Evans Jeffery D, Jacobs Tibb F, Evans Emily W
Department of Clinical and Administrative Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA, USA.
Ann Pharmacother. 2008 Nov;42(11):1686-91. doi: 10.1345/aph.1L201. Epub 2008 Oct 21.
To examine the role of acetyl-L-carnitine (ALC) in the treatment of diabetic peripheral neuropathy (DPN).
A MEDLINE search (1966-April 2008) of the English-language literature was performed using the search terms carnitine, diabetes, nerve, and neuropathy. Studies identified were then cross-referenced for their citations.
The search was limited to clinical trials, meta-analyses, and reviews addressing the use of ALC for the treatment of DPN. Studies that included other disease states that could cause peripheral neuropathy were excluded. Two large clinical studies that used ALC for the treatment of DPN were identified. No case studies were identified.
The results from 2 published clinical trials involving 1679 subjects were included. Subjects who received at least 2 g daily of ALC showed decreases in pain scores. One study showed improvements in electrophysiologic factors such as nerve conduction velocities, while the other did not. Patients who had neuropathic pain reported reductions in pain using a visual analog scale. Nerve regeneration was documented in one trial. The supplement was well tolerated. A proprietary form of ALC was used in both studies.
Data on treatment of DPN with ALC support its use. It should be recommended to patients early in the disease process to provide maximal benefit. Further studies should be conducted to determine the effectiveness of ALC in the treatment and prevention of the worsening symptoms of DPN.
探讨乙酰左旋肉碱（ALC）在治疗糖尿病周围神经病变（DPN）中的作用。
利用检索词“肉碱”“糖尿病”“神经”和“神经病变”对1966年至2008年4月的英文文献进行了MEDLINE检索。然后对所识别的研究进行了引文交叉参考。
检索限于针对使用ALC治疗DPN的临床试验、荟萃分析和综述。排除了包括其他可能导致周围神经病变疾病状态的研究。识别出两项使用ALC治疗DPN的大型临床研究。未识别出病例研究。
纳入了两项涉及1679名受试者的已发表临床试验结果。每天接受至少2克ALC的受试者疼痛评分降低。一项研究显示神经传导速度等电生理因素有所改善，而另一项研究则未显示。使用视觉模拟量表，有神经性疼痛的患者报告疼痛减轻。一项试验记录了神经再生情况。该补充剂耐受性良好。两项研究均使用了一种专利形式的ALC。
关于ALC治疗DPN的数据支持其应用。应在疾病早期向患者推荐，以提供最大益处。应进行进一步研究以确定ALC在治疗和预防DPN症状恶化方面的有效性。
