摘要
目的:应用Meta分析的方法系统评价加巴喷丁联合用药治疗卒中后中枢神经痛(Center Post-stroke Pain,CPSP)的临床有效性与安全性。方法:计算机检索中国知网(CNKI)、万方数据库(WANFANG)、维普期刊数据库(VIP)、中国生物医学文献数据库(CBM)、Pub Med、Embase、Web of Science、Cochrane Library,以及中国临床实验注册中心、美国临床实验注册中心,检索各数据库建库起至2022年3月的所有文献。将符合纳入标准和排除标准的文献数据收集,根据Cochrane系统评价手册(5.1.0版)进行质量评价,应用Review Manager 5.4.1软件进行Meta分析。结果:共纳入7篇文献进行Meta分析,包含405例患者,其中试验组202例,对照组203例。结果显示,加巴喷丁联合用药的有效率高于单用加巴喷丁[比值比(Odds Ratio,OR)=4.50,95%置信区间(Confidence Interval,CI)为(2.60,7.79),Z=5.38,P<0.00001)];对视觉模拟评分法(Visual Analogue Scale,VAS)评分的分析结果显示加巴喷丁联合用药较单用药加巴喷丁能更好地缓解疼痛[均数差(Mean Difference,MD)=-1.14,95%CI为(-1.41,-0.88),Z=8.51,P<0.00001)];安全性Meta分析结果显示加巴喷丁联合用药与单用加巴喷丁在安全性的比较上无明显差异[OR=1.32,95%CI为(0.73,2.38),Z=0.91,P=0.36>0.05)]。选取有效率为指标绘制漏斗图,显示漏斗图基本对称,提示纳入的研究存在发表偏倚的可能性较小。结论:加巴喷丁联合用药治疗CPSP有较好的有效性与安全性。
Objective:To systematically evaluate the clinical efficacy and safety of gabapentin combined therapy in the treatment of poststroke central neuralgia by meta-analysis.Methods:Computer retrieval of China National Knowledge Infrastructure,WANFANG Database,VIP Journal Database,China Biomedical Literature Database,PubMed,Embase,Web of Science,Cochrane Library,and the Chinese Clinical Trial Registry and the United States Clinical Trial Registry was made.All literature from the establishment of each database to March 2022 was searched.Data of literature met inclusion and elimination criteria was collected,quality evaluation was performed according to Cochrane Systematic Review Manual(5.1.0 edition),and a meta-analysis was performed using Review Manager 5.4.1 software.Results:A total of 7 articles were included for the meta-analysis,with 405 patients,including 202 in the experimental group and 203 in the control group.The results showed that the effective rate of gabapentin combined therapy was higher than that of gabapentin alone(OR=4.50,95%CI was[2.60,7.79],Z=5.38,P<0.00001);the analysis of VAS score showed that gabapentin combined therapy was more effective than gabapentin alone.Gabapentin alone can better relieve pain(MD=-1.14,95%CI[-1.41,-0.88],Z=8.51,P<0.00001).The safety meta-analysis showed that there was no significant difference in safety between gabapentin combined therapy and gabapentin alone(OR=1.32,95%CI[0.73,2.38],Z=0.91,P=0.36>0.05).The efficiency was selected as the index to draw a funnel plot,which showed that the funnel plot was basically symmetrical,indicating that the included studies were less likely to have publication bias.Conclusion:Gabapentin combined therapy has good efficacy and safety in the treatment of poststroke central neuralgia.
作者
严卫勤
张祯慧
王琦
李小军
YAN Weiqin;ZHANG Zhenhui;WANG Qi;LI Xiaojun
出处
《中医临床研究》
2023年第15期78-83,共6页
Clinical Journal Of Chinese Medicine
