• 1. 四川大學(xué)華西醫(yī)院內(nèi)分泌科（成都 610041） 2. 延安大學(xué)附屬醫(yī)院（陜西延安 716000） 3.四川大學(xué)華西醫(yī)院中國(guó)循證醫(yī)學(xué)中心（成都 610041）;

目的 　系統(tǒng)評(píng)價(jià)前列腺素E1（PGE1）治療糖尿病周?chē)窠?jīng)病變（DPN）的療效與安全性。
方法 　計(jì)算機(jī)檢索Cochrane圖書(shū)館2006年第1期、PubMed 、EMbase、CNKI、VIP，手工檢索《中華內(nèi)分泌代謝雜志》、《中華糖尿病雜志》、《新醫(yī)學(xué)》，收集以PGE1為干預(yù)措施治療DPN的隨機(jī)對(duì)照試驗(yàn)（RCT），按Cochrane系統(tǒng)評(píng)價(jià)方法，評(píng)價(jià)納入研究的方法學(xué)質(zhì)量并提取有效數(shù)據(jù)進(jìn)行Meta分析。
結(jié)果 　共納入了31個(gè)RCT，包括2 497例 DPN患者。Meta分析結(jié)果顯示，PGE1改善DPN癥狀及體征均優(yōu)于B族維生素、安慰劑及其它改善微循環(huán)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(duì)DPN神經(jīng)傳導(dǎo)速度的改善亦優(yōu)于B族維生素、安慰劑以及其它改善微循環(huán)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(fā)性疼痛和感覺(jué)異常等癥狀更有效［RR=1.43，95％CI（1.16，1.76）］。有16個(gè)研究報(bào)道了不良反應(yīng)，結(jié)果顯示大多較輕微。
結(jié)論 　本系統(tǒng)評(píng)價(jià)結(jié)果顯示，較之B族維生素、安慰劑及其他微循環(huán)改善藥物，PGE1對(duì)改善糖尿病周?chē)窠?jīng)病變癥狀、體征及神經(jīng)傳導(dǎo)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(xiàn)質(zhì)量較低，若有高質(zhì)量、大樣本、長(zhǎng)期隨訪的研究進(jìn)一步證實(shí)其有效性和安全性，該結(jié)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?chē)窠?jīng)病變的系統(tǒng)評(píng)價(jià). 中國(guó)循證醫(yī)學(xué)雜志, 2006, 06(6): 404-415. doi: 復(fù)制

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  1. 1. 譚元菊，安崢. 前列地爾治療糖尿病性周?chē)窠?jīng)病變的臨床研究. 中國(guó)醫(yī)院用藥評(píng)價(jià)與分析，2004；4(3) :175~177.
  2. 2. 劉玉春，向光大，樂(lè)嶺等. 前列腺素E1對(duì)糖尿病周?chē)窠?jīng)病變的療效觀察. 中國(guó)綜合臨床，2000；6(16) :427~428.
  3. 3. 楊斌，徐廣珍，吳麗華等. E1注射液治療糖尿病周?chē)窠?jīng)病變的療效觀察. 中國(guó)基層醫(yī)藥，2002; 9(1) :8~9.
  4. 4. 宋文娟，王華，余清等. 凱時(shí)治療糖尿病性周?chē)窠?jīng)病變臨床研究. 中華綜合醫(yī)學(xué)，2002；3(2)：116~118.
  5. 5. 黃耀忠，胡斌. 前列腺素E1治療糖尿病周?chē)窠?jīng)病變35例療效觀察. 廣東醫(yī)學(xué)，2002；23(9)：980~981.
  6. 6. 尤巧英, 李益明, 周麗諾等. 凱時(shí)治療糖尿病周?chē)窠?jīng)病變臨床研究. 中國(guó)新藥雜志，2000；9(7)：471~473.
  7. 7. 呂愛(ài)玲，阮?lèi)?ài)兵. 前列地爾治療糖尿病神經(jīng)病變33例臨床觀察. 臨床薈萃，2004; 19(8) :459~460.
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