牛痘疫苗接种家兔炎症皮肤提取物治疗神经病理性痛疗效的系统评价

EFFICACY OF EXTRACT OF INFLAMMATORY RABBIT SKIN WITH VACCINATED SMALLPOX VACCINATION FOR NEUROPATHIC PAIN: A SYSTEMATIC REVIEW

目的:根据目前的临床研究证据评价牛痘疫苗接种家兔炎症皮肤提取物用于治疗神经病理性痛的疗效,为临床预后评估提供理论依据。方法:计算机检索PubMed、Medalink、Springerlink、CNKI、同方、万方等数据库,同时辅助手工检索相关文献,查阅纳入文献的参考文献。检索时间为1987至2011年的文献,收集牛痘疫苗接种家兔炎症皮肤提取物治疗神经病理性疼痛的临床随机对照研究。按照Cochrane系统评价方法评价纳入研究的质量,提取有效的数据,采用RevMan 5.0软件进行统计分析。结果:共纳入15项研究,1009例病例。Meta分析结果显示:牛痘疫苗接种家兔炎症皮肤提取物对神经病理性疼痛疗效优于安慰剂、卡马西平、弥可保、胰激肽原酶对照,OR值为[OR=2.69,95%CI(1.99,3.65)];治疗终点的视觉模拟评分(visual analogue scale,VAS)差异有统计学意义[OR=-1.94,95%CI(-2.05,-1.84)];牛痘疫苗接种家兔炎症皮肤提取物与对照组药物的安全性比较,差异无统计学意义[OR=0.53,95%CI(0.30,0.96)]。结论:牛痘疫苗接种家兔炎症皮肤提取物可以有效的缓解神经病理性疼痛。

Objective： To evaluate the treatment effects of extract of inflammatory rabbit skin vaccinated with smallpox vaccination on neuropathic pain according to current clinical research evidence, and provide the theoretical basis for clinical prognostic evaluation. Methods： Electronic database including PubMed, Medalink, Springerlink, CNKI, Tongfang Data, and Wanfang Data were searched, meanwhile related articles were searched by auxiliary manual retrieval, and the reference lists of enrolled reports and reviews were looked up. The search collected the randomized controlled clinical trials on the treatment of extract of inflammatory rabbit skin vaccinated with smallpox vaccination for neuropathic pain from 1987 to 2011. The quality of included trials was evaluated by the Cochrane Handbook. Valid data were extracted and statistically analyzed with the software RevMan 5.0. Results： Totally 1009 patients in fit^een trials were included. Meta-analysis indicated that, compared to placebo, carbamazepine, methycobal, or pancreatic kininogenase, the treatment effects of extract of inflammatory rabbit skin vaccinated with smallpox vaccination for neuropathic pain were better [OR=2.69, 95% CI （1.99, 3.65）]. There were statistically significant differences in the visual analogue scale at the end of the treatment [0R=-1.94, 95% CI （-2.05, -1.84）]. There was no statistically significant difference in safety between the control group and the treatment group [OR=0.53, 95% CI （0.30, 0.96）]. Conclusion： Extract of inflammatory rabbit skin vaccinated with smallpox vaccination can effectively relieve the neuropathic pain.