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首页> 外文期刊>Neural regeneration research >Efficacy of epalrestat plus α-lipoic acid combination therapy versus monotherapy in patients with diabetic peripheral neuropathy: a meta-analysis of 20 randomized controlled trials
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Efficacy of epalrestat plus α-lipoic acid combination therapy versus monotherapy in patients with diabetic peripheral neuropathy: a meta-analysis of 20 randomized controlled trials

机译：依帕司他联合α-硫辛酸联合疗法与单一疗法在糖尿病周围神经病变患者中的疗效：20项随机对照试验的荟萃分析

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Objective: To evaluate the efficacy of α-lipoic acid (ALA) plus epalrestat combination therapy in the treatment of diabetic peripheral neuropathy (DPN). Data Sources: The electronic databases of PubMed, Medline, Embase, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Wanfang Database and the Chinese Biomedical Database were used to retrieve relevant studies without language restrictions. The search was conducted from the inception of each database to 7 October 2016. The key terms were (diabetic peripheral neuropathy or diabetic neuropathy or DPN) AND (α-lipoic acid or lipoic acid or thioctic acid) AND epalrestat. Data Selection: All of the eligible studies met the following inclusion criteria: (1) Randomized controlled trials that compared efficacy and safety of epalrestat plus ALA combination therapy versus epalrestat or ALA monotherapy in patients with DPN. (2) The minimum duration of treatment was 2 weeks. (3) The DPN patients were diagnosed using the World Health Organization standardized type 2 diabetes mellitus and DPN criteria. (4) Studies contained at least one measure that could reflect the efficacy of the drug and nerve conduction velocities. Studies in which the control group used epalrestat or ALA combined with other drugs were excluded. Statistical analyses were performed using STATA software for meta-analysis. Outcome Measures: The primary outcomes were the therapeutic efficacy, median motor nerve conduction velocity (MNCV), median sensory nerve conduction velocity (SNCV), peroneal MNCV and peroneal SNCV. Results: Twenty studies with 1894 DPN patients were included, including 864 patients in the ALA plus epalrestat group, 473 in the ALA group and 557 in the epalrestat group. The efficacy of ALA plus epalrestat combination therapy was superior to ALA and epalrestat monotherapies (RR = 1.29, 95% CI: 1.21–1.38; RR = 1.43, 95% CI: 1.34–1.54, respectively). ALA plus epalrestat combination therapy also significantly improved median MNCV (WMD = 5.41, 95% CI: 2.07–8.75), median SNCV (WMD = 5.87, 95% CI: 1.52–10.22), peroneal MNCV (WMD = 5.59, 95% CI: 2.70–8.47) and peroneal SNCV (WMD = 4.57, 95% CI: 2.46–6.68). Conclusion: ALA plus epalrestat combination therapy was superior to ALA and epalrestat monotherapies for clinical efficacy and nerve conduction velocities in patients with DPN.
机译：目的：评价α-硫辛酸（ALA）加依帕司他联合治疗糖尿病周围神经病变（DPN）的疗效。数据来源：使用PubMed，Medline，Embase，Cochrane图书馆，中国国家知识基础设施，万方数据库和中国生物医学数据库的电子数据库检索了相关研究，而没有语言限制。搜索从每个数据库创建到2016年10月7日进行。关键词为（糖尿病周围神经病或糖尿病神经病或DPN）AND（α-硫辛酸或硫辛酸或硫辛酸）和依帕司他。数据选择：所有符合条件的研究均符合以下纳入标准：（1）比较了在EPNrestat联合ALA联合疗法与Epalrestat或ALA单一疗法治疗DPN患者中的疗效和安全性。 （2）最短治疗时间为2周。 （3）使用世界卫生组织标准化的2型糖尿病和DPN标准诊断DPN患者。 （4）研究至少包含一种可以反映药物疗效和神经传导速度的措施。排除了对照组使用依帕司他或ALA与其他药物合用的研究。使用STATA软件进行统计学分析以进行荟萃分析。结果指标：主要结果是治疗效果，中位运动神经传导速度（MNCV），中位感觉神经传导速度（SNCV），腓骨MNCV和腓骨SNCV。结果：包括20项研究，对1894名DPN患者进行了研究，其中ALA加依帕司他组为864例，ALA组为473例，依帕司他组为557例。 ALA加依帕司他联合疗法的疗效优于ALA和依帕司他单一疗法（分别为RR = 1.29，95％CI：1.21-1.38; RR = 1.43，95％CI：1.34-1.54）。 ALA加依帕司他联合治疗还显着改善了中位MNCV（WMD = 5.41，95％CI：2.07–8.75），中位SNCV（WMD = 5.87，95％CI：1.52–10.22），腓骨MNCV（WMD = 5.59，95％CI ：2.70–8.47）和腓骨SNCV（WMD = 4.57，95％CI：2.46–6.68）。结论：ALA加依帕司他联合疗法在DPN患者的临床疗效和神经传导速度方面优于ALA和依帕司他单一疗法。

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