带状疱疹后遗神经痛危险因素的Meta分析

Meta-analysis of risk factors for postherpetic neuralgia

摘要:

目的 系统评价带状疱疹后遗神经痛的危险因素。方法 检索PubMed、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库(Wanfang)以及维普信息资源系统(VIP)中建库至2018年9月发表的相关文献,由2名研究员独立按照纳入与排除标准筛选文献、提取数据及质量评价后,采用RevMan5.3软件进行Meta分析。结果 最终纳入文献21篇。Meta分析显示,年龄、情绪状态、前驱痛、皮损面积、急性期疼痛程度、基础疾病、初治时间为带状疱疹后遗神经痛的危险因素,早期小剂量使用激素是其保护因素,各因素分析合并OR值及95%CI分别为5.54(4.21~7.29)、5.49(2.92~10.32)、3.99(2.46~6.48)、6.41(1.76~23.34)、6.04(3.22~11.33)、4.30(3.14~5.89)、2.44(1.85~3.22)、0.34(0.19~0.62)。结论 年龄、情绪状态、前驱痛、皮损面积、急性期疼痛程度、基础疾病、初治时间为带状疱疹后遗神经痛的危险因素,早期小剂量使用激素是其保护因素。

Abstract:

Objective To systematically review the risk factors for postherpetic neuralgia. Methods We electronically searched databases including Pubmed, CNKI, VIP, CBM and WanFang Date from inception to September 30_^th 2018, to collect studies about the risk factors for postherpetic neuralgia. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using RevMan 5.3 and Stata 14.0 software. Results A total of 21 studies were included. The results of meta-analysis showed that factors as: age, mood, precursory pain, area of the lesion, the degree of pain during the acute phase, underlying disease, duration of primary treat and combination of small dose steroids were associated with the incidence of PHN, the pooled OR values and 95%CI were 5.54(4.21~7.29), 5.49(2.92~10.32), 3.99(2.46~6.48), 6.41(1.76~23.34), 6.04(3.22~11.33), 4.30(3.14~5.89), 2.44(1.85~3.22), 0.34(0.19~0.62) respectively. Conclusion Eight risk factors including age, mood, precursory pain, area of the lesion, the degree of pain during the acute phase, underlying disease, duration of primary treat were associated with the incidence of PHN, while combination of small dose steroids was protect factor on the contrary .