Lipoic Acid Combined with Epalrestat versus Lipoic Acid in Treating Diabetic Peripheral Neuropathy:A Meta-analysis.
10.3881/j.issn.1000-503X.2017.05.010
- VernacularTitle:硫辛酸联合依帕司他和硫辛酸治疗糖尿病周围神经病变临床疗效比较的Meta分析
- Author:
Xiao-Tong WANG
1
;
Hai-Xiong LIN
2
;
Shu-Ai XU
3
;
Ying-Kun LU
2
Author Information
1. Shenzhen Bao'an District TCM Hospital Group,the Affiliated Hospital of Guangzhou University of Chinese Medicine,Shenzhen,Guangdong 518133,China.
2. The First School of Clinic Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510405,China.
3. School of Chinese Materia Medica of Guangzhou University of Chinese Medicine,Guangzhou 510006,China.
- Publication Type:Journal Article
- From:
Acta Academiae Medicinae Sinicae
2017;39(5):656-664
- CountryChina
- Language:English
-
Abstract:
Objective To compare the clinical effectiveness of lipoic acid combined with epalrestat versus lipoic acid in treating diabetic peripheral neuropathy(DPN). Methods Randomized controlled trials(RCTs) and clinical controlled trials on lipoic acid versus epalrestat for DPN before February 2016 were searched through five databases:CNKI,CBM,VIP,Wanfang,and PubMed. The quality of the included trials were assessed using Cochrane software and Jadad scores. Data were analyzed with Review Manager 5.3 software. Results Nine studies were included in the analysis. Meta analysis showed that the lipoic aid monotherapy was significantly inferior to lipoic acid-epalerestat combination therapy [RR=0.58,95%Cl(0.47,0.71),P<0.00001]. Inferiority of the lipoic acid monotherapy was also shown in nerve conduction velocity with WMDs of-4.94 [95%Cl(-7.41,-2.46),P<0.0001] for median motor nerve conduction velocity(MNCV),-5.08 [95%Cl(-7.68,-2.49),P=0.0001] for peroneal MNCV,-4.24 [95%Cl(-6.20,-2.29),P<0.0001] for median sensory nerve conduction velocity(SNCV),and-3.66 [95%Cl(-5.02,-2.31),P<0.00001] for peroneal SNCV. Sensitivity analysis showed that the results were robust. However,the included trials were limited by simple design,few subjective indicators,and short follow-up time. Conclusions Lipoic acid combined with epalrestat is better than lipoic acid alone in the treatment of DPN,as well as the MNCV and SNCV of median or peroneal nerve. Due to the low quality of the included studies,high-quality RCTs are warranted to validate the results.
