前列腺素E1治療糖尿病周圍神經病變的系統評價_《中國循證醫學雜志》

作者：

李亞 ¹ , 方弟晉 ² , 高霞 ² ,  田浩明 ¹ , 吳泰相 ³

1. 四川大學華西醫院內分泌科（成都 610041） 2. 延安大學附屬醫院（陜西延安 716000） 3.四川大學華西醫院中國循證醫學中心（成都 610041）;

關鍵詞：

糖尿病周圍神經病變前列腺素E1 系統評價

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目的　系統評價前列腺素E1（PGE1）治療糖尿病周圍神經病變（DPN）的療效與安全性。
方法　計算機檢索Cochrane圖書館2006年第1期、PubMed 、EMbase、CNKI、VIP，手工檢索《中華內分泌代謝雜志》、《中華糖尿病雜志》、《新醫學》，收集以PGE1為干預措施治療DPN的隨機對照試驗（RCT），按Cochrane系統評價方法，評價納入研究的方法學質量并提取有效數據進行Meta分析。
結果　共納入了31個RCT，包括2 497例 DPN患者。Meta分析結果顯示，PGE1改善DPN癥狀及體征均優于B族維生素、安慰劑及其它改善微循環藥物，其 RR（95%CI）分別為［RR=1.75，95％CI（1.54，2.00）］、［RR合并=1.57，95％CI（1.42，1.74）］及［RR=1.31，95％CI（1.19，1.45）］。PGE1對DPN神經傳導速度的改善亦優于B族維生素、安慰劑以及其它改善微循環藥物。PGE1不同劑型間比較，前列腺素E1脂微球載體制劑（Lipo-PGE1）較PGE1粉針劑（PGE1-CD）改善自發性疼痛和感覺異常等癥狀更有效［RR=1.43，95％CI（1.16，1.76）］。有16個研究報道了不良反應，結果顯示大多較輕微。
結論　本系統評價結果顯示，較之B族維生素、安慰劑及其他微循環改善藥物，PGE1對改善糖尿病周圍神經病變癥狀、體征及神經傳導速度均有較好療效。在PGE1的劑型選擇上傾向于Lipo-PGE1。但目前收集到的文獻質量較低，若有高質量、大樣本、長期隨訪的研究進一步證實其有效性和安全性，該結論將更可信。

引用本文： 李亞,方弟晉,高霞,田浩明,吳泰相. 前列腺素E1治療糖尿病周圍神經病變的系統評價. 中國循證醫學雜志, 2006, 06(6): 404-415. doi: 復制

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3. 楊斌，徐廣珍，吳麗華等. E1注射液治療糖尿病周圍神經病變的療效觀察. 中國基層醫藥，2002; 9(1) :8~9.
4. 宋文娟，王華，余清等. 凱時治療糖尿病性周圍神經病變臨床研究. 中華綜合醫學，2002；3(2)：116~118.
5. 黃耀忠，胡斌. 前列腺素E1治療糖尿病周圍神經病變35例療效觀察. 廣東醫學，2002；23(9)：980~981.
6. 尤巧英, 李益明, 周麗諾等. 凱時治療糖尿病周圍神經病變臨床研究. 中國新藥雜志，2000；9(7)：471~473.
7. 呂愛玲，阮愛兵. 前列地爾治療糖尿病神經病變33例臨床觀察. 臨床薈萃，2004; 19(8) :459~460.
8. 吳偉瓊，劉偉芳，許美倫等, 凱時與甲鈷胺聯合治療糖尿病周圍神經病變. 河北醫學, 2005.11(5):411~413.
9. 王莉. 前列腺素E1治療糖尿病周圍神經病變的療效觀察. 安徽醫學, 2004; 25(1): 62~64.
10. 黃雌友，姚偉峰. 前列腺素E1治療糖尿病周圍神經病變的效果觀察. 齊齊哈爾醫學院學報, 2002；23(10): 1126~1127.
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12. 王志宏，張萍，沈絢梅等，前列腺素E1治療糖尿病周圍神經病變56例觀察. 中國醫師雜志, 2003,(9) :1287.
13. 譚元菊，安崢. Lipo PGE1對糖尿病周圍神經病變及糖尿病腎病的治療作用. 中日友好醫院學報, 2004; 18(4) 223~226.
14. 譚宗章. 前列腺素E1治療糖尿病周圍神經病變40例療效觀察. 實用神經疾病雜志, 2004;7(6): 78~79.
15. 劉應蘭，肖曉嵐，劉江華等. Lipo- PGE1治療糖尿病周圍神經病變32例. 南華大學學報(醫學版), 29(6):584~585.
16. 郝建平，顏文盛，曾維新等. 前列地爾脂微球載體聯合甲鈷胺治療糖尿病周圍神經病變——附40例報告. 新醫學，2004；35(9):545~547.
17. 徐文華，萬長秀，張漢祥，等. 前列地爾治療糖尿病性周圍神經病變20例. 醫藥導報, 2001; 20(12): 755~756.
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《中國循證醫學雜志》

前列腺素E1治療糖尿病周圍神經病變的系統評價

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《中國循證醫學雜志》

前列腺素E1治療糖尿病周圍神經病變的系統評價

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