目的 系統(tǒng)評(píng)價(jià)帕瑞昔布對(duì)比氟比洛芬酯用于術(shù)后鎮(zhèn)痛的療效和安全性。方法 計(jì)算機(jī)檢索中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)（CBM）、中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)（CNKI）、萬(wàn)方數(shù)據(jù)庫(kù)、PubMed、Cochrane圖書(shū)館，收集帕瑞昔布對(duì)比氟比洛芬酯治療術(shù)后疼痛隨機(jī)對(duì)照試驗(yàn)（RCT），檢索時(shí)間從建庫(kù)至2019年10月。提取資料并進(jìn)行文獻(xiàn)質(zhì)量評(píng)價(jià)后，使用RevMan 5.3軟件進(jìn)行Meta-分析。結(jié)果 共納入14篇RCTs，共984例患者，對(duì)照組采用氟比洛芬酯進(jìn)行治療，試驗(yàn)組采用帕瑞昔布進(jìn)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(píng)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(jì)學(xué)意義（P<0.05）；而對(duì)術(shù)后1 h、2 h和4 h的VAS評(píng)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(wú)統(tǒng)計(jì)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?xún)?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