普萘洛尔预防偏头痛疗效及不良反应的Meta分析  

The efficacy and safety of propranolol in migraine prophylaxis:a Meta-analysis

作　　者：郭益邑[1] 韩喜梅[2] 满玉红[1] 于挺敏[1] 

机构地区：[1]吉林大学第二医院神经内科,长春130041 [2]赤峰市医院神经内科

出　　处：《中华临床医师杂志（电子版）》2012年第1期87-90,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的系统评价普萘洛尔与安慰剂及氟桂利嗪对比预防偏头痛的疗效与安全性。方法计算机检索MEDLINE数据库(1988.3～2011.4)、EMBASE(1988.3～2011.4)、Cochrane图书馆(1999.7～2011.4)、CALIS外文期刊网(1988.3～2011.4)、中国期刊全文数据库(CNKI,1988.3～2011.4)及中文科技期刊全文数据库(VIP,1988.3～2011.4),并追索已获文献的参考文献,纳入普萘洛尔与安慰剂或氟桂利嗪比较的随机对照试验(RCT)。由2名研究者独立进行质量评价及数据提取,采用RavMan5.0软件进行Meta分析。结果共纳入6项RCT,合计1173例患者。Meta分析结果显示:普萘洛尔预防治疗偏头痛有效率高于安慰剂(OR=2.13,95%CI1.45～3.14,P=0.0001),与氟桂利嗪相比无统计学差异(OR=0.69,95%CI0.36～1.32,P=0.26)。普萘洛尔的不良反应发生率高于安慰剂(P<0.00001),与氟桂利嗪相当(P=0.81)。结论普萘洛尔预防治疗偏头痛疗效优于安慰剂,与氟桂利嗪相当,不良反应发生率高于安慰剂,与氟桂利嗪相当。受纳入研究的数量及样本量影响,上述结论仍需要更多的随机对照试验进一步验证。Objective To evaluate the efficacy of propranolol versus placebo and flunarizine for migraine prophylaxis.Methods Such databases as The Cochrane Library（1999.7-2011.4）,MEDLINE（1988.3-2011.4）,CALIS（1988.3-2011.4）,CNKI（1988.3-2011.4）and VIP Database（1988.3-2011.4）were searched,and the references of all included studies were also traced.Quality assessment and data extraction were conducted by two reviewers independently.Meta-analysis were conducted by using RevMan 5.0 software.Results A total of 6 RCTs involving 1173 patients were included.The results of meta-analyses showed that the responder rate of propranolol is higher than placebo（OR=2.13,95% CI 1.45-3.14,P=0.0001）,and equal to flunarizine（OR=0.69,95% CI 0.36-1.32,P=0.26）.The rate of adverse events is higher than placebo（P0.00001）,and is similar with flunarizine（P=0.81）.Conclusions As current evidence shows,the efficacy of propranolol for migraine prophylaxis is better than placebo and as good as flunarizine.However,the results should be interpreted with caution because of the quantity and sample size of the included trials.More high quality studies are needed to further prove the results.

关 键 词：普萘洛尔 氟桂利嗪 偏头痛 META分析 预防 

分 类 号：R747.2[医药卫生—神经病学与精神病学]