α-硫辛酸对比依帕司他治疗糖尿病周围神经病变临床疗效的系统评价

Clinical Efficacy of α-Lipoic Acid versus Epalrestat in the Treatment of Diabetic Peripheral Neuropathy:A Systematic Review

目的:系统评价α-硫辛酸对比依帕司他治疗糖尿病周围神经病变(DPN)的疗效,为临床提供循证参考。方法:计算机检索中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库、万方数据库、Pub Med,收集α-硫辛酸对比依帕司他治疗DPN的随机对照试验(RCT),按照纳入与排除标准进行筛选,提取资料并采用Cochrane系统评价员手册进行质量评价后,利用Rev Man 5.3统计软件对数据进行Meta分析。结果:共纳入6项RCT,合计408例患者。Meta分析结果显示,α-硫辛酸组患者总有效率[RR=0.98,95%Cl(0.84,1.15),P=0.81]、运动神经传导速度[正中神经:MD=1.02,95%Cl(-1.10,3.14),P=0.34;腓总神经:MD=0.23,95%Cl(-1.11,1.58),P=0.73]、感觉神经传导速度[正中神经:MD=1.10,95%Cl(-0.39,2.59),P=0.15;腓总神经:MD=0.95,95%Cl(-1.47,3.36),P=0.44]与依帕司他组比较,差异均无统计学意义。结论:α-硫辛酸与依帕司他治疗DPN的疗效相当,两者改善DPN患者正中神经、腓总神经的运动、感觉神经传导速度效果相似。

OBJECTIVE：To systematically review the efficacy of α-lipoic acid versus epalrestat in the treatment of diabetic peripheral neuropathy（DPN）,and provide evidence-based reference for clinic. METHODS：Retrieved from CJFD,CBM,VIP,Wanfang Database and Pub Med,randomized controlled trials（RCT）about α-lipoic acid versus epalrestat in the treatment of DPN werecollected,and the study was screened by inclusion and exclusion criteria. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by Cochrane software. RESULTS：Totally 6 RCTs were enrolled,involving 408 patients. Results of Meta-analysis showed,compared with epalrestat,there were no significant differences in the total effective rate[RR=0.98,95%C（l0.84,1.15）,P=0.81],motor nerve conduction velocity [median nerve：MD=1.02,95%C（l-1.10,3.14）,P=0.34;common peroneal nerve：MD=0.23,95%C（l-1.11,1.58）,P=0.73] and sensory nerve conduction velocity [median nerve：MD=1.10,95%C（l-0.39,2.59）,P=0.15;common peroneal nerve：MD=0.95,95%C（l-1.47,3.36）,P=0.44] in α-lipoic acid group. CONCLUSIONS：The efficacy of α-lipoic acid is similar to epalrestat in the treatment of DPN,as well as the motor nerve conduction velocity and sensory nerve conduction velocity of median nerve or common peroneal nerve.