依帕司他治疗糖尿病周围神经病变疗效的Meta分析

Treating diabetic peripheral neuropathy with epalrestat:a Meta-analysis

目的客观评价依帕司他治疗糖尿病周围神经病变（DPN）的有效性。方法以依帕司他治疗组与对照组的主观症状改善的比值比（OR）为统计量检索和筛选目前已发表的相关文献,应用Meta分析软件包RevMan5.0对各研究结果进行数据合并,并进行发表偏倚分析和敏感性分析评价结果的稳定性。对不能进行Meta分析的文献和相关指标用描述性方法分析结果。结果检索到相关文献10篇,共805例DPN患者,各研究结果间存在异质性（P=0.07）,依帕司他治疗DPN的症状改善较对照组明显有效（P〈0.000 01）,其合并OR（95%CI）为8.08（5.04~12.94）,发表偏倚分析和敏感性分析结果显示有两项研究存在发表偏倚。相关文献研究提示依帕司他在提高神经传导速度、降低血黏度等方面效果也是明显的。结论依帕司他能有效减轻DPN的各种症状,改善相关实验室指标,值得临床推广应用。

Objective To evaluate the therapeutic effect of epalrestat on diabetic peripheral neuropathy（DNP）.MethodsThe odds ratio of symptom improving between the treatment and control groups was analyzed.Related published literatures on effect of epalresta on DPN were fully searched and screened through computed database.The data were extracted for summarizing all the studies,calculating the pooled OR and its 95%confidence interval（95%CI）,and testing the overall effects by RevMan5.0.Both publication bias analysis and sensitivity analysis were performed for evaluating the reliability and stability of the meta-analysis.Other indexes in the literatures which were not adapted for meta-analysis were also described.Results10 literatures,totally 805 cases,were obtained.Some heterogeneity were discovered between the studies（P=0.07）.Epalresta may significantly relieve the symptom of patients with diabetic peripheral neuropathy.Its OR and 95%C1 was 8.08（5.04-12.94,P0.000 01）.The results of sensitivity analysis and publication bias analysis accounted for the reliability and two studies had publication bias of this meta-analysis.Epalrestat also played an role in raising nerve conduction velocity and reducing blood viscosity according to the results of the literatures.ConclusionEpalresta can effectively relieve DPN symptoms,improve the relative laboratory indexes.It is a better method for DPN treatment.