曲坦类药物对偏头痛疗效及副作用的Meta分析

摘要

Objective: To assess the relative efficacy and side effects of 7 kinds of triptans in the treatment of migraine. Methods: Medline, PubMed, Cochrane collaboration database, CALIS and SAGE foreign periodical net, CNKI, VIP database were searched for randomized control trials of triptans from January 1995 to June 2010. Meta-analysis was performed for the included studies using RevMan 5.0 software. Results: A total of 127 articles were searched out and 56 of them were enrolled in present meta-analysis. The pain relief rate at 2 hours and sustained efficacy at 24 hours in rizatriptan 10 mg and at 2 hours in 5 mg were significantly higher than that in placebo. All 3 doses of eletriptan (20 mg, 40 mg, 80 mg) had higher efficacy than placebo. Sumatriptan 50 mg, 100 mg orally disintegrating tablet and 50 mg tablet were more effective than placebo, 100 mg tablet was more effective than placebo except sustained pain relief rate at 24 hours. Almotriptan 12.5 mg was more effective than placebo, pain relief rate of 6.25 mg and 25 mg after 2 hours were significantly higher than that in placebo. Zolmitriptan 2.5 mg and 5 mg were more effective than placebo. In both frovatriptan 2.5 mg and naratriptan 2.5 mg, the efficacy at 2 hours were significantly higher than that in placebo. In almotriptan, eletriptan, naratriptan, zolmitriptan 2.5 mg and 10 mg tablet, spray sumatriptan 5 mg and 10 mg, the incidence rate of side effects were similar to placebo. Conclusion: All 7 kinds of triptans had certain efficacy and tolerance.%目的:评估七种曲坦药物治疗偏头痛的效能及副作用.方法:检索Medline,PubMed,Cochrane 图书馆、CALIS外文期刊网、SAGE外文期刊网,中国知网,维普全文数据库.检索年限为1995年1月～ 2010年6月.纳入曲坦类药物治疗的随机安慰剂对照试验.采用Cochrane协作网提供的RevMan 5.0软件对纳入文献进行Meta分析.结果:共检索到127篇文献,纳入符合标准的56篇进行分析.利扎曲坦10 mg的2小时及24小时持续疗效、5 mg的2小时头痛缓解率与安慰剂对比具有统计学差异;依来曲坦20 mg、40 mg、80 mg治疗效能均优于安慰剂;舒马曲坦50 mg、100mg速崩片及50 mg片剂所有治疗效果均优于安慰剂,100mg片剂除24小时持续疼痛缓解率外,其他治疗效能优于安慰剂组;阿莫曲坦12.5 mg所有效能、6.25 mg、25 mg 2小时疼痛缓解率与安慰剂对比有显著差异;佐米曲坦2.5 mg、5 mg治疗效能均优于安慰剂;夫罗曲坦2.5 mg、那拉曲坦2.5 mg 2小时治疗效能优于安慰剂.阿莫曲坦、依来曲坦、那拉曲坦、佐米曲坦2.5 mg、10 mg口服片剂,舒马曲坦5 mg、10 mg喷剂的副作用发生率与安慰剂相当.结论:7种曲坦类药物均有一定的有效性和耐受性.