【原】【罌粟摘要】普瑞巴林和加巴噴丁治療脊髓損傷相關(guān)神經(jīng)性疼痛：一項(xiàng)網(wǎng)絡(luò)meta分析

罌粟花anesthGH 2021-09-19

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普瑞巴林和加巴噴丁治療脊髓損傷相關(guān)神經(jīng)性疼痛：一項(xiàng)網(wǎng)絡(luò)meta分析

貴州醫(yī)科大學(xué) 麻醉與心臟電生理課題組

翻譯：劉云琴修改/編輯：佟睿審校：曹瑩

背景

本研究旨在探索普瑞巴林和加巴噴丁對(duì)脊髓損傷（SCI）誘發(fā)的神經(jīng)病理性疼痛患者的療效和安全性，以確定哪種治療方法最適合此類患者。

方法

我們搜索了從數(shù)據(jù)庫(kù)建立到2020年8月31日PubMed、MEDLINE、Embase和Cochrane等圖書(shū)館數(shù)據(jù)庫(kù)。對(duì)納入的研究進(jìn)行了質(zhì)量評(píng)估。我們分別選擇治療后的平均疼痛強(qiáng)度和因不良反應(yīng)而停止治療的患者比例作為療效和安全性的結(jié)果指標(biāo)。使用Stata v16.0和RevMan v5.3軟件進(jìn)行統(tǒng)計(jì)分析。

結(jié)果

我們納入了八項(xiàng)隨機(jī)對(duì)照試驗(yàn)，研究了四種干預(yù)措施（普瑞巴林、加巴噴丁、卡馬西平和安達(dá)米特林）。根據(jù)治療后的平均疼痛強(qiáng)度，療效從高到低依次為普瑞巴林、加巴噴丁、阿米替林、卡馬西平和安慰劑。根據(jù)因不良反應(yīng)而停止治療的患者比例，從高到低依次為普瑞巴林、阿米替林、卡馬西平、加巴噴丁和安慰劑。此外，有五項(xiàng)研究報(bào)道了兩種干預(yù)(普瑞巴林和加巴噴丁)治療相關(guān)不良反應(yīng)的總發(fā)生率。根據(jù)這些研究的匯總分析，治療相關(guān)不良反應(yīng)的總體發(fā)生率從高到低依次為普瑞巴林、加巴噴丁和安慰劑。

結(jié)論

、

該研究表明，對(duì)于SCI相關(guān)神經(jīng)病理性疼痛患者，普瑞巴林對(duì)緩解疼痛最有效，而加巴噴丁在與藥物治療相關(guān)的安全性方面表現(xiàn)更好。

原始文獻(xiàn)來(lái)源

Davari M ，Amani B ，Amani B ，et al. Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: A systematic review and meta-analysis[J]. The Korean journal of pain, 2020, 33(1):3-12.

Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: A systematic review and meta-analysis

Abstract

Introduction: This study was performed toexplore the efficacy and safety of pregabalin andgabapentin in patients with spinal cord injury(SCI)-induced neuropathic pain to determinewhich treatment is most suitable for suchpatients.

Methods: We searched the PubMed, MEDLINE,Embase, and Cochrane Library databases fromdatabase inception to August 31, 2020. Thequality of the included studies was assessed. Weselected the average pain intensity after treat-ment and the proportion of patients who dis-continued treatment because of adverse effectsas the outcome indicators for efficacy andsafety, respectively. Statistical analyses wereperformed using Stata, v16.0, and RevMan,v5.3, software.

Results: We included eight randomized con-trolled trials that examined four interventions(pregabalin, gabapentin, carbamazepine, andamitriptyline). Based on the average painintensity after treatment, the efficacy orderfrom highest to lowest was pregabalin, gaba-pentin, amitriptyline, carbamazepine, and pla-cebo. Based on the proportion of patients whodiscontinued treatment because of adverseeffects, the order from highest to lowest waspregabalin, amitriptyline, carbamazepine,gabapentin, and placebo. In addition, fivestudies reported the overall incidence of treat-ment-related adverse effects for two interven-tions (pregabalin and gabapentin). According tothe pooled analysis of these studies, the orderfor the overall incidence of treatment-relatedadverse effects from highest to lowest was pre-gabalin, gabapentin, and placebo.

Conclusions: This study revealed that forpatients with SCI-related neuropathic pain,pregabalin was the most effective for relievingpain, whereas gabapentin performed better inaspects associated with drug therapy-related safety.