夫罗曲坦治疗月经期偏头痛的系统评价

发布时间：2018-06-30 04:35

  本文选题：夫罗曲坦 + 月经　； 参考：《山西医科大学》2017年硕士论文

【摘要】：目的:系统评价夫罗曲坦治疗月经期偏头痛的疗效。方法:计算机检索PubMed、OVID、EMbase、Cochrane图书馆、万方数据库、中国知网、维普网数据库,检索时限从建刊至2016年4月,手工检索中国循证医学、中国疼痛医学杂志、中华神经科杂志等相关医学类杂志,同时追溯已获取文献的参考文献,获取有关夫罗曲坦治疗月经期偏头痛的随机对照研究。按Cochrane图书馆提供的系统评价方法,对所选文献进行文献质量评价,并提取数据,采用RevMan5.3软件进行统计分析。结果:经过筛选最终共纳入8篇随机对照研究,共3373例样本。1.夫罗曲坦治疗急性期月经期偏头痛的疗效:有5个RCT被纳入该项评价,每个研究评价均为中度偏倚。Meta分析结果显示:(1)两组2小时头痛缓解率无统计学意义(RR=1.00,95%CI=0.77-1.28,P=0.97);(2)两组4小时头痛缓解率无统计学意义(RR=1.10,95%CI=0.75-1.60,P=0.63);(3)两组24小时头痛缓解率无统计学意义(RR=1.01,95%CI=0.92-1.11,P=0.89);(4)两组2小时头痛消失率无统计学意义(RR=0.97,95%CI=0.67-1.42,P=0.88);(5)两组4小时头痛消失率无统计学意义(RR=1.15,95%CI=0.84-1.58,P=0.39);(6)两组24小时头痛消失率无统计学意义(RR=1.04,95%CI=0.894-1.15,P=0.45);(7)两组24小时头痛复发率有统计学意义(RR=0.5,95%CI=0.37-0.67,P0.00001),夫罗曲坦组24小时头痛复发率明显小于其他对照组。2.夫罗曲坦对月经期偏头痛预防性治疗的评价,共纳入3项RCT研究,每个研究评价均为中度偏倚。Meta分析结果显示:(1)夫罗曲坦2.5mg每日一次组偏头痛发生率小于安慰剂组,两组有统计学意义(RR=0.77,95%CI=0.71-0.84,P0.00001);(2)夫罗曲坦2.5mg每日两次组偏头痛发生率小于安慰剂组,两组有统计学意义(RR=0.61,95%CI=0.55-0.67,P0.00001);(3)夫罗曲坦2.5mg每日两次组偏头痛发生率小于2.5mg每日一次组,两组有统计学意义(RR=0.79,95%CI=0.71-0.88,P0.00001)。3.安全性:文献报道的不良反应多为轻-中度,主要是恶心、头晕、疲劳、口干、思睡、腰痛等,心血管方面的不适也较少见,包括高血压、不正常心电图、血压波动,每天重复使用夫罗曲坦不会加重头痛。结论:头痛发作后使用夫罗曲坦头痛缓解迅速,与对照组药物相比无差别(2小时、4小时、24小时缓解率与消失率),但夫罗曲坦可减少24小时头痛复发率;对于预防偏头痛发作,夫罗曲坦2.5mg BID与QD都有效,夫罗曲坦2.5mg BID效果更佳。不良反应少,极少严重不良反应,主要是恶心、头晕、疲劳、口干、思睡、腰痛、高血压、不正常心电图、血压波动等。由于本研究纳入文献少,文献质量不高,以上研究结果要更有说服力,需要更多、更大样本的研究。
[Abstract]:Objective: to evaluate the efficacy of flortretan in the treatment of menstrual migraine. Methods: a computer-based search was conducted for PubMedOVIDE EMbase Cochrane Library, Wanfang Database, China Knowledge-Net and Weipu Web Database. The time limit for retrieval was from the establishment of the publication to April 2016, and the Chinese Journal of pain Medicine was manually searched for the Chinese Journal of Evidence-Based Medicine (EBM) and Chinese Journal of pain Medicine (CJM). Related medical journals such as the Chinese Journal of Neurology and other related medical journals were reviewed retrospectively and a randomized controlled study on the treatment of menstruating migraine with flortrextan was obtained. According to the systematic evaluation method provided by Cochrane Library, the quality of selected documents was evaluated, and the data were extracted, and the statistical analysis was carried out with Revman 5.3 software. Results: a total of 3373 samples. 1. 1. Efficacy of flortretan in the treatment of acute menstrual migraine: five RCTs were included in the evaluation. The results of Meta-analysis showed that: (1) there was no significant difference in the relief rate of 2-hour headache between the two groups (RRR 1.00 + 95 CI 0.77-1.28 P0. 97); (2). There was no significant difference in the relief rate of 4 h headache between the two groups (RRN 1. 10 + 95 CI 0. 75-1. 60 P0. 63); (3) and the 24 h headache remission rate was not statistically significant in both groups (RRN 1. 10 + 95 CI 0. 75% 1. 60 P0. 63); (3). (RR=1.01,95%CI=0.92-1.11,P=0.89);(4)涓ょ粍2灏忔椂澶寸棝娑堝け鐜囨棤缁熻�″�︽剰涔，

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