普瑞巴林治疗带状疱疹后神经痛的效果:Meta分析

目的 采用Meta分析评价普瑞巴林治疗带状疱疹后神经痛的效果.方法 检索Medline、Web of Science、Cochrane Library、万方和CNKI等数据库,检索时间从1966年1月至2010年12月.收集普瑞巴林治疗带状疱疹后神经痛的随机安慰剂对照研究.采用改良Jadad法评价文献质量.以治疗8周时数字疼痛评分(NRS评分)、镇痛有效率和不良反应发生率为评价指标.采用Review Manager 4.2软件进行Meta分析.结果 共纳入4项研究,包括1024例患者.4项研究的Jadad评分均≥4分.分为安慰剂组和普瑞巴林组.与安慰剂组比较,普瑞巴林150、300和600 mg/d组NRS评分降低,镇痛有效率升高(P＜0.05).普瑞巴林300.mg/d组与150mg/d组间NRS评分及镇痛有效率比较差异无统计学意义(P＞0.05)；普瑞巴林600 mg/d组NRS评分低于300 mg/d组(P＜0.05),而镇痛有效率比较差异无统计学意义(P＞0.05).普瑞巴林常见不良反应为头晕、嗜睡、水肿和头痛等,以轻、中度为主,不良反应发生与剂量有关.结论 普瑞巴林治疗带状疱疹后神经痛的效果好,且安全性良好,但是减轻疼痛的效果不呈剂量依赖性.

Efficacy of pregabalin in patients with posst-herpetic neuralgia: a meta-analysis

Objective To systematically review the efficacy of pregabalin in patients with post-herpetic neuralgia.Methods A comprehensive search was undertaken to identify all randomized placebo-controlled trials of pregabalin in patients with post-herpetic neuralgia.Medline,Web of Science,Cochrane Library,Wanfang Database and CNKI were searched from January 1966 up to December 2008.The modified Jadad scale was used for quality assessment.Numerical rating scale ( NRS),effective analgesia rate and the incidence of adverse effects were taken as main outcomes.Meta-analysis was conducted using the Cochrane Collaboration Review Manager 4.2 software.Results A total of four studies involving 1024 patients were included in this meta-analysis.The modified Jadad scale scores for the 4 studies were ≥ 4.The NRS scores were significantly lower,while effective analgesia rate was higher in groups 150,300,600 mg/d than placebo-controlled group (P ＜ 0.05).There were no significant differences in NRS scores and effective analgesia rate between 150 mg/d and 300 mg/d groups.The NRS scores were significantly lower in 600 mg/d group than in 300 mg/d group,but there were no significant differences in effective analgesia rate between 600 mg/d and 300 mg/d groups.The most frequent adverse effects were dizziness,somnolence,peripheral edema,and headache.Most of the adverse effects were mild or moderate in intensity.The occurrence of adverse effects appeared to be dose-related.Conclusion Pregabalin is effective and safe in patients with post-herpetic neuralgia,but the efficacy of reducing pain is not a dose-dependent manner.