度洛西汀改善膝骨性关节炎疼痛症状有效性和安全性的Meta分析

目的:系统评价度洛西汀改善膝骨性关节炎(KOA)疼痛症状的有效性和安全性,为临床治疗KOA提供循证参考。方法:计算机检索PubMed、Embase、Medline、Cochrane Library、中国知网、维普网和万方数据库中发表的度洛西汀(试验组)对比安慰剂(对照组)改善KOA疼痛症状的随机对照试验(RCT),检索时限为建库起至2019年9月。对符合纳入标准的文献进行资料提取,并采用Cochrane系统评价员手册5.1.0进行质量评价后,采用Stata 14.0软件对膝关节的西安大略麦马斯特大学骨关节炎指数可视化量表(WOMAC)总分、WOMAC疼痛评分、WOMAC僵硬程度评分、WOMAC功能评分、简明疼痛评估量表(BPI-S)评分以及口干、嗜睡、恶心等不良反应发生率进行Meta分析。结果:共纳入6项RCT,合计2 059例患者。Meta分析结果显示,试验组患者WOMAC总分[MD=-0.34,95%CI(-0.48,-0.20),P<0.05]、WOMAC疼痛评分[MD=-0.41,95%CI(-0.54,-0.29),P<0.05]、WOMAC僵硬程度评分[MD=-...

Efficacy and Safety of Duloxetine in the Improvement of Pain Symptoms of Knee Osteoarthritis:A Meta-analysis

OBJECTIVE:To systematically evaluate the efficacy and safety of duloxetine in the improvement of pain symptoms of knee osteoarthritis(KOA),and to provide evidence-based reference for clinical treatment of KOA.METHODS:Retrieved from PubMed,Embase,Medline,Cochrane Library,CNKI,VIP and Wanfang database,during the establishment of the database to Sept.2019,RCTs about duloxetine(trial group)vs.placebo(control group)in the improvement of pain symptoms of KOA were collected.After data extraction and quality evaluation using Cochrane system evaluator’s manual 5.1.0,Meta-analysis was performed by using Stata 14.0 software for WOMAC total score,WOMAC pain score,WOMAC stiffness score,WOMAC function score and BPI-S score,as well as the incidence of adverse reaction such as dry mouth,somnolence and nausea.RESULTS:A total of 6 RCTs were included,involving 2059 patients.Meta-analysis results showed that WOMAC total score[MD=-0.34,95%CI(-0.48,-0.20),P<0.05],WOMAC pain score[MD=-0.41,95%CI(-0.54,-0.29),P<0.05],WOMAC stiffness score[MD=-0.24,95%CI(-0.37,-0.12),P<0.05],WOMAC function score[MD=-0.43,95%CI(-0.55,-0.31),P<0.05],BPI-S score[MD=-0.38,95%CI(-0.48,-0.28),P<0.05]of trial group were significantly lower than those of control group;the incidence of dry mouth[RR=3.55,95%CI(2.00,6.29),P<0.05],somnolence[RR=3.23,95%CI(1.88,5.54),P<0.05]and nausea[RR=6.95,95%CI(2.99,16.15),P<0.05]in trial group were significantly higher than control group,with significant difference.CONCLUSIONS:Duloxetine can relieve the pain and improve knee function in patients with KOA,but it is necessary to pay attention to its adverse reactions.