曲坦类药物对儿童和青少年偏头痛有效性及安全性的Meta分析

摘要

目的 评估曲坦药物治疗儿童和青少年偏头痛的效能及副作用. 方法 检索1996-01~2016-10期间EMBASE、Cochrane Library databases、PubMed、Springerlink,2010-01~2016-10维普期刊全文数据库、中国学术期刊全文数据库、中国生物医学文献数据库、中国生物医学期刊引文数据库等数据库内关于儿童和青少年偏头痛的随机对照试验(RCT),用改良后的Jadad量表进行评价并提取资料,然后运用Review Manager5.3软件对纳入文献进行系统评价. 结果 最终纳入12篇文献,Meta结果显示,与安慰剂相比,舒马曲坦治疗青少年偏头痛2 h头痛缓解率(OR=1.49,95%CI 1.25-1.77,P<0.000 01)、2 h头痛消失率(OR=1.48,95%CI 1.20-1.83,P=0.000 2)均有统计学意义,而利扎曲坦、佐米曲坦2 h头痛缓解率无统计学意义. 结论 三类曲坦药物的安全性均较好,但舒马曲坦对治疗青少年偏头痛疗效肯定,利扎曲坦、佐米曲坦有一定安慰剂效应.%Objective To assess the efficacy and side effects of triptans in the treatment of migraine in children and adolescents.Methods Double-blind randomized controlled trials on migraine in children and adolescents were collected from EMBASE,Cochrane Library databases,PubMed,SpringerLink from January 1996 to October 2016,and from CQVIP,CNKI,CBM,CMCI database from January 2010 up to October 2016.The data were extracted after evaluating the quality of documents by modified Jadad scale,and Meta-analysis was conducted by Review Manager 5.3 software.Results Totally 12 articles were included.Meta-analysis showed that sumatriptan was statistically more effective than placebo for the pain relief rate at 2 h(OR=1.49,95%CI 1.25-1.77,P<0.000 01)and the pain-free rate at 2 h(OR=1.48,95%CI 1.20-1.83,P=0.000 2).Conclusion All three kinds of triptans are relatively safe in the treatment of migraine in children and adolescents,among which sumatriptan is the most effective agent.