神经妥乐平治疗神经源性疼痛有效性系统评价 .pptVIP

纳入研究的特征（二） * Fig 1 治疗有效率的meta分析：神经妥乐平和安慰剂或空白对照比较 NT: neurotropin * Anecdote:轶闻，没有确切依据的 * Types of studies We included randomised and quasi-randomised controlled trials of neurotropin treatment for neuropathic pain. Types of participants We considered participants with neuropathic pain of all ages, sex, and degrees of severity. Types of intervention We included trials of any form of tramadol treatment compared with placebo, other pain relieving treatment or no treatment. Types of outcome measures Primary outcome measure The primary outcome measure was 50% or more pain relief, or 50% or more reduction of the score on a validated pain scale. Secondary outcome measures (1) 50% or more reduction in touch-evoked pain after at least two weeks of treatment. (2) Adverse events occurring during or within 48 hours after treatment which were: (a) sufficient to cause withdrawal from the trial or; (b) fatal, life threatening, or required admission to hospital or prolongation of hospital admission. * The primary outcome measure was reduction of the score on a validated pain scale. * We collected efficacy and safety data from all published and unpublished trials. * * 20 clinical trials (%) were of poor methodological quality, scoring 4 points * this review has shown a definite beneficial effect of neurotropin over placebo in the treatment of neuropathic pain * Neurotropin to Treat Chronic Neuropathic Pain ；Neurotropin to Treat Fibromyalgia 神经源性疼痛和癫痫(尤其是在背角神经元发作和海马神经元诱发的癫痫)在病理生理学和生物化学机制方面存在大量的相似点。尽管两者确切的机制不同,但抗癫痫药能够增加抑制性神经递质,减少兴奋性神经递质,调节阳离子通道的传导[6],因而抗癫痫药有神经保护的效果 * 神经妥乐平治疗神经源性疼痛有效性的系统评价 刘芳 北京大学第三医院 Email:liufang8-111@163.com * 背 景 神经妥乐平 神经源性疼痛或神经病理性疼痛（Neuropathic pain） * 关于药品名称 neurotropin? ≠ neurotropins, NTs neurotrophins Neurotrophic factors Nerve growth factors * 问题的提出 神经妥乐平用于神经源性疼痛的有效性和安全性如何？ 和其他治疗药物，如NSAID,抗癫痫药、抗抑郁药等相比，神经妥乐平在有效性和安全性上是否有优势？ * FIP2007主题 From Anecdote to Evidence: Pharmacists Helping Patients Make the Best Use of Medicine