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局部辣椒素治疗带状疱疹后神经痛的有效性和安全性:一项系统评价和荟萃分析。

The Effectiveness and Safety of Topical Capsaicin in Postherpetic Neuralgia: A Systematic Review and Meta-analysis.

作者信息

Yong Yi Lai, Tan Loh Teng-Hern, Ming Long Chiau, Chan Kok-Gan, Lee Learn-Han, Goh Bey-Hing, Khan Tahir Mehmood

机构信息

Novel Bacteria and Drug Discovery Research Group, School of Pharmacy, Monash University Malaysia Selangor Darul Ehsan, Malaysia.

Unit for Medication Outcomes Research and Education (UMORE), Pharmacy, School of Medicine, University of Tasmania (UTAS) Hobart, TAS, Australia.

出版信息

Front Pharmacol. 2017 Jan 10;7:538. doi: 10.3389/fphar.2016.00538. eCollection 2016.

Abstract

In particular, neuropathic pain is a major form of chronic pain. This type of pain results from dysfunction or lesions in the central and peripheral nervous system. Capsaicin has been traditionally utilized as a medicine to remedy pain. However, the effectiveness and safety of this practice is still elusive. Therefore, this systematic review aimed to investigate the effect of topical capsaicin as a pain-relieving agent that is frequently used in pain management. In brief, all the double-blinded, randomized placebo- or vehicle-controlled trials that were published in English addressing postherpetic neuralgia were included. Meta-analysis was performed using Revman version 5.3. Upon application of the inclusion and exclusion criteria, only six trials fulfilled all the criteria and were included in the review for qualitative analysis. The difference in mean percentage change in numeric pain rating scale score ranges from -31 to -4.3. This demonstrated high efficacy of topical capsaicin application and implies that capsaicin could result in pain reduction. Furthermore, meta-analysis was performed on five of the included studies. All the results of studies are in favor of the treatment using capsaicin. The incidence of side effects from using topical capsaicin is consistently higher in all included studies, but the significance of safety data cannot be quantified due to a lack of -values in the original studies. Nevertheless, topical capsaicin is a promising treatment option for specific patient groups or certain neuropathic pain conditions such as postherpetic neuralgia.

摘要

特别是,神经性疼痛是慢性疼痛的一种主要形式。这种类型的疼痛源于中枢神经系统和外周神经系统的功能障碍或损伤。辣椒素传统上一直被用作治疗疼痛的药物。然而,这种治疗方法的有效性和安全性仍然难以捉摸。因此,本系统评价旨在研究外用辣椒素作为一种在疼痛管理中常用的止痛剂的效果。简而言之,纳入了所有发表于英文的、针对带状疱疹后神经痛的双盲、随机、安慰剂或赋形剂对照试验。使用Revman 5.3版本进行荟萃分析。在应用纳入和排除标准后,只有六项试验符合所有标准,并被纳入综述进行定性分析。数字疼痛评分量表得分的平均百分比变化差异范围为-31至-4.3。这表明外用辣椒素具有很高的疗效,意味着辣椒素可以减轻疼痛。此外,对纳入研究中的五项研究进行了荟萃分析。所有研究结果均支持使用辣椒素进行治疗。在所有纳入研究中,使用外用辣椒素产生副作用的发生率一直较高,但由于原始研究中缺乏P值,安全性数据的显著性无法量化。尽管如此,外用辣椒素对于特定患者群体或某些神经性疼痛状况(如带状疱疹后神经痛)而言是一种有前景的治疗选择。

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