预防性治疗偏头痛的临床实验中反安慰剂效应的meta分析

发布时间：2018-05-22 08:39

本文选题：偏头痛预防治疗 + 反安慰剂效应　；参考：《重庆医科大学》2014年硕士论文

【摘要】：目的：系统地量化在偏头痛预防性治疗的临床实验中反安慰剂效应的发生率及反安慰剂退出率。方法：应用计算机检索的方法，全面检索偏头痛预防性药物治疗实验的相关文献，汇合成大样本资料，，要求所纳入文献的设计均为安慰剂对照随机临床实验。对所获文献进行筛选、质量评价、提取数据及异质性检验，采用Stata12.0软件对提取的数据进行Meta分析。结果：有24篇文献进入Meta分析，共获得1671例样本。Meta分析结果显示：采用随机效应模型合并统计量，在偏头痛预防性治疗的临床实验中反安慰剂效应发生率为38.0%(95%CI24-52.1%)，反安慰剂退出率为2%(95%CI1.2-2.7%)。分层分析提示抗癫痫药物的反安慰剂效应发生率高于β受体阻滞剂；此外，年龄较小，发表年限更后和更高的Jadad得分都与更高的反安慰剂效应发生率相关。结论：反安慰剂效应在偏头痛的预防治疗中有着巨大的影响。为了进一步研究反安慰剂效应，应考虑设计新的实验方法学。在临床实践中，反安慰剂效应限制了偏头痛的预防性药物的使用。因此，临床医生在告知患者药物的安全信息时应更加重视沟通技巧。
[Abstract]:Aim: to systematically quantify the incidence of anti-placebo effect and the anti-placebo withdrawal rate in clinical trials of migraine prophylaxis. Methods: the related literatures of preventive drug therapy for migraine were searched by computer search method. The data were collected into a large sample. The design of the literature was designed as a placebo controlled randomized clinical trial. The obtained documents were screened, quality evaluated, extracted data and heterogeneity tested, and Meta analysis of the extracted data was carried out with Stata12.0 software. Results: there were 24 articles in Meta analysis. A total of 1671 samples were obtained. The results of Meta-analysis showed that random effect model was used to combine statistics. The incidence of anti-placebo effect in the clinical trial of preventive migraine treatment was 38.0% and 95% CI 24-52.1%, and the withdrawal rate of anti-placebo agent was 2.95% 1.2-2.7%. Stratified analysis showed that the incidence of antiplacebo effect of antiepileptic drugs was higher than that of 尾 receptor blockers, and that younger, older and higher Jadad scores were associated with higher incidence of antiplacebo effects. Conclusion: the anti-placebo effect has a great effect on the prevention and treatment of migraine. In order to further study the anti-placebo effect, new experimental methodology should be considered. In clinical practice, the anti-placebo effect limits the use of preventive drugs for migraine. Therefore, clinicians should pay more attention to communication skills when informing patients about drug safety information.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R747.2

【共引文献】