摘要： 目的 系统评价加巴喷丁治疗带状疱疹后遗神经痛的疗效和安全性。方法 计算机检索美国国立医学图书馆（PubMed）、英国Cochrane 图书馆随机对照临床试验资料库、荷兰医学文摘（EMBASE），以及中国生物医学文献数据库（CBM）、维普中文科技期刊数据库（VIP）、中国知识基础设施工程（CNKI）和万方数据库，并手工检索相关杂志，由两位研究者独立进行质量评价及数据分析，RevMan 5.0 统计软件对数据进行Meta 分析。结果 根据Cochrane 5.0.2 版随机对照临床试验质量评价标准，共纳入5 项随机对照临床试验计1225 例带状疱疹后遗神经痛患者。结果显示，加巴喷丁组患者平均每日疼痛评分改变高于安慰剂组（SMD = -0.920，95%CI：-1.330 ~ -0.520；P = 0.000）；简易McGill 疼痛问卷平均视觉印象评分改变高于安慰剂组（SMD = -2.650，95%CI：-3.410～ -1.890；P = 0.000）；平均每日睡眠干预评分改变高于安慰剂组（SMD = -2.480，95%CI：-3.750～ -1.200；P = 0.000）。加巴喷丁组与安慰剂组失访率差异无统计学意义（P = 0.240）。治疗期间常见药物不良反应为头晕、嗜睡、水肿等。结论 现有临床证据表明，加巴喷丁治疗带状疱疹后遗神经痛疗效显著，治疗保留率高；但应注意其所引起的头晕、嗜睡、水肿等药物不良反应。

关键词: γ氨基丁酸, 神经痛, 带状疱疹后, 疼痛测定, Meta分析

Abstract: Objective  To evaluate the effects and tolerability of gabapentin in the treatment of postherpetic neuralgia (PHN).  Methods  The randomized controlled trials (RCTs) of gabapentin for the treatment of PHN were retrieved from PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Chinese Biology Medicine (CBM), VIP, China National Knowledge Infrastructure (CNKI) and Wanfang Data. Two reviewers independently evaluated the quality of the included articles and abstracted the data. Meta-analysis was performed using RevMan 5.0.  Results  According to the enrollment criteria, 5 prospective, randomized controlled clinical trials including 1225 subjects were finally selected. The mean changes for average daily pain score were significant in gabapentin group compared with placebo group (SMD = -0.920, 95%CI: -1.330 ~ -0.520; P = 0.000), as well as the mean change for Short-Form McGill Pain Questionnaire (SF-MPQ) visual analogue scale (SMD = -2.650, 95%CI: -3.410 ~ -1.890; P = 0.000) and average daily sleep intervention score (SMD = -2.480, 95%CI: -3.750 ~ -1.200; P = 0.000). There was no significance between gabapentin group and placebo group in the withdrawl rate (P > 0.05). The common adverse reactions during gabapentin treatment included dizziness (OR = 3.710, 95%CI: 2.530-5.430; P = 0.000), somnolence (OR = 2.430, 95%CI: 1.530-3.860; P = 0.000) and peripheral edema (OR = 13.570, 95%CI: 4.190-43.970; P = 0.000).  Conclusion  It is indicated clinically that gabapentin is effective and well tolerated for the treatment of postherpetic neuralgia with high retention rate. However, adverse reactions, such as dizziness, somnolence and edema, should be paid attention.

Key words: Gamma-aminobutyric acid, Neuralgia, postherpetic, Pain measurement, Meta-analysis