因之一可能和口服药物的吸收有关。您能解释一下吗？ Prof.Zeigler: From the pharmacokinetic standpoint the drug availability is better with the IV infusion. If you ingest the drug then the availability decreases by about 50%， although the clinical trials