加巴喷丁治疗糖尿病周围神经痛的Meta分析

目的 评价加巴喷丁治疗糖尿病性周围神经痛的有效性和安全性.方法 采用循证医学的文献分析评价方法,计算机检索Cochrane图书馆系统评价数据库、Pubmed、中国学术期刊全文数据库、万方数据库、维普数据库等,采用RevMan5.2软件进行Meta分析.结果 纳入研究12项,共931例患者,Meta分析显示加巴喷丁反应有效率[OR=2.99,95%CI(1.72,5.20),P <0.000 1]及不良反应发生率[OR=4.05,95%CI(1.10,14.95),P=0.04]均高于安慰剂,加巴喷丁治疗效果高于卡马西平/奥卡西平[OR=3.60,95%CI(1.14,11.31),P=0.03]和维生素B₁₂,而不良反应则较卡马西平轻;加巴喷丁与度洛西汀、普瑞巴林比较,治疗效果相当,但度洛西汀[OR=2.06,95%CI(1.22,3.48),P=0.007]和普瑞巴林的不良反应较少.结论 加巴喷丁治疗糖尿病性周围神经痛效果显著,安全性较好.

Effects and safety of gabapentin for treatment of diabetic peripheral neuropathic pain: A Meta-analysis

Objective To compare the effects and safety of gabapentin for the treatment of diabetic peripheral neuropathic pain. Methods Cochrane library, MEDLINE, Embase, PUBMED, CNKI, VIP database, and Wanfang database were searched. The Meta-analysis was performed by RevMan5.2. Results Twelve studies were included (n = 931). The analysis indicated that there were significant differences between gabapentin and placebo in respondent rate [OR = 2.99, 95%CI (1.72, 5.20), P <0.000 1]. The adverse event rate is higher treated with gabapentin than that with placebo [OR = 4.05, 95%CI (1.10, 14.95), P = 0.04]. Compared with carbamazepine/oxcarbazepine, the efficacy of gabapentin is similar while adverse event rate is lower [OR = 3.60, 95%CI(1.14, 11.31), P = 0.03]. There were similar efficacy and safety between gabapentin and amitriptyline, duloxetine and pregabalin, but the adverse event rate of gabapentin is lower than amitriptyline [OR = 2.06, 95%CI(1.22, 3.48), P = 0.007] and higher than duloxetine and pregabalin. Conclusion With superior effects and similar safety, gabapentin may be preferred for the patients with diabetic peripheral neuropathic pain.