• Journal of Dental Anesthesia and Pain Medicine
• /
• 제21권5호
• /
• pp.379-396
• /
• 2021

Background: Trigeminal neuralgia (TN) is characterized by brief, unilateral, sharp, stabbing, and shooting pain of the fifth cranial nerve. The objective of this systematic review with meta-analysis was to determine the effect of medications compared to placebo in adult patients with TN. Methods: Review authors identified randomized placebo-controlled trials (RCTs) from PubMed, Web of Science, Cochrane, and EMBASE up to February 2021. We assessed the inclusion and exclusion criteria as well as the risk of bias of the studies based on the Cochrane Handbook. A total of 324 unduplicated references were scanned independently and reduced to eight relevant RCTs, with 89 patients included. Medications investigated included oral carbamazepine, subcutaneous sumatriptan, lidocaine (intranasal, 8% spray on the oral mucosa or intravenous), buprenorphine (ganglionic local opioid analgesia), and oral Nav1.7, a selective sodium channel blocker. Results: Meta-analyses showed that overall patients receiving lidocaine reported a significantly lower post-treatment intensity of pain -3.8 points on a 0-10 scale (95% Cl = -4.653 to -2.873; P < 0.001). Patients who received lidocaine were 8.62 times more likely to have pain improvement than patients on placebo (P < 0.001). In one RCT, patients receiving oral carbamazepine showed a significant improvement in pain intensity of -32% compared to the placebo (P < 0.001). In one trial, patients receiving 3 mg subcutaneous sumatriptan had a significantly lower intensity of pain on average -6.1 points on a scale of 0-10 compared to placebo (P < 0.001) and a significant improvement in pain intensity of -75% compared to the improvement in the placebo group (P < 0.001). Patients who received subcutaneous sumatriptan were 10 times more likely to have pain improvement than those who received placebo (P = 0.001) in one study. Due to the unclear/high risk of bias and small sample size, the quality of the evidence for lidocaine in the treatment of TN was low. Conclusion: Further studies are needed for carbamazepine, sumatriptan, buprenorphine, and oral Nav1.7 sodium channel blockers, as only one study reported outcomes.

• 농약과학회지
• /
• 제9권1호
• /
• pp.26-34
• /
• 2005

일련의 새로운 2-alkoxyphenyl-3-phenylthioisoindoline-1-one 유도체들의 구조 변화에 의한 저항성(RPC; 95CC7303)과 감수성(SPC; 95CC7105) 고추역병 균주(Phytopthora capsici)들의 살균활성에 대한 3차원적인 정량적 구조-활성관계(3D-QSAR)를 비교분자 유사성 지수분석(CoMSIA) 방법으로 연구하였다. 그 결과, RPC 균주는 field fit 정렬시 정전기장(E)과 수소결합 받게장(A) 및 분자궤도장(LUMO)이 조합된 조건에서 모델 R5를 그리고 SPC 균주는 atom based fit 정렬시 입체장(S)과 분자궤도장(HOMO)의 조건에서 모델 S1(또는 S5)이 가장 양호한 예측성과 적합성을 나타내는($q^2=0.714{\sim}0.823$ 및 $r^2_{ncv.}=0.918{\sim}0.954$) CoMSIA 모델이었다. 또한, RPC 균주에는 LUMO (24.4%) SPC 균주에는 HOMO(13.5%) 분자 궤도장이 그리고 두 균주에 대하여 공통적으로 수소결합 받게장(A)이 살균활성에 기여하는 특성을 나타내었다. 그리고 CoMSIA 등고도 분석결과, 두 균주에 대한 선택적인 살균활성은 N-phenyl 고리상 X-치환기와 S-phenyl 고리상 R-치환기의 구조변화로 이루어질 수 있을 것으로 판단된다.