前列地尔联合甲钴胺治疗糖尿病周围神经病变的Meta分析

目的比较前列地尔联合甲钴胺治疗糖尿病周围神经病变(DPN)的疗效与安全性。方法应用循证医学方法对符合标准的16个研究进行Meta分析,评价前列地尔联合甲钴胺治疗DPN的神经传导速度、有效率及不良反应发生率方面的差异。结果 Meta分析结果显示,试验组在改善DPN患者的神经传导速度及有效率方面优于对照组,而不良反应发生率多于对照组。治疗后,正中神经(MCV)和腓总神经(SCV)的运动神经传导速度的标准化均数差(SMD)及其95%CI分别是2.37(2.15,2.60)和2.05(1.86,2.25);正中神经和腓总神经的感觉神经传导速度的标准化均数差及其95%CI分别是1.84(1.65,2.03)和1.45(1.27,1.64);有效率方面,合并后的RR为1.35,95%CI为1.26～1.44;不良反应发生率方面,合并后的RR为3.58,95%CI为1.70～7.54。结论前列地尔联合甲钴胺治疗糖尿病周围神经病变是一种有效的方法。

Meta Analysis of the Control Study on Treatment of Diabetic Peripheral Neuropathy with Combination of Alprostadil with Mecobalamin

Objective To compare the treatment and safety of diabetic peripheral neuropathy （DPN） with combination of alprostadil with mecobalamin. Methods Meta-analysis was made on the 16 researches which met the criterion with the evidence-based medicine （EBM） method,to evaluate the differences in the aspects of the nerve conduction velocity （NCV）,effective rates and adverse reaction （ADR） rates of the treatment of diabetic peripheral neuropathy （DPN） with combination of alprostadil with meeobalamin. Results From the results of Meta- analysis,the NCV in experimental group was significantly better than that in the control group,while the ADR was higher than that in control group. After the treatment,the standardized mean difference （SMD） and its 95% CI of the motor nerve conduction velocity of motor nerve conduction velocity for median nerve （MCV） and common peroneal nerve （SCV） is 2.37（2. 15,2.60） and 2.05（1.86,2.25）,and the standardized mean difference （SMD） and its 95% CI of the motor nerve conduction velocity of sensory nerve conduction velocity for median nerve （MCV） and common peroneal nerve （SCV） is 1.84（1.65,2.03） and 1.45（1.27,1.64）. At the perspective of the effective rate,the combination RR was 1.35, while 95% CI was （1.26- 1.44）. For the ADR, the combination RR was 3.58,while 95% CI was （1.70-7.54）. Conclusion It is an effective method to treat diabetic peripheral neuropathy with combination of alprostadil with mecobalamin.