Salicylate-containing发红剂对急性和慢性肌肉骨骼疼痛的成年人。

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德里,马修斯公关,Wiffen PJ,摩尔RA

Salicylate-containing发红剂对急性和慢性肌肉骨骼疼痛的成年人。

Cochrane数据库系统启2014年11月26日,(11):CD007403。cd007403.pub3 doi: 10.1002/14651858.。

PubMed ID
25425092 (在PubMed
]
文摘

背景:发红剂含有水杨酸盐引起皮肤刺激和被认为缓解各种肌肉骨骼疼痛。他们可在处方,处方的补救方法是常见的组件。这是一个更新的回顾发红剂急性和慢性疼痛,最早出版于2009年,发现有限的证据效力。目的:评估局部应用的有效性和安全性水杨酸盐在成人急性和慢性肌肉骨骼疼痛。必威国际app搜索方法:我们搜查了中央、MEDLINE和EMBASE,从开始到2014年8月22日,在牛津止痛数据库,两个临床试验注册中心,包括研究和相关的参考书目中评论。选择标准:随机、双盲、安慰剂——或者active-controlled含有水杨酸盐局部发红剂的临床试验治疗肌肉骨骼疼痛在成人中,至少有10个参与者每次治疗的手臂,和报告结果接近7(最低3,最高10)对急性条件和14天(最少7天或更长时间的慢性疾病。数据收集和分析:两个评论作者独立评估试验包容和偏见的风险,和提取数据。我们计算风险比(RR)和数量需要治疗受益或伤害(例数十分或NNH)和95%可信区间(CI)使用固定效应模型。我们分别分析了急性和慢性疾病。主要结果:新搜索这更新了一个新的研究必威国际app满足入选标准,尽管它的贡献只有取款的信息。 Six placebo- and one active-controlled studies (560 and 137 participants, respectively) in acute pain, and seven placebo- and three active-controlled studies (489 and 182 participants, respectively) in chronic pain were included in the review. All studies were potentially at risk of bias, and there were substantial differences between studies in terms of the participants (for example the level of baseline pain), the treatments (different salicylates combined with various other potentially active ingredients), and the methods (for example the outcomes reported). Not all of the studies contributed usable information for all of the outcomes sought.For the primary outcome of clinical success at seven days in acute conditions (mostly sprains, strains, and acute low back pain), the RR was 1.9 (95% CI 1.5 to 2.5) and the NNT was 3.2 (2.4 to 4.9) for salicylates compared with placebo, but this result was not robust (very low quality evidence). Using a random-effects model for analysis the RR was 2.7 (1.05 to 7.0). For the same outcome in chronic conditions (mostly osteoarthritis, bursitis, and chronic back pain), the RR was 1.6 (1.2 to 2.0) and the NNT was 6.2 (4.0 to 13) (very low quality evidence). This result was not substantially changed using a random-effects model for analysis. In both categories there were a number of factors might have influenced the results but sensitivity analysis was limited because of the small number of studies and participants.For both acute and chronic painful conditions any evidence of efficacy came from the older, smaller studies, while the larger, more recent studies showed no effect.Adverse events were more common with salicylate than with placebo but most of the events occurred in only two studies. There was no difference when these studies were removed from the analysis (very low quality evidence). Local adverse events (at the application site) were again more common with salicylate but were nearly all in one study (in which salicylate was combined with another irritant). There was no difference when this study was removed (very low quality evidence).There were insufficient data to draw conclusions against active controls. AUTHORS' CONCLUSIONS: The evidence does not support the use of topical rubefacients containing salicylates for acute injuries or chronic conditions. They seem to be relatively well tolerated in the short-term, based on limited data. The amount and quality of the available data mean that uncertainty remains about the effects of salicylate-containing rubefacients.

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