α-lipoic Acid In The Treatment Of Diabetic Gastroparesis:A Meta-analysis

Objective: To evaluate the effect and the incidence of adverse events in the patients with diabetic gastroparesis by using α-lipoic acid,and to provide the basis for clinical treatment.Methods:1 Medline,Pubmed,China Knowledge Network,Wanfang and Vipu databases were searched to collect relevant literatures about α-lipoic acid in the treatment of diabetic gastroparesis from 2011.01.01~2016.12.31.2 Using Rev.Man 5 software to perform the meta analysis,and draw the forest map.Mean difference(MD)was used as the effect of the measurement data.The odds ratio(OR)was used as the effect of the count data.Results:1 A total of 10 studies were included in the study,and 762 subjects(386 in the experimental group and 376 in the control group)were included in the study,include 10 articles of total effective rate,2 articles of gastric emptying time,4 articles of gastric emptying rate,2 articles of upper abdominal distention,2 articles of belching,2 articles of nausea / vomiting,2 articles of loss of appetite,4 articles of motilin,3 articles of gastrin,6 articles of adverse events;2 The results of the meta-analysis showed:(1)The total effective rate(OR = 3.76,95% CI = 2.54 to 5.57),belching(MD =-0.23,95% CI =-0.35-0.11),loss of appetite(MD =-125.42,95% CI =-138.79 ~-122.05),motilin(MD =-125.42,95% CI =-138.79 to-122.05),gastrin(MD =-18.97,95% CI =-26.96 to-10.98),gastric emptying rate(MD = 13.37,95% CI = 10.18-16.55),gastric emptying time(MD =-1.40,95% CI =-1.88-0.91)in the experimental group which were better than those of the control group;(2)The results of the meta-analysis showed that there was no significant difference between the two groups such as incidence of adverse events(OR = 1.82,95% CI=0.74-4.48),upper abdominal distention(MD =-0.26,95% CI =-0.56-0.04)and nausea / vomiting(MD=-0.11,95%CI=-0.44~0.22).Conclusion:1 The clinical effects of α-lipoic acid combined therapy in the treatment of diabetic gastroparesis was significantly.It can significantly improve gastric emptying rate,shorten the time of gastric emptying in patients with DGP,significantly improve patient belching,loss of appetite and other symptoms.2 α-lipoic acid can significantly enhance the therapeutic effect of gastric motility drugs in the treatment of DGP,which may be related to the regulation of gastrointestinal hormone levels,significantly improve gastric motility in patients with DGP,and thus promote gastric emptying.3 The clinical treatment of α-lipoic acid to DGP has the advantages of good security and less adverse reaction.4 Because of the quality and quantity of literature in this study is limited,the above conclusions still need to carry out more large sample,multi center,rigorously designed,randomized double-blind controlled study to further verify the efficacy and possible mechanism of α-lipoic in the treatment of diabetic gastroparesis.