Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile Departamento de Morfología, Facultad de Medicina.
Universidad Andres Bello, Santiago, Chile.
Medicine (Baltimore). 2023 Nov 3;102(44):e35368. doi: 10.1097/MD.0000000000035368.
This systematic review explores the most current evidence regarding the mechanisms of neuropathic pain in patients with different types of diabetes and how this pain affects different functional and structural components of the neuroanatomical pain pathways. The review also seeks to provide guidelines for the best approach and treatment for patients experiencing this type of pain. The objective is to determine the effectiveness of alpha-lipoic acid (ALA) in improving functional and symptomatic outcomes in patients with diabetes mellitus type I and type II.
To determine the effectiveness of alpha-lipoic acid (ALA) in improving functional and symptomatic outcomes in patients with diabetes mellitus type I and type II.
We systematically search MEDLINE (via PubMed), EMBASE, SCOPUS, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature, and Web of Science databases.
The findings of this review show that different forms of ALA do not present statistically significant changes for any of the scales included, including total symptom score (standardized mean difference [SMD] = -3.59, confidence interval [CI] = -4.16 to -3.02, and P < .00001), neuropathy impairment score (SMD = -1.42, CI = -3.68 to 0.84, and P = .22), and neuropathy symptom checklist (SMD = -0.09, CI = -0.15 to -0.02, and P = .01).
In comparison to the use of a placebo, the findings suggest that ALA does not exhibit significant differences in terms of pain reduction and different functional scales. Moreover, no specific dosages are identified to support the use of ALA for the reduction of neuropathic pain.
本系统评价探讨了不同类型糖尿病患者神经病理性疼痛的最新机制证据,以及这种疼痛如何影响神经解剖疼痛通路的不同功能和结构成分。该综述还旨在为患者提供最佳治疗方法和治疗方案。目的是确定α-硫辛酸(ALA)在改善 1 型和 2 型糖尿病患者的功能和症状结果方面的有效性。
确定 α-硫辛酸(ALA)在改善 1 型和 2 型糖尿病患者的功能和症状结果方面的有效性。
我们系统地检索了 MEDLINE(通过 PubMed)、EMBASE、SCOPUS、Cochrane 对照试验中心注册库、护理与联合健康文献累积索引和 Web of Science 数据库。
本综述的结果表明,不同形式的 ALA 对纳入的任何量表均未呈现出统计学上的显著变化,包括总症状评分(标准化均数差 [SMD] = -3.59,置信区间 [CI] = -4.16 至 -3.02,P <.00001)、神经病变损伤评分(SMD = -1.42,CI = -3.68 至 0.84,P =.22)和神经病变症状检查表(SMD = -0.09,CI = -0.15 至 -0.02,P =.01)。
与使用安慰剂相比,结果表明 ALA 在减轻疼痛和不同功能量表方面没有显著差异。此外,没有确定特定剂量来支持使用 ALA 减轻神经病理性疼痛。