Department of Neurology, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.
Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.
Nutrients. 2023 Aug 18;15(16):3634. doi: 10.3390/nu15163634.
Alpha-lipoic acid (ALA) was found to improve the symptoms in patients with diabetic sensorimotor peripheral neuropathy (DSPN) by reducing oxidative stress and ameliorating microcirculation. Our meta-analysis is aimed at evaluating the effects of oral-administered ALA versus a placebo in patients with DSPN and determining the optimal dosage for this treatment. We systematically reviewed randomized controlled trials (RCTs) in the PubMed, Embase, and Cochrane databases to determine the efficacy of oral ALA for patients with DSPN. The primary outcome was total symptoms' score (TSS), and secondary outcomes were the neurological disability score (NDS), neuropathy impaired score (NIS), NIS-lower limb (NIS-LL), vibration perception threshold (VPT), nerve conduction study (NCS) results, and global satisfaction. A subgroup analysis of the ALA dosage (600, 1200, and 1800 mg/day) was also conducted. Ten RCTs (1242 patients) were included. ALA treatment produced favorable results for TSS (a dose-related trend was observed), NDS, and the global satisfaction score. For VAS, VPT, NIS-LL, and NCS results, ALA did not produce favorable results. ALA treatment had favorable effects on DSPN by reducing sensory symptoms, and it resulted in a dose-dependent response relative to the placebo for TSS and the global satisfaction score. The use of ALA to prevent neurological symptoms should be further researched.
α-硫辛酸（ALA）通过降低氧化应激和改善微循环，被发现可改善糖尿病感觉运动性周围神经病变（DSPN）患者的症状。我们的荟萃分析旨在评估口服 ALA 与安慰剂在 DSPN 患者中的疗效，并确定这种治疗的最佳剂量。我们系统地检索了 PubMed、Embase 和 Cochrane 数据库中的随机对照试验（RCT），以确定口服 ALA 对 DSPN 患者的疗效。主要结局是总症状评分（TSS），次要结局是神经功能障碍评分（NDS）、神经病变损伤评分（NIS）、NIS-下肢（NIS-LL）、振动感觉阈值（VPT）、神经传导研究（NCS）结果和总体满意度。还对 ALA 剂量（600、1200 和 1800mg/天）进行了亚组分析。纳入了 10 项 RCT（1242 名患者）。ALA 治疗对 TSS（观察到剂量相关趋势）、NDS 和总体满意度评分有较好的疗效。对于 VAS、VPT、NIS-LL 和 NCS 结果，ALA 没有产生较好的疗效。ALA 治疗通过减轻感觉症状对 DSPN 有较好的疗效，与安慰剂相比，TSS 和总体满意度评分呈剂量依赖性反应。应进一步研究 ALA 在预防神经症状方面的作用。
