本文選題：夫羅曲坦 + 月經(jīng)　； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:系統(tǒng)評價夫羅曲坦治療月經(jīng)期偏頭痛的療效。方法:計算機檢索PubMed、OVID、EMbase、Cochrane圖書館、萬方數(shù)據(jù)庫、中國知網(wǎng)、維普網(wǎng)數(shù)據(jù)庫,檢索時限從建刊至2016年4月,手工檢索中國循證醫(yī)學、中國疼痛醫(yī)學雜志、中華神經(jīng)科雜志等相關(guān)醫(yī)學類雜志,同時追溯已獲取文獻的參考文獻,獲取有關(guān)夫羅曲坦治療月經(jīng)期偏頭痛的隨機對照研究。按Cochrane圖書館提供的系統(tǒng)評價方法,對所選文獻進行文獻質(zhì)量評價,并提取數(shù)據(jù),采用RevMan5.3軟件進行統(tǒng)計分析。結(jié)果:經(jīng)過篩選最終共納入8篇隨機對照研究,共3373例樣本。1.夫羅曲坦治療急性期月經(jīng)期偏頭痛的療效:有5個RCT被納入該項評價,每個研究評價均為中度偏倚。Meta分析結(jié)果顯示:(1)兩組2小時頭痛緩解率無統(tǒng)計學意義(RR=1.00,95%CI=0.77-1.28,P=0.97);(2)兩組4小時頭痛緩解率無統(tǒng)計學意義(RR=1.10,95%CI=0.75-1.60,P=0.63);(3)兩組24小時頭痛緩解率無統(tǒng)計學意義(RR=1.01,95%CI=0.92-1.11,P=0.89);(4)兩組2小時頭痛消失率無統(tǒng)計學意義(RR=0.97,95%CI=0.67-1.42,P=0.88);(5)兩組4小時頭痛消失率無統(tǒng)計學意義(RR=1.15,95%CI=0.84-1.58,P=0.39);(6)兩組24小時頭痛消失率無統(tǒng)計學意義(RR=1.04,95%CI=0.894-1.15,P=0.45);(7)兩組24小時頭痛復發(fā)率有統(tǒng)計學意義(RR=0.5,95%CI=0.37-0.67,P0.00001),夫羅曲坦組24小時頭痛復發(fā)率明顯小于其他對照組。2.夫羅曲坦對月經(jīng)期偏頭痛預防性治療的評價,共納入3項RCT研究,每個研究評價均為中度偏倚。Meta分析結(jié)果顯示:(1)夫羅曲坦2.5mg每日一次組偏頭痛發(fā)生率小于安慰劑組,兩組有統(tǒng)計學意義(RR=0.77,95%CI=0.71-0.84,P0.00001);(2)夫羅曲坦2.5mg每日兩次組偏頭痛發(fā)生率小于安慰劑組,兩組有統(tǒng)計學意義(RR=0.61,95%CI=0.55-0.67,P0.00001);(3)夫羅曲坦2.5mg每日兩次組偏頭痛發(fā)生率小于2.5mg每日一次組,兩組有統(tǒng)計學意義(RR=0.79,95%CI=0.71-0.88,P0.00001)。3.安全性:文獻報道的不良反應多為輕-中度,主要是惡心、頭暈、疲勞、口干、思睡、腰痛等,心血管方面的不適也較少見,包括高血壓、不正常心電圖、血壓波動,每天重復使用夫羅曲坦不會加重頭痛。結(jié)論:頭痛發(fā)作后使用夫羅曲坦頭痛緩解迅速,與對照組藥物相比無差別(2小時、4小時、24小時緩解率與消失率),但夫羅曲坦可減少24小時頭痛復發(fā)率;對于預防偏頭痛發(fā)作,夫羅曲坦2.5mg BID與QD都有效,夫羅曲坦2.5mg BID效果更佳。不良反應少,極少嚴重不良反應,主要是惡心、頭暈、疲勞、口干、思睡、腰痛、高血壓、不正常心電圖、血壓波動等。由于本研究納入文獻少,文獻質(zhì)量不高,以上研究結(jié)果要更有說服力,需要更多、更大樣本的研究。
[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灝忔椂澶寸棝娑堝け鐜囨棤緇熻瀛︽剰涔，

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