目的 系統(tǒng)評價帕瑞昔布對比氟比洛芬酯用于術(shù)后鎮(zhèn)痛的療效和安全性。方法 計算機檢索中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫（CBM）、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、萬方數(shù)據(jù)庫、PubMed、Cochrane圖書館，收集帕瑞昔布對比氟比洛芬酯治療術(shù)后疼痛隨機對照試驗（RCT），檢索時間從建庫至2019年10月。提取資料并進行文獻質(zhì)量評價后，使用RevMan 5.3軟件進行Meta-分析。結(jié)果 共納入14篇RCTs，共984例患者，對照組采用氟比洛芬酯進行治療，試驗組采用帕瑞昔布進行治療。Meta-分析結(jié)果顯示：與氟比洛芬酯比較，帕瑞昔布顯著降低術(shù)后6 h、12 h和24 h的疼痛評分（VAS）［SMD=-0.62、95% CI=-0.89～-0.35，SMD=-0.60、95% CI=-0.99～-0.20和SMD=-0.48、95% CI=-0.80～-0.15］，降低不良反應(yīng)（ADR）發(fā)生率［RR=0.60、95% CI=0.46～0.78］，其中以降低頭痛頭暈發(fā)生率最顯著［RR=0.55，95% CI=0.33～0.91］，2組比較差異均有統(tǒng)計學(xué)意義（P<0.05）；而對術(shù)后1 h、2 h和4 h的VAS評分，術(shù)后阿片用量，術(shù)后惡心嘔吐發(fā)生率、皮膚瘙癢發(fā)生率、腹痛發(fā)生率和尿潴留發(fā)生率均無統(tǒng)計學(xué)差異。結(jié)論 帕瑞昔布用于術(shù)后鎮(zhèn)痛療效和安全性優(yōu)于氟比洛芬酯。

Objective To systematically evaluate the efficacy and safety of parecoxib and flurbiprofen for postoperative analgesia. Methods Databases including CNKl, CBM, Wanfang Data, PubMed and the Cochrane Library were searched from inception to October 2019. The randomized controlled trials (RCT) regarding the efficacy of parecoxib and flurbiprofen in the treatment of pain after postoperative were collected. Data were extracted and the quality of the study was evaluated. RevMan 5.3 software were used for result analysis. Results Fourteen randomized controlled trails were involved, containing 984 patients undergoing surgery. The experimental group was treated with parecoxib and the control group with flurbiprofen. Meta-analysis results showed that, compared with flurbiprofen, parecoxib significantly reduced pain scores (VAS) at 6 h, 12 h, and 24 h after surgery[SMD=-0.62, 95%CI=-0.89 to -0.35; SMD=-0.60, 95%CI=-0.99 to -0.20 and SMD=-0.48, 95%CI=-0.80 to -0.15], reduce the incidence of ADR[RR=0.60, 95%CI=0.46 to 0.78], of which the most significant decrease in the incidence of headache and dizziness[RR=0.55, 95%CI=0.33 to 0.91], which the differences were statistically significant (P<0.05). And the VAS scores at 1 h, 2 h and 4 h after surgery, postoperative opioid consumption, incidence of postoperative nausea and vomiting, incidence of skin itching, incidence of abdominal pain, and incidence of urinary retention, which the differences were not statistically significant. Conclusion The results show that parecoxib has better efficacy and safety than flurbiprofen for postoperative analgesia.

R971