度洛西汀和普瑞巴林治疗糖尿病性周围神经病理性疼痛疗效与安全性比较的Meta分析  

Comparison of efficacy and safety between duloxetine and pregabalin in treatment of diabetic peripheral neuropathic pain:a Meta-analysis

作　　者：韩俊萍 田如新 樊碧发[3] 张毅[3] 潘杰[2] 刘莹[1] 赵莉[1] 王晓星[1] 覃旺军[1] HAN Jun-Ping;TIAN Ru-Xin;FAN Bi-Fa;ZHANG Yi;PAN Jie;LIU Ying;ZHAO Li;WANG Xiao-Xing;Qin Wang-Jun(Department of Pharmacy,Beijing 100029,China;Department of Pharmacy,The Second Affiliated Hospital of Soochow University,Jiangsu Province,Suzhou 215004,China;Department of Pain Management,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院药学部,北京100029 [2]苏州大学附属第二医院药剂科,苏州215004 [3]中日友好医院疼痛科,北京100029

出　　处：《中国疼痛医学杂志》2020年第5期357-361,共5页Chinese Journal of Pain Medicine

基　　金：北京市自然科学基金资助项目(7154236)。

摘　　要：目的:比较度洛西汀与普瑞巴林治疗糖尿病性周围神经病理性疼痛(diabetic peripheral neuropathic pain,DPNP)的疗效和安全性。方法:计算机检索PubMed、Cochrane Library、Embase、知网、万方、维普数据库自建库至2019年6月30日发表的关于度洛西汀与普瑞巴林治疗DPNP的随机对照临床试验,采用Revman 5.3软件进行Meta分析。结果:共纳入6项研究,1929例病人。Meta分析结果显示,度洛西汀和普瑞巴林治疗DPNP的疗效差异有统计学意义,疼痛缓解率≥30%(OR=1.53,95%CI:1.23-1.92,P<0.05);疼痛缓解率≥50%(OR=1.48,95%CI:1.17-1.87,P<0.05)。两组不良反应总体发生率无统计学差异(OR=1.13,95%CI:0.83,1.53,P=0.62),但在主要不良反应发生率方面,度洛西汀的恶心呕吐发生率高于普瑞巴林组(OR=3.82,95%CI:1.34,10.84,P=0.01),而两组头晕嗜睡发生率无显著差异。结论:度洛西汀治疗DPNP的疗效优于普瑞巴林,两组不良反应总体发生率无显著差异,但普瑞巴林恶心呕吐发生率低于度洛西汀。Objective:To compare the efficacy and safety of duloxetine versus pregabalin in the treatment of diabetic peripheral neuropathic pain(DPNP).Methods:The databases of Pubmed,Cochrane Library,Embase,CNKI,Wan Fang database and VIP were retrieved for randomized controlled trials(RCT)of duloxetine versus pregabalin in the treatment of DPNP from inception to June 30,2019.Meta-analysis was conducted by using the Revman 5.3 software.Results:A total of 6 articles involving 1929 patients were included.The meta-analysis showed significant difference in the efficacy of duloxetine and pregabalin in the treatment of DPNP[Pain relief rate≥30%(OR=1.53,95%CI:1.23-1.92,P<0.05);Pain relief rate≥50%(OR=1.48,95%CI:1.17-1.87,P<0.05)].There was no statistical difference in the overall incidence of adverse reactions between the two groups(OR=1.13,95%CI:0.83-1.53,P=0.62).In the incidence of major adverse reactions,the incidence of nausea and vomiting of duloxetine was higher than that of pregabalin(OR=3.82,95%CI:1.34,10.84,P=0.01),while there was no significant difference in the rate of dizziness and somnolence.Conclusion:The efficacy of duloxetine is better than that of pregabalin in the treatment of DPNP.There was no significant difference in the overall incidence of adverse reactions between two groups,but the incidence of pregabalin-induced nausea and vomiting was lower than that of duloxetine.

关 键 词：度洛西汀 普瑞巴林 糖尿病性周围神经病理性疼痛 疗效 安全性 META分析 

分 类 号：R587.2[医药卫生—内分泌] R747.9[医药卫生—内科学]