局部辣椒素在成人慢性神经性疼痛。
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德里,劳埃德·R,摩尔RA,人尽其才HJ
局部辣椒素在成人慢性神经性疼痛。
科克伦数据库系统启2009 10月7;(4):CD007393。cd007393.pub2 doi: 10.1002/14651858.。
- PubMed ID
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19821411 (在PubMed]
- 文摘
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背景:局部与辣椒素霜是用来治疗各种慢性病疼痛包括神经性疼痛。后皮肤应用辣椒素引起对有害刺激的敏感性增强,紧随其后的是一段在灵敏度和减少的情况下,经过反复应用,持久的脱敏。有不确定性的疗效和耐受性辣椒素治疗痛苦的慢beplayapp性疾病。目的:评估的证据对照试验的疗效和耐受性局部应用辣椒素在成人慢性神经性疼痛。搜索策略:Cochrane中部、MEDLINE、EMBASE和牛津止痛数据库,搜索2009年5月。选择标准:随机,双盲,安慰剂对照的研究至少六周的时间,使用局部辣椒素治疗神经性疼痛。数据收集和分析:两个评论作者独立评估试验的质量和有效性,并提取数据。信息提取的参与者与缓解疼痛(临床改善)至少6周后,与当地的皮肤反应,用于计算相对风险和数字需要治疗受益(例数十分)和伤害(NNH)。缓解疼痛的定义和具体的细节所获得的不良事件。主要结果:六项研究(总共389人),而常规应用低剂量(0.075%)与安慰剂辣椒素霜霜; the NNT for any pain relief over six to eight weeks was 6.6 (4.1 to 17). Two studies (709 participants in total) compared a single application of high dose (8%) capsaicin patch with placebo patch; the NNT for >/= 30% pain relief over twelve weeks was 12 (6.4 to 70). Local skin reactions were more common with capsaicin, usually tolerable, and attenuated with time; the NNH for repeated low dose application was 2.5 (2.1 to 3.1). There were insufficient data to analyse either data set by condition or outcome definition. All studies satisfied minimum criteria for quality and validity, but maintenance of blinding remains a potential problem. AUTHORS' CONCLUSIONS: Capsaicin, either as repeated application of a low dose (0.075%) cream, or a single application of a high dose (8%) patch may provide a degree of pain relief to some patients with painful neuropathic conditions. Local skin irritation, which is often mild and transient but may lead to withdrawal, is common. Systemic adverse effects are rare. Estimates of benefit and harm are not robust due to limited amounts of data for different neuropathic conditions and inconsistent outcome definition.
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