葛根素治疗糖尿病周围神经病变的系统评价

目的评价葛根素治疗糖尿病周围神经病变的疗效和安全性.方法按照国际Cochrane协作网的系统评价方法,通过对Cochrane图书馆临床对照试验库(2003年第1期)、Medline(1966～2003.2)、EMbase数据库(1984～2001.12.4)、中国生物医学文献数据库(1978～2003.2)的机检,以及17种中文核心杂志的手检和参考文献的查阅,检索出葛根素治疗糖尿病周围神经病变的随机或半随机对照试验进行系统评价.两位研究者独立地评价试验质量和提取资料.结果10个试验共包括726例病人符合纳入标准.大部分试验的方法学质量较差.与常规治疗及B族维生素相比较,葛根素能显著提(下转第569页)高治疗的总有效率和感觉及运动神经传导速度.治疗期间未发现严重不良反应.结论由于试验方法学质量低下和可能存在发表偏倚,葛根素治疗糖尿病周围神经病变有效的证据尚不充分,亟待更多大样本、高质量的随机对照试验进一步予以证实.

Puerarin in the Treatment of Diabetic Peripheral Neuropathy:A Systematic Review

ObjectiveTo systematically evaluate the effectiveness and safety of Puerarin on diabetic peripheral neuropathy. MethodsA systematic review and evaluation of all available relevant randomized or quasi-randomized controlled trials of Puerarin for diabetic peripheral neuropathy from Cochrane Controlled Trials Register (150 issue of 2003), Medline (1966-2003. 2), EMbase (1984-2001. 12. 4), and the Chinese Biological Medicine Database (1978-2003. 2) were performed. The selection of studies, data extraction, and assessment of methodological quality were performed independently by two reviewers. The following outcomes were assessed: effectiveness of clinical symptoms, sensory nerve and motor nerve conduction velocities, and severe adverse events of Puerarin. ResultsTen randomized controlled clinical trials including 726 patients met the inclusion criteria. At the end of the treatment, compared to general treatment or vitamin B, Puerarin showed significant positive effects on the total effect rate of therapy and increased peripheral nerve conduction velocity. No severe adverse events were observed during the treatment period. However, most included trials show some degree of study design or analysis defect. ConclusionsOur analysis suggests that Puerarin appears to be an effective and safe treatment for diabetic peripheral neuropathy. However, due to the low quality trials included in this review, more rigorously designed, randomized, double-blind, placebo-controlled trials of Puerarin for diabetic peripheral neuropathy are needed to further assess its usefulness in diabetes peripheral neuropathy patients.