左乙拉西坦联合氟桂利嗪预防偏头痛的有效性和安全性Meta分析

The Efficacy and Safety of Levetiracetam in the Prevention of Migraine: A Meta Analysis

目的:Meta分析评价左乙拉西坦联合氟桂利嗪预防偏头痛的有效性和安全性,为临床应用提供一定的参考。方法:计算机检索The Cochrane Library、Pub Med、EMbase、CNKI、Wan Fang Data和VIP数据库,搜集有关左乙拉西坦联合氟桂利嗪预防偏头痛的随机对照试验(RCT),检索时限为建库始至2017年8月。由两位评价者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果:共纳入9个RCT。Meta分析结果显示:联合组比单药组预防偏头疼的效果好[RR=0.76,95%CI(0.71,0.83),P<0.00001];在安全性方面联合组与单药组无统计学意义[RR=1.06,95%CI(0.78,1.43),P=0.72];在改善患者头痛程度上联合组优于单药组[MD=0.67,95%CI(0.39,0.95),P<0.00001]。结论:左乙拉西坦预防偏头痛有一定的疗效,但由于受纳入文献数量和质量的限制,本研究需要更多高质量研究待以验证。

Objective:To evaluate the efficacy and safety of levetiracetam in the prevention of migraine.Methods:We electronically searched databases including The Cochrane Library,PubMed,EMbase,CNKI,WanFang Data and VIP databases to collect randomized controlled trials(RCTs)about the levetiracetam in the prevention of migraine from inception to August 2017.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then,meta-analysis was performed using RevMan 5.3 software.Results:Nine RCTs were included.The results of meta-analysis showed that the combined group was better than single drug group in the prevention of migraine[RR=0.76,95%CI(0.71,0.83),P<0.00001];combined group and single drug group had no statistical significance in safety[RR=1.06,95%CI(0.78,1.43),P=0.72];combined group was better than the single drug group in improve the headache extent[MD=0.67,95%CI(0.39,0.95),P<0.00001].Conclusion:Levetiracetam has some effect on migraine prevention,but because of the limitation of the quantity and quality of the literature,more high-quality studies should be conducted to verify it.