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

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（DPNP）的疗效和安全性。方法：计算机检索PubMed、Medline、Cochrane Library、Embase、知网、万方、维普数据库自建库至2019年7月31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7项研究，1977例患者。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]）。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= 4.00，95% CI：1.55，10.32，P=0.004]，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，但普瑞巴林恶心呕吐发生率低于度洛西汀。

Abstract:

Objective: To compare the efficacy and safety of duloxetine versus pregabalin in treatment of diabetic peripheral neuropathic pain(DPNP). Methods: The databases of Pubmed, Medline, Cochrane Library, Embase, CNKI, Wan Fang database and VIP were retrieved for randomized controlled trials (RCT) of duloxetine versus pregabalin in treatment of DPNP from inception to July 31, 2019. Meta-analysis was conducted by using the Revman 5.3 software. Results: A total of 7 articles involving 1977 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]). In the incidence of major adverse reactions, the difference between duloxetine and pregabalin at the aspect of the rate of nausea and vomitting was statistically significant[OR= 4.00，95% CI：1.55，10.32，P=0.004], while there is no significant difference in the rate of dizziness and somnolence. Conclusion: The efficacy of duloxetine is better than pregabalin in the treatment of DPNP, but the incidence of pregabalin induced nausea and vomitting was lower than duloxetine.