棕榈酰乙醇胺在疼痛管理中的荟萃分析：填补文献空白并增进理解

Meta-Analysis of Palmitoylethanolamide in Pain Management: Addressing Literature Gaps and Enhancing Understanding.

作者信息

Viña Isabel, López-Moreno Miguel

机构信息

IVBwellness Lab, Valencia, Spain.

Diet, Planetary Health and Performance, Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo, Spain.

出版信息

Nutr Rev. 2025 Jul 1;83(7):e1604-e1618. doi: 10.1093/nutrit/nuae203.

DOI:10.1093/nutrit/nuae203

PMID:39798151

Abstract

CONTEXT

Chronic pain is a debilitating condition that affects a significant proportion of the population. Palmitoylethanolamide (PEA), a naturally occurring fatty acid amide derived from omega-7 fatty acids, has emerged as a safe and effective alternative for pain management and exerts its effects by interacting with the endocannabinoid system, modulating inflammation, and regulating immune responses.

OBJECTIVE

A comprehensive meta-analysis was conducted to evaluate the efficacy of PEA in alleviating pain across various pathologies, considering the nociceptive, neuropathic, or nociplastic nature of pain.

DATA SOURCES

A systematic search was conducted of 4 databases: PubMed, Embase, Scopus, and Cochrane Collaboration Library.

DATA EXTRACTION

Randomized clinical trials were selected for analysis. This meta-analysis included 18 studies involving 1196 patients.

DATA ANALYSIS

Continuous variables were assessed using a standard mean difference (SMD). Heterogeneity was evaluated using the χ2 test and I2 statistics. Pain was significantly reduced in the PEA group at 6 weeks (SMD, -0.9; 95% CI, -1.60 to -0.31), 8 weeks (SMD, -0.98; 95% CI, -1.61 to -0.36), and 24-26 weeks (SMD, -1.16; 95% CI, -2.15 to -0.17). Quality of life, including pain-related items, was significantly higher in the PEA group (SMD, -0.61; 95% CI, -0.93 to -0.30). Significant differences in favor of PEA were observed at 4 (SMD, -0.36; 95% CI, -0.65 to -0.07) and 8 weeks (SMD, -0.66; 95% CI, -1.15 to -0.17). Palmitoylethanolamide was effective for all pain types: nociceptive (SMD, -0.74; 95% CI, -1.42 to -0.06), neuropathic (SMD, -0.97; 95% CI, -1.54 to -0.39), and nociplastic (SMD, -0.59; 95% CI, -1.15 to -0.03).

CONCLUSIONS

This meta-analysis confirmed that PEA effectively reduces pain and enhances quality of life, with significant benefits observed within 4-6 weeks of treatment. Palmitoylethanolamide is a promising alternative to chronic opioid analgesics, potentially reducing the risk of opioid abuse and dependency.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42024550546.

摘要

背景

慢性疼痛是一种使人衰弱的疾病，影响着相当一部分人口。棕榈酰乙醇胺（PEA）是一种天然存在的源自ω-7脂肪酸的脂肪酸酰胺，已成为一种安全有效的疼痛管理替代方法，并通过与内源性大麻素系统相互作用、调节炎症和调节免疫反应来发挥其作用。

目的

进行一项全面的荟萃分析，以评估PEA在缓解各种病理情况下的疼痛方面的疗效，同时考虑疼痛的伤害性、神经性或神经可塑性性质。

数据来源

对4个数据库进行了系统检索：PubMed、Embase、Scopus和Cochrane协作图书馆。

数据提取

选择随机临床试验进行分析。该荟萃分析包括18项研究，涉及1196名患者。

数据分析

使用标准平均差（SMD）评估连续变量。使用χ2检验和I2统计量评估异质性。PEA组在6周时疼痛显著减轻（SMD，-0.9；95%CI，-1.60至-0.31），8周时（SMD，-0.98；95%CI，-1.61至-0.36），以及24 - 26周时（SMD，-1.16；95%CI，-2.15至-0.17）。包括与疼痛相关项目在内的生活质量在PEA组显著更高（SMD，-0.61；95%CI，-0.93至-0.30）。在4周（SMD，-0.36；95%CI，-0.65至-0.07）和8周时观察到有利于PEA的显著差异（SMD，-0.66；95%CI，-1.15至-0.17）。棕榈酰乙醇胺对所有疼痛类型均有效：伤害性疼痛（SMD，-0.74；95%CI，-1.42至-0.06）、神经性疼痛（SMD，-0.97；95%CI，-1.54至-0.39）和神经可塑性疼痛（SMD，-0.59；95%CI，-1.15至-0.03）。