【原】【罂粟摘要】普瑞巴林和加巴喷丁治疗脊髓损伤相关神经性疼痛：一项网络meta分析

普瑞巴林和加巴喷丁治疗脊髓损伤相关神经性疼痛：一项网络meta分析

贵州医科大学 麻醉与心脏电生理课题组

翻译：刘云琴  修改/编辑：佟睿   审校：曹莹

背景

本研究旨在探索普瑞巴林和加巴喷丁对脊髓损伤（SCI）诱发的神经病理性疼痛患者的疗效和安全性，以确定哪种治疗方法最适合此类患者。

方法

我们搜索了从数据库建立到2020年8月31日PubMed、MEDLINE、Embase和Cochrane等图书馆数据库。对纳入的研究进行了质量评估。我们分别选择治疗后的平均疼痛强度和因不良反应而停止治疗的患者比例作为疗效和安全性的结果指标。使用Stata v16.0和RevMan v5.3软件进行统计分析。

结果

我们纳入了八项随机对照试验，研究了四种干预措施（普瑞巴林、加巴喷丁、卡马西平和安达米特林）。根据治疗后的平均疼痛强度，疗效从高到低依次为普瑞巴林、加巴喷丁、阿米替林、卡马西平和安慰剂。根据因不良反应而停止治疗的患者比例，从高到低依次为普瑞巴林、阿米替林、卡马西平、加巴喷丁和安慰剂。此外，有五项研究报道了两种干预(普瑞巴林和加巴喷丁)治疗相关不良反应的总发生率。根据这些研究的汇总分析，治疗相关不良反应的总体发生率从高到低依次为普瑞巴林、加巴喷丁和安慰剂。

结论

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该研究表明，对于SCI相关神经病理性疼痛患者，普瑞巴林对缓解疼痛最有效，而加巴喷丁在与药物治疗相关的安全性方面表现更好。

原始文献来源

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.

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