Polyunsaturated Fatty Acids and Chronic Pain: A Systematic Review and Meta-analysis.
Polyunsaturated Fatty Acids and Chronic Pain: A Systematic Review and Meta-analysis.
复制标题
多不饱和脂肪酸和慢性疼痛：系统回顾和荟萃分析。
作者：
Jesús Prego;F. Hadrya;B. Takkouche
背景
慢性疼痛是最常见的疾病症状之一，是一个具有相当大经济负担的全球健康问题。多不饱和脂肪酸(PUFA)在慢性疼痛中的作用在过去的十年里一直在争论，结果相互矛盾。
客观化
评估摄入多不饱和脂肪酸是否可作为慢性疼痛的预防或治疗工具。
研究设计
系统综述和荟萃分析。
设置
这项研究检查了所有已发表的关于PUFA补充剂和慢性疼痛的预防性或治疗性研究。
方法
我们通过系统地搜索Medline、Embase、会议论文集引文索引、论文数据库和世界卫生组织的5个地区性书目数据库，检索了以任何语言发表的研究，直到2015年5月。我们包括观察性和干预性研究，报告了在常规饮食或补充剂和疼痛中多不饱和脂肪酸摄入量的效果测量及其可信区间。两名研究人员选择了研究；独立提取了基线特征、暴露和结果的数据；并使用Jadad评分对干预研究的质量进行了评级。我们计算疼痛指数的集合标准化平均差(SMDS)，如视觉模拟评分。我们进一步根据疾病、多不饱和脂肪酸的类型、结果评分、质量指数、剂量和补充时间进行亚组分析。
结果
我们检索了5项观察性研究和46项干预性研究。只有一项观察性研究显示了多不饱和脂肪酸的保护作用。相反，干预性研究的随机效应综合效应SMD为-0.40(95%CI-0.58，-0.22)，表明有改善，因为0是表示缺乏效应的值。对痛经(-0.82，95%CI-1.21，-0.43)、补充Ω-3(-0.47，95%CI-0.68，-0.26)和综合评分(-0.58，95%CI-1.07，-0.09)的影响最大。低剂量(-0.55，95%CI-0.79，-0.30)和短补充时间(-0.56，95%CI-0.86，-0.25)的止痛效果较好。
限制
虽然治疗性研究的数量很多，但可用的预防性研究的数量有限。
结论
我们的结果表明，补充Ω-3多不饱和脂肪酸适度改善慢性疼痛，主要是由于痛经。由于证据不足，需要对补充多不饱和脂肪酸的预防潜力进行进一步调查。关键词：荟萃分析、系统综述、慢性疼痛、多不饱和脂肪酸、补充剂、Ω-3、痛经。
BACKGROUND
Chronic pain is one of the most frequent disease symptoms and represents a global health problem with a considerable economic burden. The role of polyunsaturated fatty acids (PUFA) in chronic pain conditions was debated during the last decade with conflicting results.
OBJECTIVE
To assess whether polyunsaturated fatty acids intake is useful as a preventive or curative tool in chronic pain.
STUDY DESIGN
Systematic review and meta-analysis.
SETTING
This study examined all published studies, either preventive or curative, on PUFA supplementation and chronic pain.
METHODS
We retrieved studies published in any language by searching systematically Medline, Embase, Conference Proceedings Citation Index, dissertations databases, and the 5 regional bibliographic databases of the World Health Organization until May 2015. We included both observational and intervention studies reporting effect measures and their confidence intervals of polyunsaturated fatty acids intake in the regular diet or supplementation and pain. Two investigators selected studies; extracted data independently on baseline characteristics, exposure, and outcomes; and rated the quality of interventional studies using Jadad score. We calculated pooled standardized mean differences (SMDs) of pain indexes such as the Visual Analogue Score. We further carried out subgroup analyses by disease, type of PUFA, outcome scale, quality index, dose, and time of supplementation.
RESULTS
We retrieved 5 observational and 46 intervention studies. Only one observational study showed a protective effect of PUFA. On the contrary, the interventional studies yielded a pooled random effects SMD of -0.40 (95% CI -0.58, -0.22), which indicates improvement, as 0 is the value that indicates absence of effect. The largest effect was found for dysmenorrhea (SMD -0.82, 95% CI -1.21, -0.43), Ω-3 supplementation (-0.47, 95% CI -0.68, -0.26) and composite scores (-0.58, 95% CI -1.07, -0.09). Mitigation of pain was stronger for low doses (-0.55, 95% CI -0.79, -0.30) and short supplementation periods (-0.56, 95% CI -0.86, -0.25).
LIMITATIONS
While the number of curative studies was large, that of preventive studies available was limited.
CONCLUSION
Our results suggest that Ω-3 PUFA supplementation moderately improves chronic pain, mainly that due to dysmenorrhea. Further investigation on the preventive potential of PUFA supplementation is needed, as the amount of evidence is scarce. Key words: Meta-analysis, systematic review, chronic pain, PUFA, supplementation, Ω-3, dysmenorrhea.
用黑加仑籽油治疗类风湿性关节炎。
DOI：
10.1093/rheumatology/33.9.847
发表时间：
1994
期刊：
British journal of rheumatology
影响因子：
--
作者：
Leventhal,LJ;Boyce,EG;Zurier,RB
通讯作者：
Zurier,RB
影响因子：
--
作者：
Zurier, RB;Rossetti, RG;Laposata, M
通讯作者：
Laposata, M