牛痘疫苗接种家兔炎症皮肤提取物治疗糖尿病周围神经病变的 Meta分析

目的 对牛痘疫苗接种家兔炎症皮肤提取物(神经妥乐平)治疗2型糖尿病(type 2 diabetes)同时合并周围神经病变(DPN)病人的作用效果和药物使用的安全性进行系统评价,为神经妥乐平在2型糖尿病病人同时合并DPN治疗中的合理使用提供循证证据.方法 检索循证图书馆、PubMed文献数据库、EMBASE、万方电子数据库、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)等,按照筛选标准对神经妥乐平治疗DPN相关的临床随机对照研究(RCT)相关文章进行收集整理,检索时限从各数据库建库起至2019年12月.先对纳入研究做临床证据质量评价,再进一步运行RevMan(版本5.3)对各指标数据(总有效率、正中神经运动神经传导速度、胫神经运动神经传导速度以及不良反应发生率)进行分析.结果 共纳入9篇文献,总计934例病人.研究最终结果表明,在DPN的药物治疗效果方面,试验组药物治疗总有效率较对照组具有更多优势OR=3.91,95％CI(2.64～5.78),P<0.001].在改善神经功能障碍方面,试验组的正中神经MD=4.07 m/s,95％CI(2.12～6.03),P<0.001]以及胫神经的运动神经传导速度MD=2.93 m/s,95％CI(2.08～3.79),P<0.001]也较对照组显著提高.在药品的安全性方面,试验组神经妥乐平的药品不良反应(ADR)发生率与对照组差异无统计学意义.结论 神经妥乐平作为一种有效性较好的临床药物,可显著改善神经功能,具有广泛的临床应用价值,同时对于其发生不良反应的风险在临床使用中仍需予以重视.

Efficacy and safety of neurotropin on diabetic peripheral neuropathy: a meta-analysis

Objective To make a systematical evaluation of the effectiveness and pharmaceutical safety of neuortropin (NTP) in thetreatment of type 2 diabetes complicated with peripheral neuropathy (DPN), so as to provide effective evidence-based basis for the ratio-nal application of NTP.Methods Cochrane Library, PubMed database, EMBASE, Wanfang, China Biology Medicine and CNKI data-base were searched, and articles related to randomized controlled studies (RCTs) about NTP in the treatment of DPN were collected ac-cording to the criteria of screening. The retrieval period was from the database establishment to December 2019. After retrieval, thequality of studies was evaluated and each outcome indicator (the total effective rate, median nerve motor nerve conduction velocity, tibi-al nerve motor nerve conduction velocity and incidence of adverse reactions) by was analyzed by RevMan (version 5.3).Results This study included all of 9 RCTs, involving 934 patients in total. The final results indicated that the total effective rate of DNP in the testgroup had more advantages than that of the control group OR=3.91,95%CI(2.64-5.78),P<0.001]. In terms of improvement of neurologi-cal disorders, compared to the control group,the median nerve MD=4.07 m/s,95%CI(2.12-6.03),P<0.001] and tibial nerve motor nerve conduction velocity MD=2.93 m/s,95%CI(2.08-3.79),P<0.001]of test group were significantly faster. Compared with the control groupin the respect of safety,the adverse reactions (ADR) incidence of test group was slightly higher with no statistically significant.Conclu. sion Neurotropin is a kind of clinical medicine with good efficacy, as well as a wide range of clinical application value for its signifi-cantly improvement of nerve function, the risk of adverse reactions should be paid more attention in clinical use at the same time.