目的 評價加巴噴丁治療糖尿病性周圍神經(jīng)痛的有效性和安全性.方法 采用循證醫(yī)學(xué)的文獻(xiàn)分析評價方法,計算機檢索Cochrane圖書館系統(tǒng)評價數(shù)據(jù)庫、Pubmed、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫等,采用RevMan5.2軟件進(jìn)行Meta分析.結(jié)果 納入研究12項,共931例患者,Meta分析顯示加巴噴丁反應(yīng)有效率[OR=2.99,95%CI(1.72,5.20),P <0.000 1]及不良反應(yīng)發(fā)生率[OR=4.05,95%CI(1.10,14.95),P=0.04]均高于安慰劑,加巴噴丁治療效果高于卡馬西平/奧卡西平[OR=3.60,95%CI(1.14,11.31),P=0.03]和維生素B₁₂,而不良反應(yīng)則較卡馬西平輕;加巴噴丁與度洛西汀、普瑞巴林比較,治療效果相當(dāng),但度洛西汀[OR=2.06,95%CI(1.22,3.48),P=0.007]和普瑞巴林的不良反應(yīng)較少.結(jié)論 加巴噴丁治療糖尿病性周圍神經(jīng)痛效果顯著,安全性較好.

Objective To compare the effects and safety of gabapentin for the treatment of diabetic peripheral neuropathic pain. Methods Cochrane library, MEDLINE, Embase, PUBMED, CNKI, VIP database, and Wanfang database were searched. The Meta-analysis was performed by RevMan5.2. Results Twelve studies were included (n = 931). The analysis indicated that there were significant differences between gabapentin and placebo in respondent rate [OR = 2.99, 95%CI (1.72, 5.20), P <0.000 1]. The adverse event rate is higher treated with gabapentin than that with placebo [OR = 4.05, 95%CI (1.10, 14.95), P = 0.04]. Compared with carbamazepine/oxcarbazepine, the efficacy of gabapentin is similar while adverse event rate is lower [OR = 3.60, 95%CI(1.14, 11.31), P = 0.03]. There were similar efficacy and safety between gabapentin and amitriptyline, duloxetine and pregabalin, but the adverse event rate of gabapentin is lower than amitriptyline [OR = 2.06, 95%CI(1.22, 3.48), P = 0.007] and higher than duloxetine and pregabalin. Conclusion With superior effects and similar safety, gabapentin may be preferred for the patients with diabetic peripheral neuropathic pain.