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普瑞巴林治疗脊髓损伤后神经病理性疼痛的疗效和安全性:一项随机对照试验的综述和荟萃分析。

Efficacy and Safety of Pregabalin in Neuropathic Pain Followed Spinal Cord Injury: A Review and Meta-Analysis of Randomized Controlled Trials.

机构信息

Department of Orthopaedics.

Postdoctoral Workstation, Zhongshan Hospital of Dalian University, Dalian.

出版信息

Clin J Pain. 2019 Mar;35(3):272-278. doi: 10.1097/AJP.0000000000000675.

Abstract

OBJECTIVE

Pregabalin has been approved for the treatment of the neuropathic pain following spinal cord injury (SCI). We performed a systemic review and meta-analysis of randomized, controlled, multicenter trials to evaluate the efficacy and safety of pregabalin for SCI-induced neuropathic pain.

MATERIALS AND METHODS

Research searching was performed in PubMed and EMBASE databases and the Cochrane library in May 2018. Clinical controlled trials using pregabalin for the pain treatment following SCI in adults (18 y old and above) were included. Pain and safety-related adverse events were considered as outcomes. Meta-analysis was conducted using Revman 5.0 software.

RESULTS

Five publications (pregabalin, patients=261, placebo, patients=216) were included in our study. After at least 4-week's treatment with pregabalin (flexible dose, 150 to 600 mg/d), pregabalin-treated patients showed reduced pain -1.54, 95% confidence interval (CI) (-2.33, -0.75), P=0.0001; improved >30% 1.83, 95% CI (1.37, 2.46), P<0.0001 and >50% pain relief 2.40, 95% CI (1.53, 3.77), P=0.0001; increased adverse events 1.36, 95% CI (1.18, 1.577), P<0.0001; and reduced Hospital Anxiety and Depression Scale - anxiety -1.50, 95% CI (-2.99, -0.00), P=0.05 and - depression -0.34, 95% CI (-0.55, -0.12), P=0.002 scores compared with placebo-treated patients. Stratified meta-analysis showed there was no difference in primary adverse events (drowsiness, dizziness, peripheral edema, and dry mouth) between pregabalin and placebo groups (P≥0.05).

CONCLUSIONS

Our results showed pregabalin was efficacious and might be safe treatment for chronic pain followed SCI.

摘要

目的

普瑞巴林已被批准用于治疗脊髓损伤(SCI)后的神经性疼痛。我们对随机、对照、多中心试验进行了系统评价和荟萃分析,以评估普瑞巴林治疗 SCI 后神经性疼痛的疗效和安全性。

材料和方法

2018 年 5 月,在 PubMed、EMBASE 数据库和 Cochrane 图书馆中进行了研究检索。纳入了使用普瑞巴林治疗成人(18 岁及以上)SCI 后疼痛的临床对照试验。将疼痛和安全性相关的不良事件作为结局进行评估。使用 Revman 5.0 软件进行荟萃分析。

结果

我们的研究纳入了 5 项研究(普瑞巴林,患者=261 例;安慰剂,患者=216 例)。在接受至少 4 周普瑞巴林(灵活剂量,150 至 600mg/d)治疗后,普瑞巴林治疗组患者的疼痛减轻了-1.54,95%置信区间(CI)(-2.33,-0.75),P=0.0001;疼痛缓解>30%的比例为 1.83,95%CI(1.37,2.46),P<0.0001;疼痛缓解>50%的比例为 2.40,95%CI(1.53,3.77),P=0.0001;不良事件增加 1.36,95%CI(1.18,1.577),P<0.0001;汉密尔顿焦虑量表的焦虑评分降低-1.50,95%CI(-2.99,-0.00),P=0.05;抑郁评分降低-0.34,95%CI(-0.55,-0.12),P=0.002,与安慰剂组相比。分层荟萃分析显示,普瑞巴林组与安慰剂组在主要不良事件(嗜睡、头晕、外周水肿和口干)方面无差异(P≥0.05)。

结论

我们的研究结果表明,普瑞巴林治疗 SCI 后慢性疼痛有效,可能是一种安全的治疗方法。

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