Aging, Rehabilitation and Geriatric Care, Lawson Health Research Institute, London, ON, Canada.
Parkwood Staff Library, St. Joseph's Healthcare, London, ON, Canada.
Spinal Cord. 2014 Feb;52(2):89-96. doi: 10.1038/sc.2013.146. Epub 2013 Dec 3.
Systematic review and effectiveness analysis.
Assess the effectiveness of anticonvulsants for the management of post spinal cord injury (SCI) neuropathic pain.
Studies from multiple countries were included.
CINAHL, Cochrane, EMBASE and MEDLINE were searched up to April 2013. Quality assessment was conducted using the Jadad and the Downs and Black tools. Effect sizes and odds ratios were calculated for primary and secondary outcome in the included studies.
Gabapentinoids, valproate, lamotrigine, levetiracetam and carbamazepine were examined in the 13 included studies, ten of which are randomized controlled trials. Large effect size (0.873-3.362) for improvement of pain relief was found in 4 of the 6 studies examining the effectiveness of gabapentin. Pregabalin was shown to have a moderate to large effect (0.695-3.805) on improving neuropathic pain post SCI in 3 studies. Valproate and levetiracetam were not effective in improving neuropathic pain post SCI, while lamotrigine was effective in reducing neuropathic pain amongst persons with incomplete lesions and carbamazepine was found effective for relief of moderate to intense pain.
Gabapentin and pregabalin are the two anticonvulsants which have been shown to have some benefit in reducing neuropathic pain.
系统评价和效果分析。
评估抗惊厥药在治疗脊髓损伤后（SCI）神经性疼痛中的效果。
纳入多国研究。
截至 2013 年 4 月，检索 CINAHL、Cochrane、EMBASE 和 MEDLINE。使用 Jadad 和 Downs 和 Black 工具对纳入研究进行质量评估。对纳入研究的主要和次要结局计算效应大小和比值比。
纳入的 13 项研究中检查了加巴喷丁类药物、丙戊酸、拉莫三嗪、左乙拉西坦和卡马西平，其中 10 项为随机对照试验。在 6 项研究中，有 4 项研究发现加巴喷丁对缓解疼痛的效果有较大的效应量（0.873-3.362）。在 3 项研究中，普瑞巴林对改善 SCI 后神经性疼痛有中度至较大的效应（0.695-3.805）。丙戊酸和左乙拉西坦对改善 SCI 后神经性疼痛无效，而拉莫三嗪对不完全性损伤患者的神经性疼痛有效，卡马西平对缓解中度至剧烈疼痛有效。
加巴喷丁和普瑞巴林是两种已被证明在减轻神经性疼痛方面有一定益处的抗惊厥药。
