The Effect Of Duloxetine In The Treatment Of Diabetic Peripheral Neuropathic Pain

Objective:To evaluate the efficacy and safety of duloxetine in the treatment ofdiabetic peripheral neuropathic pain(DPNP).Methods:This study is a randomized, double-blind, placebo-controlledexperiment. We choose31cases of patients with diabetic peripheralneuropathic pain as the observation. The criterion of diagnose to patientsconform to Michigan neuropathy screening scale (MNSI) score≥3points,the average pain of Brief Pain Inventory-Severity (BPI-S)≥4(moderatepain above),but not with depression. The31patients were randomly dividedinto two groups: duloxetine group (n=16) and placebo group (n=15),duloxetine group was treated with duloxetine60mg QD, the placebo groupwas given placebo QD. The treatment of two groups were last for12weeks.Before and during treatment, we follow up the changes of the24hoursaverage pain score, the24hours worst pain score, night average pain score,Brief Pain Inventory (BPI-S, BPI-I), Short Form McGill Pain Questionnaire(SF-MPQ), Clinical Global Impression of Severity (CGI-S), Patient Global Impression of Improvement (PGI-I), and choose the24hour average painscore as the evaluation index of primary efficacy. Meanwhile the adversereactions were followed.Results:Before treatment, there is no statistical significance in the24hoursaverage pain score, the24hours worst pain score, night average pain score,BPI, SF-MPQ and CGI-S (P>0.05). The scores of the24hours averagepain, the worst pain, night average pain, BPI-S, BPI-I, SF-MPQ, PGI-I andCGI-S in duloxetine group were decreased after treatment. Compared to theplacebo group, there were significant difference (P <0.05). Nausea,constipation, dysuria, dizziness, weakness, sweating, diarrhea, headacheand abdominal distension appeared in the duloxetine group, nevertheless,there was only1cases appeared dry mouth symptoms in placebo group.However, the degree of all adverse reactions were ranged from generallymild to moderate, and diminished gradually with the medication time lapse.The function of liver and renal, HbA1c,blood lipid have no significantdifference before and after treatment between two groups (P>0.05). Bothof groups didn’t appear suicidal tendency and depression.Conclusion:Duloxetine improve the pain severity in DPNP, also the quality of lifeimprove significantly.The security of duloxetine is well.