阿片类药物治疗骨关节炎安全性的Meta分析

Safety of opioids in treatment of osteoarthritis:a Meta-analysis

目的系统评价阿片类药物治疗骨关节炎的安全性。方法计算机检索PubMed、Cochrane Library、Embase、Medline、National International Trial Registers、知网、万方等数据库,纳入阿片类药物治疗膝关节或髋关节骨关节炎的临床随机对照试验(RCT)。筛选文献并进行质量评价后,采用RevMan5.3软件进行Meta分析。结果共纳入10个RCT。Meta分析结果显示,与口服安慰剂的患者比较,口服阿片类药物的患者恶心、呕吐、便秘、眩晕、嗜睡、皮肤瘙痒以及因不良反应而中断治疗的发生率均升高(均P<0.05)。结论口服阿片类药物的骨关节炎患者胃肠道、神经系统和皮肤相关的不良反应发生风险增加,建议临床上谨慎使用阿片类药物治疗骨关节炎。

Objective To systematically assess the safety of opioids in the management of osteoarthritis.Methods A computer retrieval was conducted in PubMed,Cochrane Library,Embase,Medline,National International Trial Registers,CNKI and Wanfang database,ect.,and randomized controlled trials(RCT)about opioids applied to treating knee or hip osteoarthritis were enrolled.Meta-analysis was performed using RevMan5.3 software after literature screening and quality assessment.Results Ten RCTs were included totally.The results of Meta-analysis revealed that patients receiving oral administration of opioids achieved higher incidence rates of nausea,vomiting,constipation,dizziness,somnolence and pruritus,as well as higher rate of adverse reactions-induced treatment discontinuation as compared with patients receiving oral placebo(all P<0.05).Conclusion The risk of gastrointestine,nervous system and skin-related adverse events is increased in patients with osteoarthritis receiving oral administration of opioids.It is suggested that opioids should be cautiously used in the clinical treatment of osteoarthritis.