Evidence-based guideline: Treatment of painful diabetic neuropathy

被引：260

作者：

Bril, V. ^{[1
]}

England, J. ^{[2
]}

Franklin, G. M. ^{[3
]}

Backonja, M. ^{[4
]}

Cohen, J. ^{[5
]}

Del Toro, D. ^{[6
]}

Feldman, E. ^{[7
]}

Iverson, D. J. ^{[8
]}

Perkins, B. ^{[1
]}

Russell, J. W. ^{[9
]}

Zochodne, D. ^{[10
]}

机构：

[1] Univ Toronto, Univ Hlth Network, Toronto, ON, Canada

[2] LSU Sch Med, Dept Neurol, New Orleans, LA USA

[3] Univ Washington, Seattle, WA 98195 USA

[4] Univ Wisconsin, Madison, WI USA

[5] Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USA

[6] Med Coll Wisconsin, Dept PM&R, Milwaukee, WI 53226 USA

[7] Univ Michigan, Ann Arbor, MI 48109 USA

[8] Humboldt Neurol Med Grp Inc, Eureka, CA USA

[9] Univ Maryland, Sch Med, Dept Neurol, Baltimore, MD 21201 USA

[10] Univ Calgary, Calgary, AB, Canada

来源：

NEUROLOGY | 2011年 / 76卷 / 20期

关键词：

DOUBLE-BLIND; PERIPHERAL NEUROPATHY; SYMPTOMATIC TREATMENT; SODIUM VALPROATE; CONTROLLED-TRIAL; PLACEBO; PREGABALIN; OXCARBAZEPINE; AMITRIPTYLINE; LACOSAMIDE;

D O I：

10.1212/WNL.0b013e3182166ebe

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: To develop a scientifically sound and clinically relevant evidence-based guideline for the treatment of painful diabetic neuropathy (PDN). Methods: We performed a systematic review of the literature from 1960 to August 2008 and classified the studies according to the American Academy of Neurology classification of evidence scheme for a therapeutic article, and recommendations were linked to the strength of the evidence. The basic question asked was: "What is the efficacy of a given treatment (pharmacologic: anticonvulsants, antidepressants, opioids, others; and nonpharmacologic: electrical stimulation, magnetic field treatment, low-intensity laser treatment, Reiki massage, others) to reduce pain and improve physical function and quality of life (QOL) in patients with PDN?" Results and Recommendations: Pregabalin is established as effective and should be offered for relief of PDN (Level A). Venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, opioids (morphine sulfate, tramadol, and oxycodone controlled-release), and capsaicin are probably effective and should be considered for treatment of PDN (Level B). Other treatments have less robust evidence or the evidence is negative. Effective treatments for PDN are available, but many have side effects that limit their usefulness, and few studies have sufficient information on treatment effects on function and QOL. Neurology (R) 2011;76:1758-1765

引用

页码：1758 / 1765

页数：8

共 40 条

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