对比普瑞巴林和加巴喷丁治疗带状疱疹后遗神经痛疗效和安全性的Meta分析
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摘要
比较在中国患者中普瑞巴林与加巴喷丁治疗带状疱疹后遗神经痛临床的疗效和安全性。计算机检索Pub Med、CNKI、万方、维普数据库中关于普瑞巴林与加巴喷丁治疗带状疱疹后遗神经痛在中国患者的临床随机对照试验,检索时间为建库至2018年7月,由两个研究人员根据纳入和排除标准独立筛选文献、提取资料和进行数据处理,应用Rev Man 5.3软件进行Meta分析。共纳入12篇文献、1054例患者。Meta分析结果显示,治疗效果:带状疱疹后遗神经痛的患者服用普瑞巴林或加巴喷丁后,比较患者每日疼痛指数(WMD=0.92 mmHg,95%CI:0.69～1.14,P<0.000 01),组间数据差异有统计学意义,发现普瑞巴林组的镇痛效果要优于加巴喷丁组;比较普瑞巴林组和加巴喷丁组治疗的有效例数(RR=1.22,95%CI:1.12～1.33,P<0.000 01),组间数据差异有统计学意义,普瑞巴林组的有效患者例数大于加巴喷丁组;比较患者24 h睡眠时间改善情况(WMD=0.29 mmHg,95%CI:-0.13～0.71,P=0.17)(1 mmHg=0.133 kPa),两组间数据差异无统计学意义。从上述几组的比较发现,在治疗效果方面,普瑞巴林要优于加巴喷丁。安全性方面,普瑞巴林组比较加巴喷丁组不良反应的发生例数(RR=0.80,95%CI:0.62～1.02,P=0.07)组间数据差异无统计学意义。当前证据表明,普瑞巴林在治疗带状疱疹后遗神经痛疗效方面要优于加巴喷丁,在安全性方面结果没有统计学意义,还需要更多的研究加以明确。
Objective:To compare the efficacy and safety of pregabalin versus gabapentin in the treatment of post-herpetic neuralgia in Chinese patients.Methods:The databases of Pub Med,CNKI,CBM,Wan Fang and VP were retrieved with computer for randomized controlled trials(RCT) of pregabalin versus gabapentin in the treatment of post-herpetic neuralgiain Chinese patients.The retrieval time was from the setting up of the databases to July 2018.Two researchers selected the documents,extracted the data and carried out the data processing according to the inclusion and exclusion criteria,and a Metaanalysis was conducted by using the Rev Man 5.3 software.Results:A total of 12 articles involving 1054 patients were included.Treatment effect:patients with post-herpetic neuralgia after taking pregabalin or gabapentin were compared with the daily pain index(WMD=0.92 mmHg,95%CI:0.69-1.14,P<0.000 01) and the difference between the groups was statistically significant;compared with the number of effective cases(RR=1.22,95%CI:1.12-1.33,P<0.000 01) and the difference between the groups was statistically significant;compared with the 24 hours of sleep time in patients(WMD=0.29 mmHg,95%CI:-0.13-0.71,P=0.17) and there was no statistically significant difference between the groups.Safety:there was no statistically significant difference between the pregabalin and gabapentin groups(RR=0.80,95%CI:0.62-1.02,P=0.07).Conclusion:Current evidence suggests that pregabalin is better than gabapentin in the treatment of post-herpetic neuralgia with similar safety,and more data are needed for study.
Objective:To compare the efficacy and safety of pregabalin versus gabapentin in the treatment of post-herpetic neuralgia in Chinese patients.Methods:The databases of Pub Med,CNKI,CBM,Wan Fang and VP were retrieved with computer for randomized controlled trials(RCT) of pregabalin versus gabapentin in the treatment of post-herpetic neuralgiain Chinese patients.The retrieval time was from the setting up of the databases to July 2018.Two researchers selected the documents,extracted the data and carried out the data processing according to the inclusion and exclusion criteria,and a Metaanalysis was conducted by using the Rev Man 5.3 software.Results:A total of 12 articles involving 1054 patients were included.Treatment effect:patients with post-herpetic neuralgia after taking pregabalin or gabapentin were compared with the daily pain index(WMD=0.92 mmHg,95%CI:0.69-1.14,P<0.000 01) and the difference between the groups was statistically significant;compared with the number of effective cases(RR=1.22,95%CI:1.12-1.33,P<0.000 01) and the difference between the groups was statistically significant;compared with the 24 hours of sleep time in patients(WMD=0.29 mmHg,95%CI:-0.13-0.71,P=0.17) and there was no statistically significant difference between the groups.Safety:there was no statistically significant difference between the pregabalin and gabapentin groups(RR=0.80,95%CI:0.62-1.02,P=0.07).Conclusion:Current evidence suggests that pregabalin is better than gabapentin in the treatment of post-herpetic neuralgia with similar safety,and more data are needed for study.
引文
[1]周凤坤,明少鹏.普瑞巴林、加巴喷丁、卡马西平治疗带状疱疹后神经痛的疗效比较[J].实用疼痛学杂志,2015,11(4):261-4.
[2]唐晓辉,王敏.普瑞巴林与加巴喷丁治疗带状疱疹后神经痛的疗效与安全性对比[J].中国实用神经疾病杂志,2012,15(23):15-7.
[3]樊莎莎,潘卫利.普瑞巴林与加巴喷丁治疗带状疱疹神经痛的疗效比较[J].现代实用医学,2013,25(8):883-95.
[4]唐燕,曾嘉泳,范秀针,等.加巴喷丁与普瑞巴林治疗带状疱疹后神经痛的效果对比研究[J].中国实用医药,2016,11(19):144-5.
[5]龚宇花,张俊鹏.普瑞巴林治疗带状疱疹后遗神经痛的临床观察[J].临床药学工程,2014,21(5):587-8.
[6]幸泽艇,王梅,郭余福,等.普瑞巴林和加巴喷丁辅助性治疗带状疱疹后神经痛的临床研究[J].临床麻醉学杂志,2013,29(2):117-20.
[7]李文举,张树丽,李亦梅,等.低剂量普瑞巴林与加巴喷丁治PHN的对比研究[J].新疆医学,2017,47(3):340-2.
[8]熊东林,杨娟,罗裕辉,等.普瑞巴林治疗带状疱疹后神经痛的临床观察[J].中国医学工程,2011,19(7):62-4.
[9]郑虹,冯晶,马丹.3种非阿片类止痛类药对带状疱疹后遗神经痛的疗效及不良反应的探讨[J].医院药学,2015,13(4):33-4.
[10]沈轲,周君,唐风云,等.普瑞巴林治疗带状疱疹后神经痛的临床疗效观察[J].海峡药学,2013,25(3):134-5.
[11]李京霞,汤芹芹,刘东,等.加巴喷丁与普瑞巴林治疗带状疱疹后神经痛的效果比较[J].实用医院临床杂志,2012,9(5):150-2.
[12]郭志毅,黄盛辉,敖兴亮,等.普瑞巴林与加巴喷丁治疗带状疱疹后期神经痛[J].西北药学杂志,2015,30(3):299-301.
[13]于生元,万有,万琪,等.带状疱疹后神经痛诊疗中国专家共识[J].中国疼痛医学杂志,2016,22(3):161-7.
[14]高辉.普瑞巴林和加巴喷丁辅助陛治疗带状疱疹后神经痛的临床研究[J].国际医药卫生导报,2014,20(6):837-41.
[15]Rosenstock J,Tuchman M,Moreanx L,et al.Pregabalin for the treatment of painfol diabetic peripheral neuropa a double blind,placebo-controlled trial[J].Pain,2005,110(3):628-38.
[16]Zaccara G,Gangemi P,Perucca P,et al.The adverse event profile of pregabalin:a systematic review and meta-analysis of randomized controlled trials[J].Epilepsia,2011,52(4):826-36.
[2]唐晓辉,王敏.普瑞巴林与加巴喷丁治疗带状疱疹后神经痛的疗效与安全性对比[J].中国实用神经疾病杂志,2012,15(23):15-7.
[3]樊莎莎,潘卫利.普瑞巴林与加巴喷丁治疗带状疱疹神经痛的疗效比较[J].现代实用医学,2013,25(8):883-95.
[4]唐燕,曾嘉泳,范秀针,等.加巴喷丁与普瑞巴林治疗带状疱疹后神经痛的效果对比研究[J].中国实用医药,2016,11(19):144-5.
[5]龚宇花,张俊鹏.普瑞巴林治疗带状疱疹后遗神经痛的临床观察[J].临床药学工程,2014,21(5):587-8.
[6]幸泽艇,王梅,郭余福,等.普瑞巴林和加巴喷丁辅助性治疗带状疱疹后神经痛的临床研究[J].临床麻醉学杂志,2013,29(2):117-20.
[7]李文举,张树丽,李亦梅,等.低剂量普瑞巴林与加巴喷丁治PHN的对比研究[J].新疆医学,2017,47(3):340-2.
[8]熊东林,杨娟,罗裕辉,等.普瑞巴林治疗带状疱疹后神经痛的临床观察[J].中国医学工程,2011,19(7):62-4.
[9]郑虹,冯晶,马丹.3种非阿片类止痛类药对带状疱疹后遗神经痛的疗效及不良反应的探讨[J].医院药学,2015,13(4):33-4.
[10]沈轲,周君,唐风云,等.普瑞巴林治疗带状疱疹后神经痛的临床疗效观察[J].海峡药学,2013,25(3):134-5.
[11]李京霞,汤芹芹,刘东,等.加巴喷丁与普瑞巴林治疗带状疱疹后神经痛的效果比较[J].实用医院临床杂志,2012,9(5):150-2.
[12]郭志毅,黄盛辉,敖兴亮,等.普瑞巴林与加巴喷丁治疗带状疱疹后期神经痛[J].西北药学杂志,2015,30(3):299-301.
[13]于生元,万有,万琪,等.带状疱疹后神经痛诊疗中国专家共识[J].中国疼痛医学杂志,2016,22(3):161-7.
[14]高辉.普瑞巴林和加巴喷丁辅助陛治疗带状疱疹后神经痛的临床研究[J].国际医药卫生导报,2014,20(6):837-41.
[15]Rosenstock J,Tuchman M,Moreanx L,et al.Pregabalin for the treatment of painfol diabetic peripheral neuropa a double blind,placebo-controlled trial[J].Pain,2005,110(3):628-38.
[16]Zaccara G,Gangemi P,Perucca P,et al.The adverse event profile of pregabalin:a systematic review and meta-analysis of randomized controlled trials[J].Epilepsia,2011,52(4):826-36.